Q: My girlfriend is 36 and has been told that she is going through premature menopause. Can you tell me what this means and what the implications are?
A: Menopause is the date when women have their last period. The average age for women in the West is 52. Premature or early menopause (also called premature ovarian failure) occurs under the age of 45; five per cent of women are affected, mostly over 30.
Menopause occurs when the ovaries stop producing eggs (ova). The levels of oestrogen and progesterone, the reproductive hormones, fall, causing symptoms such as hot flushes, night sweats, low sex drive, dry vagina, low bone density, sleeping problems and possibly cardiovascular problems.
Premature menopause (PM) occurs because the ovaries aren’t working properly. They stop producing eggs some years, even decades, before they should. The warning signs are infrequent or no periods.
Doctors usually do blood tests to confirm PM. These measure levels of oestradiol (a form of oestrogen) and, importantly, follicle stimulating hormone (FSH), the hormone that stimulates oestrogen production. As this slows down, the body produces more FSH to try to increase oestrogen so FSH levels increase. Rising FSH levels usually indicate the onset of menopause.
In the majority of cases, the cause of PM is unknown. But sometimes, it is due to autoimmune disorders (diabetes, thyroid disease, rheumatoid arthritis), cancer treatment or gynaecological surgery in which the ovaries are removed. A hysterectomy (removal of the uterus) alone doesn’t cause ovarian failure but may disrupt the blood supply to the ovaries, causing PM. About five per cent of women have a hereditary genetic cause.
The biggest implication is the loss of fertility. According to the Daisy Network Premature Menopause Support Group (daisynetwork.org.uk), this is the single most upsetting element. Whether or not women already have children, PM brings with it ‘wrenching emotional change’.
In most cases, the only way to achieve a pregnancy is IVF with egg donation. Other options are surrogacy, or adoption.
Talking to a trained counsellor can help greatly. The Daisy Network offers a tele-counselling support service, also a networker scheme and newsletter, which help overcome the feeling of isolation.
Premature menopause has the same side effects as normal menopause. So bone density may fall, which can lead to osteoporosis; the risk of cardiovascular disease may also increase. The standard treatment is hormone replacement therapy (HRT), or sometimes the combined oral contraceptive pill, which help maintain bone density and control other symptoms including loss of sexual desire and vaginal dryness. A good diet is essential too.
Heavenly Skincare to Blend and Send
Choosing the right skincare for someone else is tricky, but the Kate Logan Beauty Prescription ensures they get exactly what they need. (And Kate can send it as an e-card voucher in time for Christmas!) Now a cult name in skincare, Kate hand-blends balms, cleansers, toners, bath and body oils from all-natural ingredients, to suit your individual skin type (based on a detailed questionnaire). The prescription includes guidelines on application, with facial massage techniques. Our testers found that even the touchiest skins were calmed and brightened. The Kate Logan Beauty Prescription Service is free. Vouchers redeemable against products start from £10. (Truly Heavenly Bath, £17.99 for 50ml, price for p&p in UK is £3.95, make fab presents too, and you could send an e-voucher for those.) Visit kateloganbeauty.com.
Your Festive First-Aid Fix
It’s worth being prepared in case anyone gets ill over the holiday. Check your GP’s hours; your nearest hospital with A&E, and also dispensary for prescription drugs. And if you don’t have a First Aid kit, buy one now. The St John Ambulance First Aid Manual is comprehensive (stjohnsupplies.co.uk, and they also do a range of kits). Finally, don’t forget that NHS Direct gives advice 24/7, tel 0845 4647, or visit nhsdirect.nhs.uk.
The truth about… dried fruit
Festive cakes and puds are traditionally based on dried fruit, because in the past fresh fruit wasn’t available.
Dried fruit contains about 70 per cent sugar and 30 per cent water. They have differing proportions of glucose and fructose, but you’re essentially eating sucrose (table sugar) with a mild vitamin tablet.
So eat a small portion of cake or pud slowly, savouring each luscious mouthful – rather than bolting a big piece.
Preferably, enjoy dried fruit with protein, which helps to lighten the sugar load. A handful of raisins with nuts, or cheese with dried apricots, is delicious and nutritious.
Coeliac readers may want to know that YOU testers voted Genius gluten-free mince pies ‘absolutely delicious’, £2.19 for four, at supermarkets. Find your nearest one via geniusglutenfree.com, tel. 0845 874 4000.