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Menopause is defined as the cessation of menstruation. It signals the demise of a woman's reproductive life. Early menopause is arbitrarily defined as menopause before the age of 40; though some experts choose 45 as the cut-off age.

Symptoms of premature menopause are indistinguishable from normal menopause and they include the so-called climacteric symptoms such as hot flushes, insomnia, weight gain and mood changes. However, premature menopause is an indication to seek medical attention to search for a cause and if possible, reverse it as prolonged menopause might lead to development of osteoporosis, heart disease and other post-menopausal complications earlier in life.

The causes of premature menopause are protean; and but be clumped into several categories; including:

Medical Disease States
The regulation of menses require the delicate balancing of various hormones secreted by endocrine glands throughout the body. Any diseases that affect these organs can potentially lead to cessation of menses. Therefore, both hypothyroidism and hyperthyroidism; hyperprolactinemia (overproduction of prolactin), Cushing's Disease (overactive adrenal glands); Polycystic Ovarian Syndrome (PCOS) where cessation of menses is accompanied by development of male characteristics may be underlying causes of premature menopause. Fortunately, the detection and management for most of these diseases is quite straightforward; such as hormone replacement or surgery to remove a hormone-producing tumor. However, for most people, treatment might be life-long.
As well, viral infections such as mumps may affect ovarian function, retarding it prematurely. However, this remains theoretical at present.

Surgery
Total Hysterectomy; or removal of the uterus, fallopian tubes and ovaries is a common cause of premature menopause. But that doesn't make the symptoms any lesser. In fact, because of the sudden drop in ovarian hormones (estrogen and progesterone) in this circumstance, the menopausal symptoms could be more intense. As well, the ovaries may be inadvertendely damaged from surgery for other causes (ie tubal ligation). Generally, the menopause onset is more gradual as the other ovary may be still functional. Such patients are usually given hormone-replacement, depending on the individual's age and expectations.

Chemical
Tamoxifen is usually prescribed as a preventative medication against breast cancer; to women who have a strong family history. Tamoxifen acts as an estrogen-receptor blocker and thus negates the physiological effects of estrogen in other parts of the body as well. This induces the body to assume that the ovaries are no longer producing estrogen and reacts by entering menopause prematurely. Discontinuing tamoxifen resumes menstruation; but this is balanced against the threat of breast cancer.

Others
To a small group of women, the cause of their premature menopause is never found. Most of them are believed to have an autoimmune disorder whereby the body develops antibodies against the ovary; essentially attacking it. Some of these patients may respond to treatment with steroids. For others it could be an underlying genetic defect. An example would be a condition called "fragile X syndrome," whereby a woman carrier of the fragile X chromosome' have a lesser number of eggs in her ovaries at the beginning of life.

Thus, although some causes of premature menopause are irreversible or unavoidable, there many other causes that can be treated. Thus it is important for women of all ages to be cognizant of menopausal signs and symptoms.

Learn more about this author, Ernie Yap.
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