Conditions That Increase Your Risk of Early Menopause

Every woman enters the menopause stage sooner or later.

Menopause happens when the ovaries stop producing eggs and produce significantly less estrogen, the hormone that controls the reproductive cycle. You enter the menopause stage when you do not have periods for more than 12 months.

The average age for menopause onset in the United States is 51 years old, according to the National Institute on Aging (1).

But many women undergo early menopause, which refers to the onset of menopause before the age of 40.

Early menopause is not a good for your health. Infertility is the most obvious concern if you start menopause 10 or more years early.

There are many other health concerns, too. The American Heart Association states that assorted changes in the body occur with menopause, which can cause your blood pressure to go up and low-density lipoproteins (LDL or “bad” cholesterol) to increase while high-density lipoproteins (HDL or “good” cholesterol) to decline (2).

A study published in Menopause in 2012 found that early menopause is positively associated with coronary heart disease and stroke in a multiethnic cohort, independent of traditional cardiovascular disease risk factors (3).

Some other health problems linked to early menopause are osteoporosis, obesity, depression, dementia and even premature death.

There are several reasons why a woman enters into early menopause. By learning the reasons, you can take necessary steps to reduce your risk of early menopause.

Here are some of the conditions and other factors that increase your risk of early menopause.

1. Smoking

Whether a woman is an active or passive smoker, smoking is one of the main causes of early menopause. Smoking is linked to early menopause as well as fertility problems because of the effect tobacco toxins have on the reproductive system and hormone levels.

An analysis in 2012 of several studies showed that long-term or regular smokers are likely to experience menopause sooner. The review was published in Nature Genetics (4).

Another study published in Tobacco Control in 2015 reports that active smoking and secondhand smoke exposure are associated with increased risk of infertility and natural menopause occurring before the age of 50 (5).

Another 2015 study published in the Journal of Preventive Medicine & Public Health also confirmed that smokers reached menopause earlier than non-smokers, and their risk for experiencing early menopause was higher (6).

In a 2017 study published in the American Journal of Epidemiology, researchers analyzed data of 116,429 nurses from the Nurses’ Health Study II from 1989 through 2011 and found that when compared with never-smokers, current smokers and former smokers showed an increased risk of early menopause (7).

Looking at the link between smoking and early menopause, it is advisable to quit smoking as soon as you can. Seek support from experts, family member and friends to help you reach your goal.

2. Alcoholism

Women with a drinking problem may experience early menopause as well as other reproductive problems.

When a person is addicted to alcohol, they generally are not getting their vitamins, fiber and healthy proteins. These nutritional deficiencies can interfere with a woman’s reproductive hormones and trigger other disorders, such as liver disease, pancreatic disease and malnutrition.

This in turn can lead to irregular periods, stopping of periods and early menopause.

A 2017 study published in the Journal of Obstetrics and Gynecology found that in Korean women, alcohol consumption was associated with a younger age at menopause (8).

To reduce your risk of early menopause, take steps to stop drinking completely, or if you need to drink, do it in moderation.

According to the Dietary Guidelines for Americans, moderate alcohol consumption is defined as having up to one drink a day for women and up to two drinks a day for men (9).

3. Being Underweight

Being anorexic, bulimic or an elite athlete can also cause early menopause. Estrogen is stored in fat tissue, so being underweight means your body has less estrogen, which in turn leads to an earlier onset of menopause.

A 2017 study published in Human Reproduction reports that underweight women are at an increased risk for early menopause. This study followed 78,759 premenopausal women ages 25 to 42 beginning in 1989.

Over the following 22 years, 2,804 of them reported natural menopause before age 45. The women with a body mass index (BMI) under 18.5 at any age had a 30 percent increased risk of early menopause (10).

A healthy BMI is between 18.5 and 24.9, according to the Centers for Disease Control and Prevention. Below 18.5 is considered underweight and could potentially monkey with the timing of menopause (11).

So, if your BMI is below the normal range, take necessary steps to increase your body weight. With the right food and exercise regimen, you can increase your BMI to the healthy range.

4. Too Much Stress

Women who have chronic stress or are finding it hard to handle stress can enter menopause early.

While it is true that stress alone cannot trigger your ovaries to stop working properly, the physical effects of stress can affect your periods and psychological stress can disrupt your normal menstrual cycles.

Stress can lead to obesity, diabetes and sleep problems. This constellation of issues can take a toll on the body, including the ovaries and hormonal changes in the body, which in turn can lead to early onset of menopause.

On the other hand, for many women, early menopause can cause more stress, sadness, fear and anxiety.

The good thing is that stress can be managed. With relaxation techniques like deep breathing, yoga, regular exercise and healthy diet changes, you can better control your stress.

5. Surgery to Remove the Ovaries

If your ovaries are surgically removed, you automatically enter into early menopause.

You may need surgery to remove your ovaries due to severe endometriosis, a potentially cancerous cyst or problems like pelvic inflammatory disease. Without the ovaries, the reproductive show cannot go on as the ovaries are responsible for the release of reproductive hormones.

Depending upon your health problem, you may have to get either both ovaries or just one ovary removed. However, even removing one ovary can result in a decrease in the total production of the hormones estrogen and progesterone.

6. Autoimmune Diseases

Another cause for early menopause is autoimmune diseases.

In an autoimmune disease, the immune system attacks portions of your body because it mistakes it for an invader. This can have a huge effect on the reproductive system in women.

Autoimmune diseases like thyroid disease and rheumatoid arthritis are often linked to early menopause.

A 2016 study published in the Journal of Clinical & Diagnostic Research reports that thyroid autoimmunity is the most common autoimmune disease associated with premature ovarian failure (12).

7. Epilepsy

Epilepsy, a seizure disorder that stems from the brain, can also be the reason behind early menopause.

During seizures, the female hormones, estrogen and progesterone, are also affected. The brain regulates reproductive hormones and, when it is disrupted by seizures, issues like irregular ovulation and early menopause are common.

A 2001 study published in Epilepsia reports that women with epilepsy have an increased risk of developing primary ovarian insufficiency, which could lead to menopause (13).

In fact, women who suffer from epilepsy may find that they have more seizures before their periods or during the transition into menopause.

8. Chemotherapy

If you have gone through chemotherapy or radiation treatment to kill cancer cells, there is a high possibility that you may experience early menopause.

Chemotherapy and radiation can damage your ovaries or stop estrogen production, which can cause early menopause.

A study published in Human Reproduction in 2001 reports that high dose chemotherapy and radiotherapy have radically increased long-term survival of young cancer patients, but major side effects of these treatments are ovarian failure and infertility (14).

A 2016 study published in Expert Review of Quality of Life in Cancer Care reports that a possible side effect of chemotherapy in premenopausal patients is premature ovarian failure.

Even in the presence or resumed regular menses after chemotherapy, patients are at a higher risk of developing early menopause due to the damage of cytotoxic therapy to their ovarian reserve (15).

Resources:

1. What Is Menopause? National Institute on Aging. https://www.nia.nih.gov/health/publication/menopause
2. Menopause and Heart Disease. Menopause and Heart Disease. http://www.heart.org/HEARTORG/Conditions/More/MyHeartandStrokeNews/Menopause-and-Heart-Disease_UCM_448432_Article.jsp#.Wsc9R5fhXIV
3. Early Menopause Predicts Future Coronary Heart Disease and Stroke: The Multi-Ethnic Study of Atherosclerosis (MESA). Menopause (New York, N.Y.). https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3443540/. Published October 2012.
4. Meta-analyses identify 13 novel loci associated with age at menopause and highlights DNA repair and immune pathways. Nature genetics. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3288642/. Published March 2012.
5. Associations between lifetime tobacco exposure with infertility and age at natural menopause: the Women’s Health Initiative Observational Study. BMJ Journals. http://tobaccocontrol.bmj.com/content/early/2015/11/19/tobaccocontrol-2015-052510.full.
6. Effects of Smoking on Menopausal Age: Results From the Korea National Health and Nutrition Examination Survey, 2007 to 2012. Journal of Preventive Medicine and Public Health. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4542296/. Published July 2015.
7. Cigarette Smoking and Risk of Early Natural Menopause | American Journal of Epidemiology | Oxford Academic. OUP Academic. https://academic.oup.com/aje/advance-article-abstract/doi/10.1093/aje/kwx292/4080179?redirectedFrom=fulltext. Published August 10, 2017.
8. Relationship between alcohol consumption and age at menopause: The Korea National Health and Nutrition Examination Survey. Taiwanese Journal of Obstetrics and Gynecology. https://www.sciencedirect.com/science/article/pii/S1028455917301444. Published August 10, 2017.
9. Appendix 9. Alcohol. Appendix 9. Alcohol – 2015-2020 Dietary Guidelines. https://health.gov/dietaryguidelines/2015/guidelines/appendix-9/.
10. Adult adiposity and risk of early menopause | Human Reproduction | Oxford Academic. OUP Academic. https://academic.oup.com/humrep/article-abstract/32/12/2522/4562350?redirectedFrom=fulltext. Published October 25, 2017.
11. Body Mass Index (BMI). Centers for Disease Control and Prevention. https://www.cdc.gov/healthyweight/assessing/bmi/index.html. Published May 15, 2015.
12. Premature Ovarian Failure: An Association with Autoimmune Diseases. Journal of Clinical and Diagnostic Research : JCDR. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5121739/. Published October 2016.
13. Premature ovarian failure in women with epilepsy. Epilepsia. https://www.ncbi.nlm.nih.gov/pubmed/11879371. Published December 2001.
14. The effects of radiotherapy and chemotherapy on female reproduction. Human reproduction update. https://www.ncbi.nlm.nih.gov/pubmed/11727861
15. Chemotherapy-induced ovarian failure: manifestations and management. Drug safety. https://www.ncbi.nlm.nih.gov/pubmed/15853442