Premature menopause

This is defined as menopause occurring in women prior to the age of 40 years. It is a not uncommon cause of amenorrhoea. In one series, it accounted for 36% of cases of primary amenorrhoea, and 29% of cases of secondary amenorrhoea (1)

• premature menopause affects 1% of women under the age of 40 years (2)

Premature menopause can be spontaneous or induced

• induced premature menopause could be as a result of medical interventions such as chemotherapy or surgical interventions such as bilateral oophorectomy.

Women who experience oestrogen deficiency at an early age before the natural menopause are now recognized to be at increased risk for premature morbidity and mortality

Diagnosis requires elevated gonadotrophins - FSH above 40 IU per litre together with raised LH and low oestradiol (less than 100 pmol per litre) on at least two occasions.

Ultrasound usually reveals small ovaries, a small uterus and a thin endometrium.

Note that reference ranges may vary between laboratories.

Reference:

• Update 1998; 56 (7): 646-8
• Okeke T et al. Premature Menopause. Ann Med Health Sci Res. 2013 Jan;3(1):90-5.