Women diagnosed with spontaneous early menopause, Premature Ovarian Insufficiency (POI), or medically-induced early menopause can experience a range of symptoms which vary in severity and duration (see Symptoms of early menopause). In the long-term, early menopause (EM) can also lead to the loss of bone density (osteoporosis) and negatively impact and cardiovascular disease risk and cognitive function.
The health practitioners we interviewed emphasised the importance of pharmacological therapies (see Hormone-based medications for early menopause) such as Hormone Replacement Therapy (HRT), also known as Menopausal Hormone Therapy, where possible, and lifestyle changes (see Lifestyle changes following early menopause) to help reduce the long-term health risks of EM especially bone health.
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While younger women experiencing EM can initially have good bone density and cardiovascular health, health practitioners explained that it is important to monitor them for any changes over time. Dr Baber, an obstetrician-gynaecologist, said, ‘it depends on the age of the patient and on her history, and her family history … But I think you should do a baseline assessment on most of them. If they’re teenagers they’re obviously going to have normal bones and a normal heart, but you do need to follow that regularly as time goes by.’
A few health practitioners remarked that younger women diagnosed with EM may not monitor their bone density as regularly as older women. Breast surgeon Dr P attributed this in part to the fact that their friends or relatives who are of a similar age have different health concerns and so ‘their peers are unlikely to tell them, you know, ‘Have you gone and had your bone density done yet?’ because they’re just not in that … phase of their life.’
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Health practitioners spoke of the importance of prevention when monitoring women’s bone, cardiovascular and cognitive health. They emphasised offering women HRT where possible, until the usual age of menopause (about 51 years old) and encouraging lifestyle changes such as exercise (see Lifestyle changes following early menopause).
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Monitoring women diagnosed with EM following cancer treatment for long-term health impacts, in particular osteoporosis, was also seen as important. Dr Goeltom explained that women diagnosed with oestrogen-positive cancer who may be unable to take HRT should do ‘weight-bearing exercise, and [take] calcium, and Vitamin D’ to help protect their bone density.
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A few health practitioners who are involved in the care of women with EM or menopausal symptoms related to cancer treatment remarked that hormone (adjuvant endocrine) therapies for cancer, such as aromatase inhibitors have a higher risk of negatively affecting bone density.
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Further information
Talking Points (health practitioners)
- Symptoms of early menopause
- Hormone-based medications for early menopause
- Non-hormone based medications for early menopause symptoms after oestrogen-sensitive cancers
Talking Points (women)
- Long-term health effects of early menopause
- Taking hormone-based medications for early menopause
- Non-hormone based medications for early menopause
Other resources
- Resources and Information page – Health Practitioners
- Early Menopause – Diagnosis and Evaluation Algorithm
- Early Menopause – Management Algorithm
- Webpage: Spontaneous POI (AMS)
- Webpage: Surgical menopause (AMS)
- Webpage: Early menopause due to chemotherapy or radiotherapy (AMS)
- Guidelines: Management of POI (ESHRE)
- Booklet: Breast cancer and early menopause: A guide for younger women (Cancer Australia)
- Webinar: Premature Menopause (Jean Hailes)
- Website: Osteoporosis Australia
- Factsheet: Osteoporosis and breast cancer (Osteoporosis Australia)
- Factsheet: Bone health and POI