Early Menopause Linked to Increased Risk of Breast and Ovarian Cancer

Women who experience early menopause (before the age of 40) could have a higher risk of ovarian and breast cancer, according to new research presented at ENDO 2024, the Endocrine Society’s annual meeting.

Researchers at the University of Utah Health in Salt Lake City began the study with the hypothesis that some women who have primary ovarian insufficiency and members of their family might be predisposed to certain types of reproductive or hormone-related cancers.

Primary ovarian insufficiency is a condition that occurs when a woman’s ovaries stop working normally before the age of 40.

During the study, the researchers found that women who had early menopause had two times greater risk for breast cancer, and the risk was increased by almost four times for ovarian cancer.

Breast cancer risk was increased 1.3 times and colon cancer by 1.5 times in second-degree relatives (i.e. aunts, uncles, grandparents, nieces, or nephews, etc.), while prostate cancer was increased by 1.3-1.6 times in first-, second-, and third-degree relatives (i.e., great grandfathers, first cousins).

Study authors hope the findings could encourage women experiencing early menopause to ensure they attend regular cancer screenings.

“Women who have infertility from low egg numbers or experience early menopause should make sure they are regularly screened for breast cancer, especially if they have family members with cancer,” Corrine Welt, chief of the Division of Endocrinology, Metabolism and Diabetes at the University of Utah Health says.

“Doctors who practice general medicine, gynaecology and fertility treatment should be aware that early menopause increases risk for a number of diseases, and they should now be aware that breast cancer may be one of these diseases to watch for.”

Dr Elise Dallas, women's health GP specialising in menopause at The London General Practice, says the new research is highly significant.

“The study reveals that women who experience early menopause (before age 40) have an increased risk of developing breast and ovarian cancer," she says. "These women face double the risk for breast cancer and nearly four times the risk for ovarian cancer compared to those who undergo menopause at a typical age.

“Given these findings, for those women who undergo early menopause and those having fertility issues due to early menopause or low egg numbers, need to have regular cancer screenings, especially if there is a family history of cancer.

"But also those doctors of women's health (general practitioners, gynecologists, and fertility specialists) need to be particularly vigilant about the increased cancer risks associated with early menopause and women at higher cancer risk should undergo regular screenings.”

What is early menopause?

Premature menopause is menopause that occurs before the age of 40 years.

"Early menopause occurs between the age of 40 and 45," explains Dr Dallas. "Perimenopause is when you have symptoms of menopause, but your periods have not stopped.

"Perimenopause ends and you reach menopause when you have not had a period for 12 months - if this happens before the age of 45 years this is early menopause."

Menopause normally happens between ages 45-55 years with the average age being 51 years.

"A spontaneous (natural) early menopause affects approximately 5% of the population before the age of 45," Dr Dallas continues. "Premature menopause is estimated to affect 1% of women under the age of 40 years and 0.1% of women under the age of 30 years."

During early menopause, hormonal changes in the body can have an impact on both the physical and mental health.

"Some common symptoms include hot flushes, night sweats, and changes in the menstrual cycle," Dr Dallas continues.

"Additionally, fluctuations in hormone levels can also affect mood and mental wellbeing. Women may experience increased feelings of anxiety, stress, and even depression during this time. It is also not uncommon to feel a sense of anger or irritability."

The primary indicator of early menopause is irregular or complete cessation of menstrual periods. Additional symptoms may include:

If you are under 45 years of age and have irregular periods, or they have stopped for more than three months, your GP might think you are going through early menopause.

"They'll ask you about your symptoms and ask if early menopause runs in your family, do a physical examination, do other tests, such as a pregnancy test, hormone tests (oestradiol, follicle-stimulating hormone (FSH), and luteinizing hormone (LH) and an ultrasound," Dr Dallas explains.

If you think you might be suffering from early menopause there are some steps you can take including:

Seeking help from a specialist

Dr Dallas suggests accessing specialists in this area who can address not only menopause but fertility issues also.

"Other downsides to going into early menopause is that so low oestrogen levels can affect bone density and heart function, but specialists can advise on ways to manage the symptoms and protect the heart and bones," she explains.

"Hormones need to be replaced to ensure not only improvement of symptoms but protection of future bone, brain and heart health."

Make lifestyle modifications

Dr Dallas suggests working on four pillars - nutrition (ensuring enough vitamin D and calcium and omega 3 and magnesium and keeping cholesterol down), exercise (weight bearing for bones and cardiovascular for the heart), ensuring a good nights sleep and enhancing stress and wellbeing.

Try non hormonal medications

These could help with symptoms. "Acupuncture, meditation, cognitive behavioural therapy and yoga have all found to be helpful," Dr Dallas suggests.

Prioritise self-care

It's important for women experiencing these symptoms to prioritise self-care. "This includes getting adequate rest, practising stress-management techniques such as mindfulness or deep breathing exercises, and maintaining a healthy lifestyle with regular exercise and nutritious diet," Dr Dallas explains.

Open communication

Dr Dallas suggests communicating with your employer or supervisor about your menopausal symptoms and how they may impact your work. "Establishing an open dialogue can lead to accommodations or adjustments that support your productivity and wellbeing," she says.

Utilise Resources

Take advantage of resources available in the workplace, such as employee assistance programs or wellness initiatives, that may offer support.

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