Can Early End Of Periods Lead To Autoimmune Conditions?

A recent study by Finnish scientists has revealed that women with premature ovarian insufficiency (POI) are at a higher risk of severe autoimmune disorders. POI is a condition when women under 40 no longer produce eggs because their ovaries stop working healthily. Menstruation becomes irregular before stopping completely. Some women also report experiencing menopause symptoms like irritability, weight gain, hot flashes, etc. POI affects about 1% of women globally, according to reports.

Why POI Can Cause Risk For Autoimmune Diseases

Scientists in Finland have discovered that women with POI are twice to thrice as likely to develop severe autoimmune conditions compared with the general population. Some common autoimmune conditions include Type 1 diabetes, lupus, inflammatory bowel disease, thyroid conditions, and more.

The study has been reported as the largest to investigate the link between autoimmune conditions and POI. Published in the medical journal Human Reproduction, the findings significantly strengthen the hypothesis that autoimmune processes play a “pivotal role” in the onset of POI, scientists stated.

The researchers studied almost 20,000 women for at least 12 years for these findings. They analysed data from Finland’s comprehensive medical registries and identified almost 4,000 women under 40 with a POI diagnosis between 1988 and 2017. Each was matched with four women of similar ages.

The researchers then studied how many developed severe autoimmune conditions between 1970 and 2017. Their comprehensive study found that 5.6% of Finnish women with POI had been diagnosed with at least one autoimmune disorder before their diagnosis and 12.7% after diagnosis with POI.

Researchers found that women with POI, who did not have a pre-existing autoimmune condition, were nearly thrice as likely to be diagnosed with one in the following three years.

Compared to the control group, women were 2.6 times more likely to have an autoimmune disease before a POI diagnosis. The study found that these risks varied from nearly double for overactive thyroid glands and rheumatoid arthritis to nearly 26 times for polyglandular autoimmune diseases.

Links Between POI And Autoimmune

The links between POI and autoimmune conditions are likely to be an underestimation, the Finnish scientists behind the study said. The researchers acknowledged some limitations in their study which could affect the accuracy of the data. However, they are confident that the observations can be applied on a larger scale.

The study only included autoimmune disorders diagnosed in specialist health centres: less severe conditions such as coeliac disease and underactive thyroid glands are often diagnosed and treated in primary healthcare, so the overall prevalence of autoimmune disorders in women with POI is likely to be higher.

Lead researcher Dr Susanna Savukoski, a gynaecology and obstetrics doctor at Oulu University Hospital and the University of Oulu, Finland, said in the study, “Most women with POI do not develop severe autoimmune conditions, and most women with severe autoimmune diseases do not develop POI."

However, medical professionals should be aware of the increased risk, and patients should be informed about it as well, Dr Savukoski asserted.

What Happens In When Periods End Prematurely?

Responding to the study, Louise Kenny, a professor of maternal and foetal health at Liverpool University, told The Guardian, “POI is poorly understood and devastating. It limits the possibility of young women carrying their biological child as well as increasing their risk of menopausal-related complications.”

Dr Tanveer Aujla, a gynaecologist and obstetrician at Motherhood Hospitals in Noida, told SheThePeople that early end of periods can cause several issues including loss of fertility, risk of osteoporosis at an early age, cardiovascular diseases, and decline in cognitive function due to low oestrogen levels.

Dr Aujla also asserted that the complications caused by POI and premature menopause go beyond its physiological impacts. "Premature menopause usually happens before the age of 40, impacting women physiologically, emotionally and socially as well," she noted. 

Dr Aujla stated some of the consequences of premature menopause on women. "The consequence of such condition includes an increase in anxiety levels, depression, body image issues, and challenges in personal relationships, during family planning."

Prevention And Cure

Dr Tanveer Aujla shared the factors which can cause POI and premature menopause, including family medical history, autoimmune conditions like thyroid disease or rheumatoid arthritis, chemotherapy, radiation or surgery that affect ovaries, or chromosomal abnormalities like Down Syndrome or Turner Syndrome.

The researchers in the Finnish study said that their findings aim to help in the development of preventive treatments for POI. Lead author Dr Savukoski said: “We are investigating whether long-term use of [hormone replacement therapy] can prevent other conditions developing among women with POI.”

Dr Aujla also shared that HRT and other medical interventions may help manage the symptoms and reduce the long-term health risks of premature menopause. She added, "While genetic and medical causes are often unavoidable, women can reduce risks by maintaining a healthy lifestyle-- balanced diet, regular exercise, stress management and avoiding smoking."