What is Premature and Early Menopause

Premature and early menopause is conditions where a woman experiences menopause at an early age than is naturally expected.

Every phase of a women’s life is beautiful, right from puberty to motherhood and finally the changeover to menopause. Menopause is a phenomenon when a women’s monthly menstrual period stops permanently. Normally menopause occurs at the age of 45-55 years. At this age, ovaries stop producing estrogens leading to the permanent cessation of menstrual periods and women’s ability to bear children.

However, some women may experience menopause before this age. About 5% to 10% of women go through menopause between the ages of 40-45 years. This is known as early menopause.  And about 1% to 2% attain menopause before the age of 40. This is known as premature menopause. Premature menopause is also known as a premature ovarian failure or premature ovarian insufficiency. (1)

Premature and early menopause can cause severe emotional stress in many women. As fertility reduces earlier than normal, it becomes harder for them to conceive.

However, Ayurveda recommended that the intensity of the symptoms can be eased by adopting some simple remedies. Lifestyle changes, proper diet, and taking some herbal supplements on regular basis, the severity of the symptoms can be relieved. (2)

The sign and symptoms of premature and early menopause are usually the same as normal menopause.

Sign and Symptoms of Premature and Early Menopause

If you are experiencing a longer or shorter period with abnormal frequency, heavy bleeding, spotting, and periods that last longer than a week, then you are supposed to dealing with premature or early menopause.

The most disturbing sign and symptoms of premature and early menopause include

  • Hot flushes
  • Night sweats
  • Frequent and urgent urination
  • Vaginal dryness
  • Diminished interest in sex
  • Painful intercourse (dyspareunia)
  • Sleep disturbances

Some inconsistent symptoms are hair loss, cold intolerance, joint pain, hypothyroidism, headache, depression, anxiety, irritability, mood swings, and dry skin.

Causes of Premature and Early Menopause

The definite cause of premature and early menopause is uncertain, however, a few reported by several studies include: (3)

Auto-immune disorder

Autoimmune diseases such as thyroid disorder, mumps, hyperparathyroidism, pelvic tuberculosis, and Addison’s disease are more common causes of premature and early menopause.

Genetic causes

A recent study revealed that if your mother or sister experienced premature and early menopause, you too have a higher risk of experiencing it earlier than usual. Furthermore, Sex chromosome irregularity (Turner’s syndrome) prevails as a major cause of premature and menopause

Medical treatment

Cancer therapy such as radiation and chemotherapy can cause premature and early menopause. However, sometimes the effect is reversible and the ovary may restart ovulation and menstruation after one year of missed periods. Prolonged use of chemotherapeutic drugs may also cause ovarian failure that leads to premature or early menopause.

Surgery

Surgical removal of the ovary (bilateral oophorectomy) to prevent ovarian cancer, before 45yrs of age can cause premature and early menopause. Furthermore, ovarian failure due to surgical removal of the uterus (hysterectomy) may also cause premature or early menopause.

Some other causes are

  • Smoking and alcohol consumption
  • Poor nutrition and poor health
  • Stress, anxiety & mental tension

Diagnosis of Premature and Early Menopause

There are no specific clinical diagnostic criteria for early or premature menopause. The diagnosis is mainly based on (4)

  • Presence of menstrual disturbance
  • Elevated follicle-stimulating hormone (FSH): FSH >40 Miu/ml
  • Decrease in Estradiol (E2) level:  E2 <20 pg/ml

Your doctor may also investigate the following:

  • Sex chromosome analysis to check chromosomal defects 
  • Thyroid function test to rule out autoimmune adrenal or thyroid failure
  • Blood sugar level
  • Bone mineral density test for osteoporosis
  • X-ray of the pituitary gland to rule out a tumor

Long Term Health Risk of Premature and Early Menopause

Women with premature and early menopause are at increased risk for certain long term health consequences that include:

  • Infertility
  • Osteoporosis
  • Ischemic heart disease and angina
  • Neurological diseases

Treatment for Premature and Early Menopause

There is no specific treatment for Premature and Early Menopause that can reverse or prevent the condition. However, severity of the symptoms can be relieved in the line of Home remedy, Modern medical management and Ayurvedic management as well as . Let’s check it out….

Eat healthy to ease premature and early menopause
Eat healthy to ease premature and early menopause

Home Remedies For Premature and Early Menopause

During premature and early menopause, lack of ovarian hormones can result severe mineral deficiency. For this reason you should supplement your daily diet with sufficient minerals.

Besides, to relieve certain specific symptoms you can also try some home remedies.

Mineral Supplements for Premature and Early Menopause

Since lack of estrogens causes severe mineral deficiency, a supplement of calcium, magnesium, zinc, and vitamin D is very much essential. This will give you relief from hot flushes, night sweats and can help prevent osteoporosis, hair fall, and vaginal dryness. Daily intake amount approximately as follows:

  • Calcium: 1200 mg
  • Magnesium: 600 mg
  • Zinc: 60 mg
  • Vitamin D: 600 IU

Some rich natural sources of vitamins and minerals beneficial for menopausal symptoms are

  • Pumpkin seeds
  • Flax seeds
  • Sunflower seeds
  • Sesame seeds
  • Mushrooms
  • Fruits and nuts
  • Dry fruits
  • Green vegetables

Remedy For Hot Flushes

  • To relieve hot flushes drink 1cup of pomegranate juice mixed with a little lime juice. Add organic sugar to taste. You can take this 2 or 3 times a day as required.
  • Soak ½ teaspoon of fenugreek seeds (methi) in water overnight. In the morning boil the seeds, strain the water, and consume it adding ½ teaspoon honey.  It has natural hormonal balancing properties that help to relieve hot flashes.

Remedy For Vaginal Dryness

  • To alleviate vaginal dryness you can apply sesame oil into the vagina. Pour some oil on a piece of sterile cotton, mold it into a tampon like shape, and apply into the vagina at night. 

Remedy For Mental Stress

  • 2 gm of Indian spikenard (Jatamansi) daily will soothe your nervous system. This helps to reduce symptoms like anxiety, depression, stress, and sleep disturbances.
  • Beetroot is much more helpful than synthetic drugs to relieve symptoms like mood swings, insomnia, and dizziness. Take 60-90 ml of beetroot juice daily.
  • Cherries are good for fatigue, stress, and insomnia. Eat 10 to 20 cherries daily to get relief from these conditions.

Modern Medical Management

With the recent advancement of medical science, it is now possible to restore follicular maturation, ovulation, and menstruation with treatment after diagnosing the proper cause of premature/early menopause.

Your doctor will identify the cause and apply treatment based on the cause. Some common treatments include:

Hormone replacement therapy (HRT)

Estrogens replacement therapy is beneficial to reduce the painful symptoms of premature and early menopause. It helps prevent the risk of osteoporosis, the development of cardiovascular diseases, and dementia.

However, HRT has several side effects and increases the risk of breast cancer, endometrial cancer, osteoporosis, heart disease, stroke, and Alzheimer’s disease. Hence short term use of HRT is considered to be a good option for women with premature menopause.  

Oocyte (Egg) Donation

Oocyte donation is a successful option to manage infertility due to untimely menopause and ovarian failure. You can conceive and hope for a child with oocyte donation using in vitro fertilization (IVF) procedure.

Shatavari for premature and early menopausal hormone imbalance
Shatavari for hormone imbalance

Ayurvedic Management

Due to the side effects associated with Hormone replacement therapy (HRT) many women look for a natural substitute.

Ayurveda has some rejuvenating herbs with estrogenic properties to prevent or alleviate menopausal symptoms. (5)

Herbal Supplement for Hormone Imbalance

The herbs Shatavari, Wild yam, Liquorice, and Aloe vera contain natural phytoestrogens that can compensate the symptoms to some extent.

Shatavari (Shatamull)

Shatavari contains phytoestrogen compounds Shatavarin-I to Shatavarin-VI and Isoflavones. These compounds can support female hormone levels by exerting an estrogen-like effect on the reproductive systems. (6)

Shatavari means “curer of 100 diseases”. In Ayurveda, this wonderful herb is known as the “Queen of herbs” and is considered as the main female reproductive tonic.

It promotes fertility by increasing libido, boosts follicular maturation and ovulation, prepares the womb for conception, prevents miscarriages, and increases milk secretion during lactation.

Shatavari is effective in relieving symptoms like irregular menstruation, hot flushes, night sweats, irritability, depression, stress, and vaginal dryness.

How to take Shatavari

Take half to one teaspoonful Shatavari powder with plain water, milk or honey twice daily after meals. 

Shatavari is available in the market in the form of powder, tablet, churna, capsules, root, and Shatavari granules.

According to the ayurvedic classical literature, it is safe for long term use, even during pregnancy and lactation.

Wild Yam (Aluka)

Diosgenin is the main active phytoestrogen compound in wild yam. It is a natural precursor to estrogens, and progesterone.

Source of DHEA (Wild yam)

Wild yam is also a source of DHEA (dehydroepiandrosterone), a steroid hormone that is produced by the adrenal glands. It can function as a natural precursor to estrogens and testosterone. (7)

Wild yam can reduce symptoms like hot flashes, headaches, painful menstruation, low libido, osteoporosis, and vaginal dryness.

How to take Wild yam

Wild yam is available in the form of liquid, powder, tablets, capsules, and cream. 

Doses may vary according to the severity of the symptoms and your health conditions. Follow relevant directions for use on product labels and consult your doctor or pharmacist before using it.

Chronic toxicity of wild yam is not reported. However, large doses taken by mouth may cause vomiting.

Pregnant women, breastfeeding mothers, and children should avoid wild yam as it is found to stimulate uterine contractions.

Ghrita-kumari (Aloe vera)

Aloe vera (Ghrita-Kumari)

Aloe vera contains Beta-sitosterol as the main phytoestrogen compound.  It produces estrogen-like effects.

Aloe vera significantly decreases the severity of hot flushes, night sweats, vaginal dryness, sleep problems, depressive mood, irritability, and joint pain. (8)

It will also provide you minerals like calcium, chromium, copper, selenium, magnesium, manganese, potassium, sodium, and zinc to meet up the deficiencies caused by lowered estrogen levels. 

How to take Aloe vera

Mix 1 teaspoon fresh Aloe vera gel with 1 teaspoon honey. Take this mixture 3 times daily to get relief from uncomfortable symptoms.

Commercially, Aloe vera is available in the form of juice, drinks, gels, ointments, creams, lotion, and soap.

Prolonged use may increase the risk of colorectal cancer and cause electrolyte imbalances (low potassium levels). Oral aloe vera is not recommended during pregnancy and in breastfeeding mothers due to the stimulation of uterine contractions.

Yastimadhu for hot flash, night sweat

Liquorice (Yastimadhu)

Liquorice is one of the oldest and most popular drugs having a long history of traditional medicines and folk remedies. Glabridin,  Glabrene, Isoliquiritigenin, and glycyrrhetinic acid are the main phytoestrogen compounds in licorice. (9)

These phytoestrogen compounds are helpful for infertility treatments as well as effective in mitigating hot flashes and night sweats. The use of licorice cream may improve vaginal atrophy (thinning, drying, and inflammation of vaginal walls).

Liquorice is a rich source of calcium, phosphorus, sodium, potassium, iron, magnesium, silicon, selenium, manganese, zinc, and copper. It will help you to alleviate the mineral deficiencies due to a lack of estrogen.

How to take Liquorice

Mix one teaspoon of the powder with honey and take once daily. If you have high blood pressure it should be avoided.

Commercially, it is available in the form of raw roots, powder, tablet, cream, oil, and tea.

Prolonged use of this herb may increase blood pressure, heart problems, and can pose a health risk by interacting with other medications. 

Ayurvedic Herbs as Female Tonic

Bamboo Manna (Tabasheer)

Bamboo manna has been used in Ayurvedic medicine as a female tonic for several thousand years. It is also known as Vanshlochan and Tabasheer.

Bamboo manna is a dried white solid obtained from the fluid of young bamboo stem. It is extremely high in organic silica that has a cooling effect and helps reduce hot flashes, inflammation in the female reproductive system.

The silica present in bamboo manna is beneficial for potency and fertility, weakness, urinary infections, depression, and hair fall. It is also helpful to reduce the symptoms of osteoarthritis, painful joints, osteoporosis, and low bone density.

How to take Bamboo Manna

According to Ayurveda appropriate safer dose is 250mg to 500mg twice daily. However, follow relevant directions for use on the product label or seek advice from your doctor.

Ashoka plant for premature and early menopause
Flower of Ashoka plant

Ashoka Plant

Ashoka is another female herbal tonic. The bark of Ashoka is used for the treatment of several gynecological and menstrual disorders in women. 

It acts as a blood purifier and beneficial for irregular and heavy menstruation, painful periods, vaginal pain, white discharge. Asoka is a potent herb against heart disease, joint pain, uterine infections, and pimples. (10)

How to take Ashoka

Commercially Ashoka is available in the form of powder, churan, capsule, and juice.  It is also available as an ayurvedic polyherbal formulation (contains multiple herbs) called Asokarishta.

Ashoka powder: ½ teaspoon with water or milk. You can add honey to it.

Ashoka juice: Mix 8-10 teaspoon of Ashoka juice with water. Add honey to it and drink.

Ashokarishta: 12 to 24 ml with an equal quantity of water after a meal or as directed by the physician.

Ashoka tablet and capsule: Take 1 to 2 tablets after a meal. 

However, seek advice from your physician before taking the medication.

Aswagandha for premature or early menopausal
Female tonic Aswagandha

Indian Ginseng (Aswagandha)

Indian Ginseng has been used as a traditional female tonic to improve overall health and to boost immunity. It reduces stress, fatigue, insomnia, and depression. It also improves thyroid and adrenal gland function.

How to take Ginseng

It is available as herbal supplements in the form of capsules, root extract powder, tablets, ginseng tea, and ginseng tonic in the market. Follow relevant directions for use on the product label or seek advice from your doctor. 

Prolonged use may cause hypertension, headache, sleeplessness, skin eruptions, and diarrhea. It should not be used for more than 3 months at a time. It is not recommended during pregnancy and for breastfeeding mothers.

Yoga Therapy for Hormonal Imbalances

A daily pranayama and yoga practice will keep your body active and help you to maintain inner peace.

  • To reduce stress, depression, and mood swing practice meditation, slow and deep breathing daily. 
  • Practice Sheetali pranayama (cooling breath) and Anuloma-viloma (alternate nostril breathing) for twenty minutes daily to get relief from hot flashes, and night sweats.
  • Several yoga asanas such as Surya namaskar, padmasana, shalabhasana, dhanurasana, pavana muktasana, matsyendrasana, and leg lifting are beneficial for the management of menopausal symptoms. These postures will strengthen your lower abdominal area.

Exercise

  • Take a daily walk for about half an hour.
  • Lie on your back for at least 15 min every afternoon.
  • Dancing, swimming, and cycling are good exercises for your heart health.

Ayurveda believes in “prevention is better than cure”. A little bit of concern about the premature or early menopausal symptoms and consequent lifestyle changes with proper diet will reduce the probability of chronic health problems. 

Book References:

  • Natural Home Remedies for Common Ailments; H.K Bakhru; Orient Paperbacks.
  • The Complete Book of Ayurvedic Home Remedies, Vasant Lad

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