Assessment of factors responsible for early menopause in Interior Sindh, Pakistan

  • Latafat Ali Chughtai
  • Aliza Sahito
  • Jawaid Ahmed Zai
  • Zaibunisa Mughal
  • Jamshed Warsi
  • Benazir Mahar SINDH UNIVERSITY
Keywords: Early menopause, ovarian cancer, family history, hormonal disturbance.

Abstract

Objective: To evaluate the factors leading to the early onset of menopause (<40 years) in the women in the interior of Sindh.

Materials and Methods: A cross-sectional study was conducted on 218 individuals among them 109 were postmenopausal women (with premature menopause)  and 109 were normal menstruating females during the period of six months from November 2014 to April  2015, data was obtained from Interior Sindh, Larkana, Hyderabad, and Benazirabad.  Factors considered were age, number of children, history of the obstetric process (ovarian and uterine), diseases, and premature menopause history in first-cousin marriages. The questionnaire data and blood samples were collected for hormonal assays such as LH,  prolactin, and FSH. The hormone levels were analyzed by ELISA method, SPSS version 17 was used for data analysis.

Results:  Out of 109 subjects the percentage of early menopause due to: anorexia nervosa was 17%, brain tumor 7%, ovarian cancer 6%, hormonal disorders 23%, hysterectomy 15%, oophorectomy 5%, Pituitary gland dysfunction 4%, Sheehan Syndrome 24%, Polycystic Ovarian Syndrome (PCOS) 8%.

Conclusion: Early menopause was found related to pathological and psychological factors including brain tumor, ovarian cancer, family history, Anorexia nervosa, and certain surgical interventions.

References

1. A. M. Gharaibeh, A. E.-N. E. Al-Bdour, and H. F. Akasheh, "Premature and Early Menopause: Risk Factors in Jordanian Women," Journal of the Royal Medical Services, vol. 102, pp. 1-5, 2010.
2. K. J. Lund, "Menopause and the menopausal transition," Medical Clinics of North America, vol. 92, pp. 1253-1271, 2008.
3. D. Goswami and G. S. Conway, "Premature ovarian failure," Hormone Research in Paediatrics, vol. 68, pp. 196-202, 2007.
4. N. H. Alzubaidi, H. L. Chapin, V. H. Vanderhoof, K. A. Calis, and L. M. Nelson, "Meeting the needs of young women with secondary amenorrhea and spontaneous premature ovarian failure," Obstetrics & Gynecology, vol. 99, pp. 720-725, 2002.
5. N. Panay and E. Kalu, "Management of premature ovarian failure," Best practice & research Clinical obstetrics & gynaecology, vol. 23, pp. 129-140, 2009.
6. P. N. Maclaran K, "Premature ovarian failure," J Fam Plann Reprod Health Care, vol. 37, pp. 35-42, 2011
7. M. a. B. R. C. Beverly G Reed, MD., "The Normal Menstrual Cycle and the Control of," endotext, 2018.
8. S. C. Manolagas, C. A. O'brien, and M. Almeida, "The role of estrogen and androgen receptors in bone health and disease," Nature Reviews Endocrinology, vol. 9, p. 699, 2013.
9. O. Svejme, H. Ahlborg, J. Å. Nilsson, and M. Karlsson, "Early menopause and risk of osteoporosis, fracture and mortality: a 34‐year prospective observational study in 390 women," BJOG: An International Journal of Obstetrics & Gynaecology, vol. 119, pp. 810-816, 2012.
10. L. T. Shuster, D. J. Rhodes, B. S. Gostout, B. R. Grossardt, and W. A. Rocca, "Premature menopause or early menopause: long-term health consequences," Maturitas, vol. 65, pp. 161-166, 2010.
11. P. L. Beck-Peccoz P, "Premature ovarian failure.," Orphanet J Rare Dis., vol. 6, 2006.
12. K. F, "Sheehan's syndrome," Pituitary, vol. 6, pp. 181-8, Pituitary. 2003;6(4):181-8.
13. J. Marshall, D. Anderson, T. R. Fraser, and P. Harsoulis, "Human luteinizing hormone in man: studies of metabolism and biological action," Journal of Endocrinology, vol. 56, pp. 431-439, 1973.
14. M. Maes, K. Mommen, D. Hendrickx, D. Peeters, P. D’Hondt, R. Ranjan, et al., "Components of biological variation, including seasonality, in blood concentrations of TSH, TT3, FT4, PRL, cortisol and testosterone in healthy volunteers," Clinical endocrinology, vol. 46, pp. 587-598, 1997.
15. P. Anagnostis, K. Christou, A.-M. Artzouchaltzi, N. K. Gkekas, N. Kosmidou, P. Siolos, et al., "Early menopause and premature ovarian insufficiency are associated with increased risk of type 2 diabetes: a systematic review and meta-analysis," European journal of endocrinology, vol. 180, pp. 41-50, 2019.
16. S. Naz, N. Y. Memon, and S. Shaikh, "Factors associated with early menopause," Rawal Medical Journal, vol. 44, pp. 141-144, 2019.
17. S. Tsiligiannis, N. Panay, and J. C. Stevenson, "Premature ovarian insufficiency and long-term health consequences," Current vascular pharmacology, vol. 17, pp. 604-609, 2019.
18. D. Verma, P. Singh, and R. Kulshrestha, "Analysis of histopathological examination of the hysterectomy specimens in a north Indian teaching institute," International Journal of Research in Medical Sciences, vol. 4, pp. 4753-4758, 2016.
19. L. Foxcroft, Hot flushes, cold science: A history of the modern menopause: Granta Books, 2011.
20. M. M.-W. Botkin, "The Association Between Osteoporosis and Early Menopause Following Hysterectomy," 2016.
21. K. K. Crean-Tate, S. S. Faubion, H. J. Pederson, J. A. Vencill, and P. Batur, "Management of genitourinary syndrome of menopause in female cancer patients: a focus on vaginal hormonal therapy," American journal of obstetrics and gynecology, vol. 222, pp. 103-113, 2020.
22. P. G. Moorman, E. R. Myers, J. M. Schildkraut, E. S. Iversen, F. Wang, and N. Warren, "Effect of hysterectomy with ovarian preservation on ovarian function," Obstetrics and gynecology, vol. 118, p. 1271, 2011.
23. K. A. Hansen, "Accelerated Menopause With Ovary-Sparing Hysterectomy?," Obstetrics & Gynecology, vol. 127, pp. 817-818, 2016.
24. C. M. Farquhar, L. Sadler, S. A. Harvey, and A. W. Stewart, "The association of hysterectomy and menopause: a prospective cohort study," BJOG: An International Journal of Obstetrics & Gynaecology, vol. 112, pp. 956-962, 2005.
25. Q. Chen, H. Ke, X. Luo, L. Wang, Y. Wu, S. Tang, et al., "Rare deleterious BUB1B variants induce premature ovarian insufficiency and early menopause," Human Molecular Genetics, 2020.
26. T. Sathyapalan, M. Aye, A. S. Rigby, W. D. Fraser, N. J. Thatcher, E. S. Kilpatrick, et al., "Soy reduces bone turnover markers in women during early menopause: a randomized controlled trial," Journal of bone and mineral research, vol. 32, pp. 157-164, 2017.
27. Y. Fu, Y. Yu, S. Wang, J. S. Kanu, Y. You, Y. Liu, et al., "Menopausal age and chronic diseases in elderly women: a cross-sectional study in Northeast China," International journal of environmental research and public health, vol. 13, p. 936, 2016.
28. S. B. Jungari and B. G. Chauhan, "Prevalence and determinants of premature menopause among indian women: issues and challenges ahead," Health & social work, vol. 42, pp. 79-86, 2017.
29. P. S. Mehler, M. J. Krantz, and K. V. Sachs, "Treatments of medical complications of anorexia nervosa and bulimia nervosa," Journal of eating disorders, vol. 3, p. 15, 2015.
30. G. D. Mishra, N. Pandeya, A. J. Dobson, H.-F. Chung, D. Anderson, D. Kuh, et al., "Early menarche, nulliparity and the risk for premature and early natural menopause," Human Reproduction, vol. 32, pp. 679-686, 2017.
31. I. Pérez‐Alcalá, L. L. Sievert, C. M. Obermeyer, and D. S. Reher, "Cross cultural analysis of factors associated with age at natural menopause among latin‐american immigrants to madrid and their spanish neighbors," American Journal of Human Biology, vol. 25, pp. 780-788, 2013.
32. K. S. Ruth, J. R. Perry, W. E. Henley, D. Melzer, M. N. Weedon, and A. Murray, "Events in early life are associated with female reproductive ageing: a UK Biobank Study," Scientific reports, vol. 6, pp. 1-9, 2016.
33. A. Hyland, K. Piazza, K. M. Hovey, H. A. Tindle, J. E. Manson, C. Messina, et al., "Associations between lifetime tobacco exposure with infertility and age at natural menopause: the Women's Health Initiative Observational Study," Tobacco control, vol. 25, pp. 706-714, 2016.
34. G. D. Mishra, H.-F. Chung, A. Cano, P. Chedraui, D. G. Goulis, P. Lopes, et al., "EMAS position statement: Predictors of premature and early natural menopause," Maturitas, vol. 123, pp. 82-88, 2019.
35. F. S. Canavez, G. L. Werneck, R. C. M. Parente, R. K. Celeste, and E. Faerstein, "The association between educational level and age at the menopause: a systematic review," Archives of gynecology and obstetrics, vol. 283, pp. 83-90, 2011.
Published
2020-09-30
How to Cite
1.
Chughtai L, Sahito A, Zai J, Mughal Z, Warsi J, Mahar B. Assessment of factors responsible for early menopause in Interior Sindh, Pakistan. JRMC [Internet]. 30Sep.2020 [cited 22Oct.2020];24(3):198-03. Available from: http://journalrmc.com/index.php/JRMC/article/view/1175