Daily Trust (Abuja)

2 March 2013

Nigeria: Why Some Women Experience Early Menopause

Agnes Dashwep was troubled recently. Another month has just ended and she did not see her period. She was concerned because it was five months since she saw her menses last. She went to the hospital to do a pregnancy test and it was negative. She was not pregnant. She asked her gynaecologist what the problem was.

The gynaecologist examined her and said she showed signs of Premature Ovarian failure. This means having premature menopause. Agnes was amazed because she was only 37 years old.

Dr Nathaniel Adewole, Consultant Gynaecologist and Obstetrician at the University Abuja Teaching Hospital say menopause is the permanent caesation of menses. "It is usually diagnosed retrospectively that is after about 12months of no menses. Menopause occurs around the age of 45 - 55years. It is a normal physiological event but the symptoms could be so inconveniencing. Early menopause or what we term premature menopause occurs when menses stopped before the age of 40years."

Experts say a woman's periods stop because her ovaries have run out of eggs, are no longer responding to her body's hormonal signals or have been damaged or have been surgically removed.

Dr Adewole says causes could be divided into genetic or chromosomal and medical/ surgical procedures. "Women who have had their ovaries removed, those who have had radiotherapy and women who have genetic diseases that led their ovaries to become atretic do have premature menopause. Endocrine disorders like hypothyroidism could also be a cause of premature ovarian failure."

Some other causes of early menopause are explained below by experts.

Chromosomal Irregularity

Some cases of hereditary premature menopause are caused by defects on an X chromosome. Women have two X chromosomes and, even though only one of these chromosomes is active, a defect on either one can cause premature menopause. This defect, sometimes called "fragile X syndrome," apparently interferes with the production of eggs. So if you are a fragile X carrier, you have a lesser number of eggs in your ovaries, which in turn lead to an earlier menopause generally at least six to eight years before other women.

Family History

It is not a rule, but most women go through menopause at about the same age their mothers did which means that if there is a family history of premature menopause (your mother, your grandmother, your sister), there is a chance that you too will experience it. Some studies, however, seem to indicate that only about 5% of all women who are prematurely menopausal have a family history of this condition.

Viral Infections

If your mother contracts a viral infection while you are still in her uterus, it can affect your ovarian development, causing you to be born with lower number of eggs than you otherwise would have had. In this case, since you start with fewer eggs than most women, you run out of eggs more quickly, this results in premature menopause.

Experts mention some of the physical signs of menopause. These include irregular periods, infertility, hot flashes and night sweats, vaginal dryness, disrupted sleep, palpitations, weight gain (especially around your waist and abdomen). There are also emotional signs that women approaching menopause experience. They are easily irritable, have mood swings, memory lapses, anxiety, lowered libido amongst others.

Health experts say there are natural ways of managing early menopause. These are usually with vitamins, nutrients and supplements. Some of the main supplements can help you deal with menopause naturally but you must check with your doctor before taking them.

It is a good idea to aim for at least 25 grams of soya protein daily to help with symptoms. You can get protein from a variety of sources including soya milk.

Soya beans: Rich in phyto-estrogens, specifically isoflavones, cholesterol-free and containing protein, omega 3 fatty acids, calcium, folic acid, iron and other vitamins and minerals.

More specifically, a number of recent studies have found that soya beans can help reduce hot flashes, night sweats, and other menopausal symptoms. It can also help lower your cholesterol which often rises when you enter premature menopause and help your coronary blood vessels dilate, both of which are important in fighting heart disease.

Vitamin E is also good for helping with vaginal dryness. Vitamin A or Beta Carotene: If you are suffering from vaginal dryness or if you have noticed a change in your skin texture, a drying or loss of elasticity, Vitamin A or beta carotene can help. Vitamin A (which is what beta carotene converts to in your body) helps maintain tissues, skin, and mucous membranes which can help fight back against vaginal dryness and skin changes that often come with low estrogen levels.

B-Vitamins: This family of vitamins can be a big help in coping with premature menopause, both in terms of helping combat symptoms and fighting negative long-term risks. B vitamins can keep your energy levels up; support your liver function, increase your resistance to infection; help maintain your adrenal gland function-which is where the precursor to estrone (the form of estrogen still produced by your body after menopause) is produced.

Potassium: Another important mineral, potassium also can help boost energy. Another big benefit: It regularizes your heart beat, which can help if you get palpitations-a fairly common symptom of menopause.

Several months after Agnes visit to the doctor, still, she did not see her period. This confirmed the doctors' diagnosis that she had a premature menopause. But her consolation was that she had two lovely children and was not desperate for another child.

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