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Awaiting moderation 17831 Article |
Early menopause EARLY MENOPAUSE
Women can experience menopause in their early forties or before. In some women early menopause occurs because of medical intervention, and is described as artificial menopause. For others there is no intervention - they have a 'natural' menopause. The most common type of artificial menopause, surgical menopause, occurs when a woman's ovaries are removed because they are making other medical conditions worse or these conditions are damaging the ovaries.
Endometriosis is one such condition. The endometrium is the lining of the womb (uterus), shed during the menstrual period, and endometriosis is the presence of endometrial tissue in sites other than the womb. In Valerie's case, endometrial cells passed through her reproductive system to her ovaries, settling on them as well as on other parts in the pelvis and abdominal cavity. There, the endometrial cells multiplied and interfered with the normal function of her ovaries, causing
Valerie's periods to be irregular, prolonged and painful. Intercourse was also painful, and this was not relieved by lubricants or relaxation therapy. She decided to go ahead with surgery to remove the endometriosis. Every effort was made to spare the ovaries, but the extent of the condition meant that this was not possible.
The ovaries may also be removed if they are not functioning normally, because of multiple cysts, for example. The cysts can grow as big as golf balls or footballs or any size in between, damaging other vital tissues in the process. (Surgeons increasingly try to preserve at least part of one ovary if the cysts are not cancerous.)
Then again if, before menopause, you have a hysterectomy in which your ovaries are removed along with your uterus and cervix, you can expect to experience symptoms of menopause within days or months of surgery. About half the hysterectomies carried out in the US are of this comprehensive type (in medispeak, a total hysterectomy plus a bilateral salpingo-oophorectomy). In Australia the figure is believed to be somewhat lower. Losing your ovaries has a lot of bearing on the severity of menopausal symptoms; if they are removed before menopause rather than at or after it, symptoms tend to be more severe.
The more common type of hysterectomy performed in Australia involves removal of only your uterus and cervix, not your ovaries. Somewhat confusingly, this operation is termed a total hysterectomy. In theory, a total hysterectomy should not produce menopause. The only change should be an end to your periods and removal of the problems that made the surgery necessary.
In practice, however, a significant number of hysterectomised women who still have ovaries experience symptoms of menopause up to four years earlier than might be expected.
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