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cystic fibrosis and menopause

Question
Hello,
I was diagnosed at 50 years old with the G551D and Q1476X mutations. I had an early menopause at age 26. Is-it related to cystic fibrosis?
Thank you for your reply.
Answer
Hello,
There is little information on the age of menopause in women with cystic fibrosis as, until recent years, few patients reached the age of menopause (around age 50) because of the severity of the disease. In my experience of care of adult patients with cystic fibrosis, one cannot conclude that cystic fibrosis is usually accompanied by premature menopause (before the age of 40).
Causes of premature menopause include:
- consumption of tobacco, passive or active cigarette smoke,
- X-ray treatment (radiation) of the ovaries,
- chemotherapy,
- surgical removal of ovaries,
- viral infections,
- chromosomal abnormalities (Turner syndrome with one X chromosome or trisomy X with 3 X chromosomes),
- dysregulation (malfunction) of the endocrine system (disorder of the secretion of hormones) that can be linked to an autoimmune process, with the patient making antibodies against his own glands. The most often affected glands are thyroid, adrenal gland (Addison's disease), pancreas (diabetes) and ovaries.
This last cause of autoimmune process, although rare, could occur in CF, because patients make more easily autoantibodies because of their chronic inflammatory respiratory disease. I have known a patient with cystic fibrosis who had an early menopause before age 30, after presenting thyroiditis with thyroid deficiency and adrenal gland insufficiency. This patient also had joint and skin reactions due to the autoimmune process. It is possible that your early menopause was similar, but in this case, there might have been other symptoms.
In case of premature menopause, treatment consists of estrogen replacement. In women desiring pregnancy and with no cons-indication (mainly respiratory) for pregnancy, oocyte donation is indicated.
Yours sincerely.
Dr Dominique Hubert
22.02.2011