The period of menopause is characterized by the absence of menstruation for at least 12 consecutive months, by changes in hormonal secretions and by other physiological changes.
The cyclical cessation of ovarian activity and the fertile season normally occurs around the average age of 50 years (+ or - 5 years). However, due to dysfunction of ovarian activity, certain diseases, genetics or particular medical procedures, some women enter menopause early, under the age of 40. This natural or induced condition is known as premature menopause (or In addition to dealing with hot flashes, mood swings and other typical symptoms that accompany climacteric, many premature menopausal women face additional emotional and physical problems (infertility, reduced bone density, metabolic effects that can compromise numerous organs, etc.).
) before the age of 40. This condition can occur spontaneously or induced, by bilateral oophorectomy surgery or by pharmacological or radiotherapy ovarian suppression. The phenomenon concerns approximately 1-3% of Italian women of reproductive age. , elevated serum gonadotropins (FSH and LH) and hypoestrogenism (reduced plasma estradiol).
In reality, the two conditions are not exactly equivalent:
- Premature ovarian failure can be considered a transitory phenomenon, since in many cases an intermittent spontaneous ovarian activity can occur for years, characterized by occasional menstrual periods alternating with others of amenorrhea (absence of menstruation for at least three months). Women with premature ovarian failure are still able to produce estradiol (hence, ovulation can occur) and can sometimes succeed in becoming pregnant.
- The patient with premature menopause completely (and permanently) stops menstruating and is therefore unable to get pregnant.
In women with premature ovarian failure:
- There are dysfunctional primordial follicles, which are physiologically unpredictable and absolutely irregular;
- Ovulation can occur in 5-10% of cases.
When POF becomes a lifelong condition, it equates to premature menopause.
it does not present alterations (i.e. there are no specific gene anomalies that predispose to premature menopause).Possible causes that promote early menopause are:
