Dr. Divya Sahitya Nambala, Fertility Specialist, Nova IVF Fertility, Visakhapatnam

The age range for menopause is in the early fifties, but increasingly, women are entering menopause
in their forties and a few before the age of forty. But this is not just a nuisance in terms of the age
factor because the premature loss of function of the ovaries can contribute to issues with the heart
and bones, fertility issues, and mood swings.

What Is “Early” Menopause And How Common Is It?
Early menopause refers to menopause that manifests before reaching age 45 years, although
occurrence before reaching age 40 years may be considered Premature Ovarian Insufficiency. In any
case, estimates show that between 5-10 per cent of women have experienced menopause at age 45
years, while between 1-3 per cent at age 40 years. Whatever the statistics, one thing is plain: this is
not a remote occurrence.

The Usual Suspects: Genes, Medical Treatments And Autoimmunity
Biological factors comprise a large part of early menopause. Your family history is significant here,
and if your mother had an early menopause, the tendency is higher in your case as well. Certain
genetic factors and chromosomal problems are identified as causes for early menopause as well.

Then, of course, there are some iatrogenic causes of early menopause, such as pelvic surgery that
involves removing the ovaries, chemotherapy and radiotherapy for some forms of cancer, and some
other medications that rapidly induce ovarian failure. Some autoimmune disorders, in which the
immune system attacks the ovary tissue, are other causes of early menopause.

The Lifestyle And Environmental Mix
Concerning lifestyle and environmental factors that are more relevant to PNJ beyond strictly
biological issues, smoking is one of the most recognised risk factors to date. Moreover, smoking
accelerates the process of ovarian aging the ovaries in a dose-dependent manner. Factors that are
associated with an early onset of menopause include very low body weight in childhood and certain
infections. More recent studies are investigating the potential role of environmental factors and
social issues, such as chronic stress or poverty.

Is The Average Age Sliding Down?
“The jury is still out.” Huge numbers of data show only small changes in some regions but stability in
many others. This is in part due to differences in study design, recall bias (women reporting on ages
of past occurrences), and changes in trends related to childbearing. But when it comes to looking at
it from an individual aspect, increased risk factors of smoking, poor metabolism, and early-life stress
are turning up more frequently, as more young cases are then also being diagnosed by doctors.

Why Early Menopause Matters (Beyond Fertility)
The loss of ovarian hormones before the natural age has consequences. Early menopause raises the
risk of osteoporosis, cardiovascular disease, cognitive changes, and mood disorders. It also shortens
the reproductive window and can lead to practical and emotional grief that many women don’t
expect so early. Hormone therapy can reduce some long-term risks when there are no
contraindications, which is why timely diagnosis matters.

What Women Can Do Practical Steps
a)    Know your family history. It’s a useful early clue.
b)    Avoid smoking. This is one modifiable risk with strong evidence.
c)    Plan fertility if you’re worried. Egg freezing or earlier family planning are options some women
choose after counselling.

d)    Screen and treat early. If periods become irregular, seek evaluation simple blood tests can
detect ovarian insufficiency early, and hormone therapy can be discussed to protect bone and heart
health.
A Final, Practical Note
Early menopause can surprise you and leave you feeling alone. The bright side, though, is that a lot
of reasons can easily be identified, and some consequences can easily be avoided and taken care of.

Being aware, first and foremost, would help, for the woman, her family doctor, and a specialist as
well. If you do experience changes in menstruation or if there’s a family history, don’t hesitate to
bring it up with your doctor.