Most women have their last period between the ages of forty-five and fifty-five. Only 5 per cent continue to menstruate after fifty-three, and the menopause is labelled premature if it occurs before forty, which it does in about 8 per cent of women. The age at which each individual woman has her menopause does not seem to be related to anything. Once it was thought to be related to menarche or when the periods started – ‘the earlier she started the earlier she stopped’ – but today this belief is known to be unfounded. It is most closely related to family background. Mothers, daughters, sisters, all tend to have their menopause at a similar age. Ovarian failure may occur in the early twenties and in some cases this is inherited; in these cases an endocrinologist should be consulted. Other causes of early menopause are physical illness and psychological trauma.
Women who have had hysterectomies, even when their ovaries are left, often have an earlier menopause, thought perhaps to be due to the disturbance of blood supply to the ovaries, and their consequent atrophy or shrinkage. Menopause, of course, occurs immediately if ovaries are removed surgically, or irradiated for any reason, because ovarian hormone production suddenly stops.
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