After a lack of menstruation for 12 consecutive months, the ovaries are no longer functioning, and Menopause is officially declared. In most cases, menopause occurs between the ages of 45 and 55. However, there may be deviations from the typical age for entering the menopause.
Late menopause
The "late menopause" occurs after the age of 55 and occurs in 5% of women. In general, a later onset of menopause is associated with a longer life expectancy. Although the risk of breast and uterine cancer is increased, the positive effects, for example on the risk of osteoporosis and cardiovascular health, outweigh the negative effects.
The causes of late menopause are not clearly understood. The timing is determined by a combination of genetic factors and environmental influences through individual lifestyle.
There are some factors that have been linked to a later menopause. According to the "Study of Women's Health Across the Nation (SWAN)" in the USA, these include a higher weight, alcohol consumption, not smoking, better self-rated health, use of hormonal contraceptives and less physical activity. Socio-demographic factors such as a higher level of education and having a job were also associated with a later timing of menopause.
Early and premature menopause
If menopause occurs before the age of 45, a distinction is made between early menopause (between the ages of 40 and 45) and premature menopause (before the age of 40). The "early menopause" affects around 10% of women. Approximately 1% of those affected experience premature menopause, also known as premature ovarian failure.
The reasons why the ovaries stop functioning prematurely in some people are often unclear. Causes may include medical treatments, genetic conditions, and certain autoimmune and infectious diseases.
In the late 1990s, an Italian study examined15,253 women over 55 who sought medical advice on menopause. Premature and early menopause occurred more frequently in women with irregular menstrual cycles. Women who had breastfed in the past were less frequently affected. In contrast to other studies, there were no correlations with age at first menstruation, use of oral contraceptives and smoking.
A Korean study, however, reported an increased risk of premature ovarian failure in smokers. Women with an older age at first menstruation, women with irregular cycles and women who breastfed for a longer period showed a reduced risk of early menopause and premature ovarian failure. A lower risk of an earlier menopause was also found in women who had used oral hormonal contraceptives.
The symptoms of premature ovarian failure (premature menopause) are similar to those of natural menopause and are treated similarly. Premature ovarian failure results in a prolonged period of low estrogen levels and is therefore an indication for hormone replacement therapy.
In addition to the early menopausal symptoms, premature ovarian failure also has long-term effects on health outcomes. The risk of osteoporosis and cardiovascular disease is increased, and early estrogen deficiency can have an impact on the skin, sexual function and much more.
Only limited data is available on early menopause, but it can be assumed that the risks are similar to those of premature ovarian failure, albeit less pronounced. For this reason, hormone replacement therapy should be considered for early menopause in order to counteract the long-term consequences.
