Menopause in one’s early 20s is affecting approximately 250,000 to 1 million American women. One in 1,000 women between 15 and 29 years old and one in 100 between the ages of 30-39 are diagnosed with premature menopause, meaning; their ovaries stopped working before they reach 40, and it could be due to primary ovarian insufficiency or primary ovarian failure.
Primary Ovarian Insufficiency (POI) or Premature Ovarian Failure (POF) are a loss of ovarian function before the age of 40. POF affects women from teenage years to 30s, but it could happen at any age or any time, and they are at greater risk of estrogen deficiency, osteoporosis, and heart disease but it could be managed by Hormone Therapy. It could also happen before or after a woman has children. However, the probability of pregnancy is reduced.
Although POF is sometimes called early menopause, women may continue to have irregular menstrual cycles, and some women can conceive naturally.
While the actual cause is still unknown, it has been ruled out that 10 to 30 percent of affected women have an autoimmune disease such as Crohn’s disease, hypothyroidism, rheumatoid arthritis or lupus erythematosus. Thirty percent of women have familial ovarian failure and galactosemia characterized by enzyme problems like adrenal hyperplasia.
Menopause in early 20s that are affecting up to 1 million American women could be due to abnormal individual genes or chromosomes. Chromosomal abnormality that leads to POI includes:
• Turner syndrome – women usually have two X chromosomes, and men have one X and Y chromosomes. If you have Turner syndrome, one X chromosome is missing, which can cause reproductive system abnormalities, especially primary ovarian insufficiency.
• Fragile X syndrome – when you have Fragile X syndrome you have a faulty gene on the X chromosome, which is the common cause of mental retardation. However, those who have a defective gene do not always have mental retardation, but they have a risk of having intellectually disabled baby.
• Genetic and chromosomal causes – if a woman has Y chromosome material, which should only exist on men, it can lead to POI. While this condition is quite rare, women with Y chromosomes need to have their ovaries removed because it can cause ovarian tumors.
• Toxic or medical reasons like drugs or chemotherapy and radiation therapy to treat cancer. Hysterectomy with both ovaries removed or treatment for Hodgkin’s disease or leukemia could also induce premature menopausal. Although viral infections such as mumps or cytomegalovirus have inconclusive evidence, it was thought to trigger premature menopause.
Most causes of POI are idiopathic, meaning it has no obvious cause, which is why it is important for women to be tested because some known causes are associated with their health or their family’s health.
Menopause usually occurs at age 51 but premature ovarian failure can occur at any age usually around age 27. If you are one of the 1 million American women diagnosed with early menopause or POF, you should talk to your health care provider about proper treatment and management if you are thinking about getting pregnant.
Written by: Janet Grace Ortigas