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Why are so many women starting the menopause before 40
22:49 GMT, 18 June 2012
When Amanda Warne’s periods stopped at the age of 21, doctors put it down to stress and over-training following an intensive diet and exercise regimen.
For the next four years she suffered terrifying mood swings and depression and paid countless visits to her GP and a specialist — while a series of blood tests revealed see-sawing hormone levels.
Finally, doctors concluded the sporty student had suffered a premature menopause.
'Some days I could barely crawl out of bed. I felt as though I was going mad,' said Amanda Warne (now aged 33) of her menopause, which began at just 21
Blood tests showed her levels of key hormones were such that she had been through the menopause — and it wasn’t clear why.
‘I couldn’t believe it,’ says Amanda.
‘I was studying at the London College of Fashion and was with my first boyfriend, the love of my life, who was desperate for children.
‘He told me bluntly he knew he wouldn’t be able to stay with me for ever because his desire for children would always outgrow the love he had for me.
'I became an insecure wreck and felt worthless.’
She also found herself crippled with mood swings, depression, panic attacks and bouts of exhaustion — classic menopausal symptoms.
‘Some days I could barely crawl out of bed. I felt as though I was going mad.
'I knew something had really changed in my body, but no one seemed to listen,’ says Amanda, now 33 and a businesswoman living in North London.
Taking Hormone Replacement Therapy (HRT) improved her quality of life, but Amanda still suffers exhaustion, low libido, headaches and a tingling sensation in her head.
'I knew something had really changed in my body, but no one seemed to listen,' said Amanda (pictured aged 21)
She finds the latter particularly worrying following the publication of alarming new research last week by U.S. doctors who discovered that women who go through a premature menopause are also more likely to suffer a potentially fatal brain haemorrhage, a cerebral aneurysm.
This occurs when part of the artery weakens and swells.
The artery can then burst and cause a stroke or death, with half of those suffering a cerebral aneurysm likely to die.
And the younger a woman is when she becomes menopausal, the greater the chances of a cerebral aneurysm — Amanda went through the menopause 30 years before the average age of 51.
‘I do realise I may be facing a shortened life expectancy,’ she says.
The new U.S. research is part of a growing body of evidence pointing to the staggering toll on a woman’s overall health associated with early menopause — a concern because more women are being diagnosed with the disorder.
Most scientists define a premature menopause, or premature ovarian failure (POF), as occurring when a woman’s ovaries stop working before the age of 40, though some studies include women up to the age of 45.
As well as cerebral aneurysm, they are also at greater risk of heart disease — they are 50 per cent more likely to die and 80 per cent more likely to suffer from heart disease than women who go through the menopause between the ages of 52 to 55.
A study last year by Imperial College London found that women who had early menopause were also twice as likely to have a poor quality of life in health terms.
Another study, by the Mayo Clinic in the U.S., found that affected women had a greater risk of dying early, developing heart disease, neurological disorders, including Parkinson’s and Alzheimer’s, psychiatric disorders and osteoporosis.
Women were particularly likely to die early or develop heart disease if they’d not been taking HRT following their early menopause, said the researchers.
‘These recent studies are telling us what we have suspected for some time, but until now no one has done the work to quantify it,’ says Dr Kevin Harrington, a consultant gynaecologist at the Bupa Cromwell Hospital in London.
Taking Hormone Replacement Therapy (HRT) improved her quality of life, but Amanda still suffers exhaustion, low libido, headaches and a tingling sensation in her head
The trigger for all this is dramatically falling levels of the hormone oestrogen.
‘Oestrogen plays a very important role in maintaining the health of all the connective tissues in the body,’ he says.
‘This includes blood vessels, skin, ligaments and bones.’
The deteriorating quality of the blood vessels in the brain is responsible for conditions such as strokes. Low oestrogen affects connective tissues in the eyes and mouth, too, which is why these patients are more prone to gum disease, tooth loss and cataracts.
The thyroid gland can also be affected, says Dr Harrington.
This is possibly because auto-immune diseases are thought to be a major cause of premature menopause.
‘It may be the kind of person whose body produces antibodies that attack the ovaries is also prone to producing antibodies that attack the thyroid.’
This could be the case for Amanda, as she also suffers from an underactive thyroid — causing her to gain weight and feel permanently tired.
But though Amanda’s heart-breaking story is unusual, it’s not nearly as rare as was once thought.
‘Premature menopause is more common than people realise,’ says Nick Panay, chairman of the British Menopause Society and consultant gynaecologist at Queen Charlotte’s and the Chelsea and Westminster hospitals in London.
Indeed, previous estimates put the number affected at just 1 per cent, but a study last year from Imperial College London suggested as many as 6 per cent (one in 16) of women experience it.
Lifestyle may be to blame. The Imperial College study found a link with smoking.
Further research last year also suggested a link between premature menopause and PFCs — chemicals found in non-stick pans and food packaging. The women with the highest levels of PFCs in their body had the lowest levels of oestrogen in their blood.
Genetics may play a part, too, with women more likely to go through early menopause if their mother did. However, doctors say more research is needed.
Mr Panay also believes that while doctors are seeing more cases of premature menopause, this might be because the condition has previously been under-reported.
Furthermore, the success in treating cancer in children, adolescents and women of child-bearing age might lie behind some cases of POF — for instance, premature menopause can be a side-effect of chemotherapy and radiotherapy.
But bleak as this sounds, all experts agree that for many women serious health risks can be reduced if they’re given a suitable course of HRT from the time they are diagnosed up to the age of 52.
‘HRT replaces the oestrogen the woman would otherwise be producing naturally during this time — and with it the protection it affords,’ says Mr Panay.
Clearly early diagnosis is key, yet despite improved recognition of POF, campaigners say much more could be done.
A recent British Menopause Society report noted some doctors were still unaware of the need to protect prematurely menopausal women against future illness and called for the creation of a national register of all such patients to ensure they receive correct advice and care.
Campaigners are also calling for HRT to be made free of prescription charge for women who’ve suffered a premature menopause.
‘If you had diabetes you would get insulin, so why should women who have gone through a premature menopause and have a hormone deficiency have to pay’ argues Mr Panay, who is also patron of the support group Daisy Network.
This is something 42-year-old Tracy Higgins, a welfare officer from Bishop’s Stortford, Herts, would agree with.
Tracy, who is married to Nigel, 47, went through the menopause after giving birth to her daughter Amelie, now four.
She suffered Sheehan’s Syndrome, where the pituitary gland in the brain becomes damaged after being starved of oxygen following severe blood loss.
One of the results can be that the ovaries no longer produce eggs.
‘I am pleased to be protected by HRT, but being made to pay for it is adding insult to injury,’ she says.
‘My prescription involves two hormones, oestrogen and progesterone, so I pay double; 15 every three months.’
The bill for Amanda Warne has been far steeper.
She struggled to find an oestrogen replacement that didn’t make her feel ill — symptoms included sore breasts, extreme bloating and exhaustion — and at one stage was spending 250 a month on a plant-based oestrogen remedy she bought online; she’s stopped because of the cost.
A year ago, she spent 12,000 on IVF using donor eggs after falling in love with a new partner, Greg. Unfortunately, she suffered a miscarriage at three months.
The couple were subsequently told they were eligible for a free round of IVF on the NHS and waited three months for an appointment — only to be finally told no funds were available.
Amanda feels that further IVF would be too expensive and take too great a toll on her emotionally and physically.
‘It’s been a long battle for me, but there are other young women out there who may have issues with their periods that they are not getting answers to.
'If my story helps just one, that will be enough.’