Women with early maternal menopause history are at a higher risk of entering this biological transition prematurely
Written by Hetal Thaker
With quotes from Dr Madhuri Vidyashankar (gynecologist), Dr Hina Shaikh (gynecologist)
Lifestyle factors such as stress can also contribute to accelerated ovarian depletion.
Medical science defines menopause as a complete cessation of menstrual cycles for a period of one year. This important biomarker for women comes with a number of challenges. So, for some women — for instance, those keener on getting a proper foothold in a career before conceiving — knowing the approximate age when menopause could hit can help in planning marriage and family in a better way.
Current trends in India indicate that women are experiencing menopause earlier (at age 46) than their Western counterparts (51).
Doctors, meanwhile, say it is possible to predict a woman’s likely menopause age from the age at which her mother entered it.
Early menopause: Role of family history
“Daughters of women who had early menopause (before age 46) are at a higher risk of entering menopause prematurely,” says Dr Hina Shaikh, consultant gynecologist and obstetrician, Fortis Hiranandani Hospital, Vashi, Navi Mumbai. “Lifestyle factors — including smoking, stress and obesity — can also contribute to accelerated ovarian depletion, further compressing a woman’s fertility window. This trend highlights the importance of proactive fertility assessments and early family planning for women, especially those in their 30s with a family history of early menopause.”
Along with the age of menopause of the mother, tests such as AMH (anti-müllerian hormone) and AFC (antral follicle count) can also help predict ovarian aging and the fertility of a woman.
“It is advisable for women with early maternal menopause history to get assessed and take preventive steps for conception before they experience fertility decline,” Dr Madhuri Vidyashankar P, consultant, gynecologist and laproscopic surgeon, Motherhood Hospitals, Bangalore, tells Happiest Health.
Signs of decline in ovarian reserve
The first and most basic sign of a decline in the ovarian reserve is a shorter menstrual cycle — when it shortens from 28-30 days to about 21-24 days. Irregular or missed menstruation periods and reduced or sparse bleeding are also symptoms of a declining ovarian reserve.
“We advise women to undergo AMH and AFS scans and other supportive tests when these symptoms continue for more than three cycles a year,” says Dr Vidyashankar. “Monitoring symptoms along with supportive tests can help determine if a woman is experiencing a decline in ovarian reserve.”
Early vs late menopause
Early menopause (before 45 years) is associated with psychological imbalance like mood swings, sadness and depression due to hormonal changes. Women who experience early menopause face the risk of cognitive decline, dementia, Parkinson’s, stroke and cardiovascular ailments, too. Reduced protection of estrogen in early menopause also affects bone health, increasing the risk of osteoporosis and fractures.
Late menopause (after 55 years), on the other hand, comes with a mixed bag of risks and benefits. Women who experience late menopause too undergo mood swings and depression, and face increased risk of breast and endometrial cancer due to higher exposure to estrogen. However, this increased exposure to estrogen is beneficial for bone and heart health.
Fertility planning and egg freezing
Doctors highlight the role of genetics in fertility and the importance of proactive fertility assessments for women with a family history of early menopause.
A couple of years ago, 34-year-old Sarah Joseph became concerned about her family history after learning that her mother experienced menopause at age 46. Sarah had just got married and was planning to start a family. But during a routine doctor’s visit, she was recommended a fertility assessment. Tests revealed a lower-than-expected AMH level, indicating a reduced ovarian reserve consistent with her family history. An ultrasound also showed fewer egg-containing follicles.
Given their desire to have more than one child, Sarah and her husband decided to try to conceive immediately while also preserving her eggs through freezing to secure her fertility for the future.
“After freezing several embryos, Sarah successfully had her first child at 35,” said Dr Shaikh, who treated her. “With the embryos safely stored, she plans to try for a second child after a couple of years, even though her natural fertility will decline.”
Dr Shaikh advises that women opting for late marriage and concerned about their future reproductive age should opt for egg freezing.
Takeaways
A mother’s early menopause can indicate a higher risk of infertility or early menopause for the daughter. However, it is not inevitable as lifestyle changes and proactive treatments can influence outcomes.
