Patient's question:
Female, 49 years old, wants to delay menopause.Doctor's answer:
The menopause refers to the period when ovarian function gradually declines and eventually ceases. According to foreign statistics, women who experience menopause before the age of 40 have a 39% higher risk of death compared to those who experience it between 40 and 44, a 60% higher risk compared to those between 45 and 49, and a 95% higher risk compared to those between 50 and 54. Therefore, understanding the various factors that influence menopause and delaying the age of menopause are critical issues in the healthcare of middle-aged and elderly women.The most important factor determining the age of menopause is the number of oocytes. At birth, each ovary contains about one million oocytes, which gradually decrease after birth. When the number of oocytes drops to a critical level, menopause occurs. To date, the mechanisms controlling or regulating the rate of oocyte decline are not fully understood, but the following factors are clearly associated with the timing of menopause.
Nutrition and Menopausal Age
Research has found that women with long-term malnutrition, who are shorter in stature and lighter in weight, have an average menopausal age of 43.6 years, compared to those with better nutrition, relatively taller stature, and relatively heavier weight, who have an average menopausal age of 47.3 years. Smoking is a significant factor in advancing the age of menopause. Benzo[a]pyrene in cigarettes is a lethal factor for oocytes. Animal experiments have shown that low doses of benzo[a]pyrene can destroy 25% of oocytes, while high doses can destroy 98% of them. A survey by the Royal University Hospital in the UK indicates that smoking women enter menopause an average of 54 years earlier than non-smoking women.
Diseases
It is generally believed that chronic debilitating diseases, metabolic and endocrine disorders, tumors, mumps complicated with oophoritis, and other conditions can lead to the decline of ovarian function, abnormal hormone secretion by the adrenal cortex, thyroid, pituitary gland, etc., and thus advance menopause. Additionally, radiotherapy, chemotherapy, and some autoimmune diseases can prematurely cause ovarian dysfunction and menopause.
Psychological Factors
Menopausal age is also related to various psychological and mental factors. Research shows that women with harmonious marital relationships and satisfying sexual lives tend to experience menopause later compared to those with discordant relationships, excessive sexual activity, or a lack of sexual life. In particular, women under chronic psychological stress, overexertion, or long-term depression and anxiety may experience menopause earlier due to their impact on neuroendocrine function.
The average menopausal age for urban women in China is 49.5 years, while for rural women, it is 47.5 years. The age range for menopause can be between 35 and 55 years. In the U.S., the average menopausal age is 51.4 years, with a range of 48 to 55 years. Over the past century, the age of menarche has tended to decrease, but changes in menopausal age have been less pronounced. Menopause before the age of 40 is referred to as "premature menopause" or "early ovarian failure." Approximately 1% of women experience menopause before the age of 40, while menopause after the age of 55 is called "delayed menopause."