Humanitarian and actress Angelina Jolie is making headlines once again for going under the knife in order to potentially save her own life. As a carrier of a mutated BRCA1 gene, which increases her changes of getting both breast cancer and ovarian cancer, Jolie decided two years ago to be proactive by getting a double mastectomy. And on Tuesday, Jolie revealed in an op-ed in The New York Times that she decided to have her ovaries and fallopian tubes removed as well, after a blood test revealed inflammatory markers that might have been signs of early cancer. As a carrier of the mutation BRCA1 gene, Jolie had a 87 percent chance of developing breast cancer, and 50 percent chance of developing ovarian cancer before the age of 70. Jolie’s mother died of ovarian cancer at the very young age of 49, and both her aunt and grandmother also died from cancer, so it makes sense that Jolie would opt for surgery now. But her decision is obviously not without compromise: by removing her ovaries and fallopian tubes, Jolie will not only no longer be able to have any more children, and will go into early menopause.
Early menopause is categorized as menopause that strikes before the age of 40. Although it’s rare in women who have not undergone a surgery like Jolie's, it can still happen without warning. So what exactly is early menopause like, and how can it happen without surgery?
Here’s what you should know.
What Is Early Menopause?
Early menopause is characterized as menopause that hits women 10 years earlier than it normally would. According to the National Institute of Aging, women, on average, go through menopause between the ages of 40 and 60; although 40 is on the young side, and so any woman who goes through menopause earlier than age 40 is regarded as going through early menopause.
Menopause is brought on when the ovaries, for whatever reason, stop producing the necessary hormones that keep the reproductive cycle doing its thing. If the estrogen supply is stopped, then the body goes into early menopause.
Why Does Early Menopause Occur?
There are a handful of causes of early menopause, from genetics to surgery to even being a life-long smoker.
1. Removal Of The Uterus And/Or Ovaries
If a woman has her ovaries removed, her body immediately goes into menopause, because her hormonal levels drastically drop upon the very moment of removal.
In contrast, removing the uterus will not result in immediate menopause, because the ovaries are still intact and producing hormones. However, since she no longer has a uterus, a woman will no longer get her period, and early menopause could happen a couple years earlier than expected.
2. Chemotherapy Or Radiation To The Pelvic Region
Any sort of cancer-fighting treatment used on or the near the reproductive organs is likely to result in early menopause, because of the damage that is done to the organs. The more aggressive the treatment, the higher the risk of early menopause.
Exactly when a woman goes through menopause is often decided by when her mother went through menopause. If her mom went through early menopause, there’s a good chance that she might too.
According to the Mayo Clinic, smokers usually start menopause a couple years earlier than women who do not smoke, because of the harmful effects smoking has on estrogen levels.
5. Chromosome Defects and Autoimmune Diseases
Chromosome defects such as Turner syndrome that affect ovary function, and autoimmune diseases, like thyroid issues and rheumatoid arthritis, can cause the ovaries to stop working, leading to early menopause.
How Does Early Menopause Affect The Body?
Early menopause affects the body in the same way normal menopause would. Unfortunately, someone going through menopause, even with hormone replacement therapy, can expect to experience a long list of side effects.
1. Menstruation Stops
The first big sign that menopause is in the works are changes in menstruation. Periods suddenly become erratic and when it’s going to show up (or not show up) next is anyone’s guess. Eventually, your period ceases altogether.
2. Hot Flashes
The change in estrogen levels causes the body to experience hot flashes throughout the day and night that can last for 30 seconds to 10 minutes. A hot flash causes blotches on the chest, sweating, and intense feeling of heat on the upper part of the body.
Declining estrogen levels during menopause means that a woman can feel feel like she's in a constant state of PMS. (Which would obviously cause moodiness.)
4. Vaginal Dryness
With estrogen production no longer being what it once was, vaginal lubrication suffers. Vaginal dryness not only makes sex difficult, but can result in more infections than usual. The vagina can also become less flexible, adding to discomfort during sex.
5. Changes In Sex Drive
Women going through menopause can expect to either lose interest in — or suddenly gain an overwhelming interest in — sex that they never had before, depending on how their body reacts to the lowered hormonal levels.
6. Bodily Changes
The lack of estrogen can create weight loss or weight gain, joint pain, and even makes women more susceptible to osteoporosis. Although bones gradually breakdown with age, estrogen no longer being part of the equation speeds up that process.
Is Early Menopause Reversible?
At the moment, menopause, early or otherwise, is not reversible. However, doctors are in the early stages of figuring out a way to reactivate ovaries, which would be great for women who do go through early menopause, giving them another chance to have a child, if that's what they want.
How Is It Treated?
Early menopause can be treated with hormonal supplements, both pharmaceutical and natural, that are meant to manage the physical and mental toll that the decreased estrogen creates. Lifestyle changes — like eating right, exercising, and reducing alcohol and smoking — can also greatly aid in making a menopausal woman feel more balanced. Some women, like Angelina Jolie, might also opt for a patch that contains bio-identical estrogen and/or a progesterone IUD, to help mimic pre-menopausal hormone levels.
Should I Be Worried?
None of this sounds like something you'd want to have to deal with, obviously, but remember — most likely, menopause isn't something you'll have to worry about for awhile, so try not to stress out too much about it. Only one percent of women go through early menopause before the age of 40; so it's not like every time you're feeling suddenly hot or moody you need to worry.
Protect your health by knowing the signs and your options, and like Jolie said in her op-ed, remember: "It is not easy to make these decisions. But it is possible to take control and tackle head-on any health issue. You can seek advice, learn about the options and make choices that are right for you. Knowledge is power."