Prediction of age for menopause
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By Lee Hye-jun
A month ago, a hospital in Busan reported that the average age for menopause was 47.5, two years earlier than the Korean Society of Menopause had previously announced. They suggested that emotional stress and excessive weight control may have put forward the average age for menopause. This news troubled many women because menopause is not something to look forward to.
Menopause is a permanent cessation of menstrual periods following the loss of ovarian activity. Women are born with around 2 million eggs in their ovaries. The number continues to decline and reaches 300,000 at puberty. From this reservoir, a certain number of eggs present themselves to be ovulated each month and only one egg gets selected while others fall into programmed cell death. In total, 400 eggs are ovulated in a woman’s lifetime.
As women grow older, the ovarian reservoir decreases. In average women, the total number of eggs reaches approximately 25,000 usually at age 37-38, and fertility begins to decline. Menopause follows about 13 years later at an average age of 51 when the remaining eggs fall below 1,000. Unfortunately, 10 percent of women reach menopause at age 45, probably because they are born with a smaller egg pool which is depleted at an earlier age. About 1 percent of women have been reported to experience menopause before the age of 40, which is called premature ovarian failure.
The researchers have been trying to predict the age of menopause for individuals. Anti-Mullerian hormone, also known as AMH, is a significant marker that represents the ovarian reservoir. It declines as women age and reach undetectable levels at menopause. If your AMH level is lower than your chronological age, you may experience menopause earlier than the average age. Then, what can you do to make it better or at least keep it steady?
Unfortunately, there is no medicine to refill the ovarian reservoir or postpone the menopause yet. What we can recommend so far is to avoid the risk factors before it is too late. Cigarette smoking is known to cause the menopause to start 1.5 years earlier. The more and longer you smoke, the earlier you will experience menopause. Undernourished women and vegetarians experience menopause earlier because they have smaller amounts of body fat to produce estrogen.
You may question why prediction even matters when there isn’t much to do to slow down the process of menopause by delivering such devastating news. Prediction of the age at which menopause begins identifies young women with low ovarian reservoirs so that they do not delay having children until towards the end of their reproductive life. Prediction also helps middle-aged women prepare themselves for change so that they do not become unnecessarily anxious.
There is no way to turn the clock back. But it is important to know where you stand in relation to your biological clock.
The writer is a doctor at Maria Fertility Hospital in Seoul. For further questions, send an email to the writer at hyejunlee@mariababy.com, or call the hospital’s English-speaking coordinator at 82 (Korea country code) 2 (Seoul area code) 2250-5577, or visit the hospital’s website, https://eng.mariababy.com/.