(Foreword: This is our continuation of our response to Nelly of Pantukan regarding her concern on premature menopause.)

DEAR Nelly of Pantukan,

The last time, I talked about the symptoms of premature menopause which includes the following:

• Irregular or missed periods

• Periods that are heavier or lighter than usual

• Hot flashes or a sudden feeling of warmth that spreads over the upper body

• Vaginal dryness

• Bladder irritability and worsening of loss of bladder control

• Emotional changes

• Dry skin, eyes, or mouth

• Sleeplessness

• Decreased sex drive

But, that's not enough. Give your space to the following, if you are under the age of 40, which is your case, because you are only 29 years old. And should you experience them, see your physician, as soon as possible. Don't wait for Christmas, dear, or else, you will run out of time.

• You have undergone chemotherapy or radiation

• You or a family member has an autoimmune disorder such as hypothyroidism, Graves' disease, or lupus

• You have unsuccessfully tried to become pregnant for more than a year

• Your mother or sister experienced premature menopause

So, how is premature menopause diagnosed?

Your doctor will most likely perform a physical exam and draw blood to rule out other conditions, like pregnancy and thyroid disease. This would mean a thyroid panel and a pregnancy test. But, there could be additional laboratory test, which may include your estradiol levels. Remember that low levels of estradiol, a form of estrogen, can tell that your ovaries are starting to fail. So, when your estradiol levels are below 30, it may signal that you are in menopause.

Then, there's your FSH or follicle stimulating hormone level. This is the most important test used to diagnose premature menopause. This FSH causes your ovaries to produce estrogen. But, when your ovaries slow down their production of estrogen, your levels of FSH would increase. So, when your FSH levels rise above 40 mIU/mL, it usually indicates that you are in menopause.

There are still more to say but we are again running out of space for now. We'll continue this in my next issue. Until then again!

Dr. Fritz

(Dr. Fritz Legarde Espedilla is an aesthetic dermatologist and surgeon and a clinical sexologist. She is also trained in hypnotherapy and Medical Acupuncture. She has been in the broadcast media for more than a decade and has written a book based on her 15 year stint with her radio program, “Healthy is Sexy Secrets ni Dr. Fritz.” For your questions, email them to dokfritz@yahoo.com. If you don't wish your letter to be published, we regret that we cannot answer them. Thank you for your understanding.)