Amsterdam, 29 March, 2019 – A new position statement by the European Menopause and Andropause Society (EMAS) published in the journal Maturitas summarises the evidence about predictors of premature or early natural menopause.
Almost 1 in 10 women have a menopause that is premature or early. Menopause before the age of 40 isconsidered to be ‘premature’ and before the age of 45 ‘early’. The average of menopause ranges between 50- 52 years with variations according to ethnic group. Premature or early menopause is associated with an increased risk of all-cause mortality, cardiovascular disease, type 2 diabetes, depression, osteoporosis, and fracture. There is also evidence showing that premature menopause may be associated with cognitive decline in later life
While in most cases the cause of premature or early menopause is unknown, there are some genetic and autoimmune causes; with X chromosome defects being the most common. A family history of premature or early menopause, being one of a multiple pregnancy, and some specific genetic variants are strong genetic predictors of premature and early menopause. Early menarche, nulliparity, cigarette smoking, and being underweight are strong reproductive and lifestyle predictors. In addition, adverse events in early life and childhood increase the risk of early menopause. These include poor early life nutrition and childhood growth, socioeconomic deprivation, low education level, childhood abuse, parental divorce and intimate partner violence.
EMAS recommends that in women with premature or early menopause, unless contraindicated, hormone replacement therapy (HRT) should be started early and continued until the average age of menopause taking into account ethnic group. Longer duration of HRT may be considered for symptomatic women. Younger women may require higher doses of HRT for symptom relief or protection against bone loss.
EMAS advises there should be early monitoring for women with a family history of premature or early menopause, being part of a multiple birth, and those with early menarche (especially nulliparous women) to prevent adverse health outcomes associated with premature and early menopause. More broadly, women should be encouraged to quit smoking (preferably before the age of 30 years) and maintain optimal weight to reduce the risk of premature and early menopause.
The complete statement ‘ EMAS position statement: predictors of premature and early natural menopause’ can be found in ‘by Gita Mishra and others DOI: https://doi.org/10.1016/j.maturitas.2019.03.008
It is published in Maturitas, published by Elsevier.