Researchers have proposed that because premature menopause happens out of synchrony with normal life development psychological functioning is compromised (Boughton 2002; Pasquali, 1999). Changes to body image and sexuality may be experienced which possibly impact on self-esteem and perceptions of role. There is also little social support for these women as friends are not experiencing the same physical and emotional changes, and sometimes the women's own mothers have not yet reached menopause. Loss of fertility and confidence in health may also be compromised in women with premature menopause further impacting on wellbeing.

Due to little scientific research on premature menopause our understanding of the experiences that these women go through is limited. Research has mostly been conducted using small sample sizes (Everson, Matthews, Guzick & Kuller 1995; Pasquali 1999) and women across the three conditions of premature menopause (premature ovarian failure (POF), surgically induced and chemically induced) are often combined in one group, or only one of the subgroups is studied (Liao, Wood & Conway 2000). Some of this past research relies on retrospective data in that women can be asked in their forties and fifties about menopause that occurred in their twenties. Only one small quantitative study has considered premature menopause in Australian women (Boughton 2002).

Mood

One of the largest studies so far of only 64 participants to consider POF in British women found higher levels of depression, perceived stress, and low levels of self esteem, life satisfaction and sexual function in women with POF compared to the general population (Liao, Wood & Conway, 2000). Women who experience an early surgical menopause are also more likely to experience depression, anxiety and experience problems with sexual function (Sherwin 1988; Taylor 2001). Small studies of women treated with chemotherapy for breast cancer who experienced a premature menopause were found to have mood and cognitive problems as well as a reduction in overall quality of life (Andersen, Anderson & deProsse 1989; Ganz, Greendale, Petersen, Kahn & Bower 2003; Knobf 1998; Rostom 2001), however it is often difficult to separate out the effects of experiencing cancer (Duffy, Greenberg, Younger & Ferraro 1999). Interestingly women who have had breast cancer and were taking antidepressants for the treatment of hot flushes also had a reduction in feelings of anger, tension and depression (Barton et al 2003). Researchers of women who have had breast cancer and consequent premature menopause have called for greater support and understanding of these women targeting them specifically for intervention of mood and psychological dysfunction (Knobf 1998; Rostom 2001).

Anxiety appears to increase in women with premature menopause also but more research is greatly needed. Those studies that have considered anxiety and premature menopause have focused on specific research questions such as discussions regarding fertility prior to breast cancer treatment and the risks of early menopause (Duffy, Allen & Clark 2005). Other scientific papers have considered specific case studies: one in a student aviator (Berg & Moore 2000) and one case of a woman with severe post operative anxiety following surgical menopause (Chung-Park 2005). Another study looked at the incidence of headaches and menopause and found that women who had undergone a surgical menopause had worsening of their migraines correlated with anxiety and insomnia (Neri, Granella, Nappi, Manzoni et al 1993).

Sexual Function

Once again most of the research on sexual function and premature menopause concentrates on breast cancer patients. Actual sexual function rather than libido appears to be of greater concern for these women especially with the combined effects of chemotherapy and symptoms of menopause such as dry thin vagina impacting on coital and postcoital pain (Avis, Crawford & Manuel 2004; Knobf 2001). Andersen, Anderson and deProsse (1989) found in an early study that one third of women treated for cancer were also diagnosed with sexual function problems. In their study of women with POF Liao et al (2000) suggested that these women had lower sexual satisfaction and sexual esteem but experienced problems with validation of their data. Many women from this limited research actually called for further information to be available to them and for up front discussions about the impact of premature menopause on their sexual function (Andersen, Anderson & deProsse, 1989; Knobf 2001; Tierney 2004).

Body Image

Only three papers appear to have considered body image and premature menopause. Avis, Crawford and Manuel (2004) found that women who have had breast cancer were also concerned about body image but it appears this may have been more to do with mastectomy rather than changes associated with premature menopause. In rehabilitation programs for women who have had breast cancer, exercise has been found to increase positive mood and also improve body image (Pinto & Maruyama 1999). Interestingly body image was the only psychological factor that women with POF did not differ from when compared with the general community sample in the British study by Liao, Wood and Conway (2000).

Life Stage

Experiencing an event such as menopause outside the usual developmental stage further impacts on wellbeing. How this differs across the three groups of premature menopause is not clear however. Pasquali (1999) suggested that women who experienced premature menopause as a result of cancer did not rate premature menopause as of great importance compared to women whose conditions were benign. The reason for premature menopause, the individual and social context of each women who experiences premature menopause are also likely to impact on psychological and physical wellbeing. Liao et al (2000) found that the degree of distress associated with POF depended on age, age at diagnosis, the time since diagnosis, whether women already had children, being in a long-term relationship, or having psychological support in the past or present. Distress at time taken to diagnosis and the need for support and accurate information regarding POF by health practitioners is an area of much needed future research and education according to Alzubaidi et al (2002). Social support networks are often limited for women with premature menopause as friends and peers are unable to understand the specific changes a woman with premature menopause may experience (Pasquali 1999). Infertility also impacts on the lives of many women and the inability to have children then further impacts on mood and relationships with partners (Boughton 2002).

Content updated December 5, 2007