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Dr. Andrea Stephens, St. Luke's Hospital

More than a hot flash: Managing early menopause

Menopause may be the subject of funny musicals and light-hearted conversation, but for women who experience early menopause or a condition called premature ovarian failure, it can be a serious health issue.

Premature ovarian failure (POF) is when a woman's ovaries stop functioning prior to age 40. Early menopause occurs between the ages of 40 to 45, still about 10 years earlier than the usual age of menopause.

There are many causes of these two conditions, including autoimmune disorders, the surgical removal of ovaries or chemotherapy or radiation therapy for cancer. Other times, a woman may have family members who went through early menopause or POF, or the cause simply may be unknown.

Both conditions can have significant health implications:

Heart health - When the ovaries stop functioning early, it causes changes in cholesterol that can make a woman more susceptible to heart attacks, stroke or metabolic syndrome.

Bone health - When ovary function declines as a result of spontaneous or surgical menopause, the body experiences abrupt bone loss. Women who have premature or early menopause have a four to five times higher risk for osteoporosis than non-menopausal women their age.

A woman concerned about either of these conditions should work closely with her healthcare provider to receive a thorough evaluation including checking hormone levels, testing for other autoimmune diseases and monitoring cholesterol levels. It is also important to manage hypertension, follow a heart-healthy diet, monitor bone density and use exercise and diet to manage weight.

Unlike with later onset of menopause, low-dose hormone therapy through age 50 is advised to minimize risks to heart and bone health, without the increased risk of breast cancer that pertains to starting hormone use above age 50. To further manage menopausal symptoms, there are an increasing number of lifestyle modifications that may also help, such as yoga, mindfulness and climate control, and new non-hormonal choices.

With new developments in this rapidly evolving area, it is important to talk with your healthcare provider or a provider with expertise in menopausal medicine or reproductive endocrinology.

Dr. Andrea Stephens , an OB/GYN at St. Luke's Hospital, has a special interest in medical issues related to menopause. For more information, call 314-542-4953.

This article was published in the St. Louis Post-Dispatch on December 26, 2013.