We understand the menopause as a complete end to menstruation. It is a retrospective diagnosis (looking back) and, as such, the menopause is said to have taken place when a year has gone by since the last period and, during that time, there have been no instances of menstrual bleeding.
It generally takes place at around 50 years of age and is linked to the number of eggs in the ovary.
Depending on a woman’s age, it can be:
- Premature menopause: before 45 years of age.
- Late-onset menopause: after 55 years of age.
- Premature ovarian failure: in women under 40 years of age, whether it be transitory or not.
The menopause is caused by an absence of follicles in the ovaries and the factors which lead to its onset are many. They include hereditary factors, childbirth (the number of children a woman has had), smoking and common illnesses requiring surgery, radiotherapy and chemotherapy.
Depending on how it occurs, the menopause can be:
- Natural: occurring gradually and progressively as the ovary ages
- Artificial: brought on by surgical removal of the ovaries or the destruction of germ cells due to radiation or chemotherapy.
The most common causes of premature menopause are:
- Turner syndrome
- Triple X syndrome
- Y chromosome deletions
- X isochromosome
- Hereditary diseases: non-detectable genetic abnormalities
- Systemic lupus erythematosus
- Rheumatoid arthritis
- Myasthenia gravis
- Autoimmune hemolytic anaemia
- Abnormalities in the thyroids
- Addison’s disease
- Germ cell destruction agents
- Surgery on the ovaries
- Metabolic abnormalities
- Idiopathic diseases
A menopause diagnosis is based on symptoms when amenorrhea (absence of periods) has lasted for over one year. Except in some specific cases, hormone assessments are not necessary. Should they be necessary, the hormones that are evaluated are:
- FSH > 40 UI/ml
- Estradiol < 30-50 pg/ml
The results need to be confirmed on 2 to 3 occasions or periodically in very young women because of the possibility of reversing the situation.
The menopause generates an oestrogen deficiency which has short and long-term consequences: abnormalities in neurovegetative functions (hot flushes, sweating, palpitations, insomnia, headaches…), irritability, a depressive state of mind, abnormalities in the skin and mucous glands, genital atrophy, osteoporosis (bone disease), heart disease…
All these symptoms are the main reason for treating the menopause and the perimenopause (the period prior to the menopause which is characterised by irregular periods) in order to improve quality of life.
There are very many ways of treating the menopause, all of which should be supervised by a healthcare professional. At Instituto Bernabeu, we have healthcare professionals who have specialised in these matters and who can help to find personalised solutions to ease the symptoms and improve quality of life.
PREMATURE MENOPAUSE AND HAVING CHILDREN
Nowadays, the menopause it not an issue in getting pregnant. Thanks to assisted reproduction techniques, this group of patients no longer has to give up their dream of becoming a mother.