The truth about IVF – and what can really cause early menopause

What really causes early menopause?

“The greatest predictor of early menopause is family history,” Kuku says, with some twin and family studies showing genetics can be responsible up to 65 per cent of the time. 

Female twins are also up to four times more likely to go through early menopause than other women, according to a study of twins born in Britain and Australia.

The European Menopause and Andropause Society (EMAS) says that “there should be early monitoring of women with a family history of early menopause, who are a child of a multiple pregnancy, or who have had early menarche [when menstruation begins], especially those who have had no children.”

Weight and smoking

EMAS suggests that stopping smoking (the habit can lower oestrogen levels) and maintaining a healthy weight can be preventative measures in the case of early menopause. “Being underweight is highly causal to premature ovarian failure,” Kuku says (adding that “women who are overweight and obese actually go into menopause later, because fat cells produce oestrogen”). A 2017 study of 80,000 women found that those with a BMI below 18.5 were 30 per cent more likely to experience early menopause.

Cancer treatments

“The most common medical factor that triggers early menopause is cancer treatment, such as hormone therapy, some chemotherapies or pelvic radiotherapy,” says Evans. The drugs and radiation used can damage the ovaries, while some hormonal treatments, like those used for fibroids or endometriosis, can inhibit ovarian function and trigger symptoms of menopause.

Surgical menopause

The menopause can be brought on surgically by an oophorectomy – the removal of the ovaries – which is typically used to treat ovarian cancer. This is sometimes carried out alongside a hysterectomy, where the uterus is removed. Patients are advised to consider whether the benefits of the surgery they require mitigate the downsides of going through menopause sooner than they naturally would have.

Knock-on effects

Woodall has herself noted the impact of perimenopause and menopause on her skin, which she says can become dry and prone to breakouts, lose firmness, radiance and mark easily as a result of halted ovulation and low levels of reproductive hormones in the blood.

There are more serious consequences. A 2015 Mayo Clinic paper agreed that “the long-term consequences of premature or early menopause include adverse effects on cognition, mood, cardiovascular, bone, and sexual health, as well as an increased risk of early mortality.” 

One study, published in the journal Maturitas, concluded that “regardless of the cause, women who experience hormonal menopause and oestrogen deficiency before reaching the median age of natural menopause are at increased risk for morbidity and mortality.”

Fortunately, HRT can replace some of the lost hormones. This can help reduce the symptoms and side effects, although this may not be safe for women who have had breast cancer. In such cases, talk through the options with your GP.

Have you experienced early menopause? Tell us in the comments