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Premature Menopause

by Kate Neil(more info)

listed in women's health, originally published in issue 75 - April 2002


Rita, now 25, came to see me in August 2001 complaining of severe physical and mental exhaustion, depression and a complete loss of her menstrual periods since the age of 20. She was worried about developing osteoporosis and felt that she was intolerant of certain foods.

Rita was 12 when she started her periods and they were regular between the ages of 14 and 18. She used a contraceptive pill between the ages of 18 and 20. Her periods were very heavy while using the pill and she became depressed. Since the loss of her periods five years ago she has tried various forms of HRT that made her feel nauseous, depressed and gave her headaches.

Glandular fever was diagnosed when she was 19 and she has felt chronically fatigued since she was 22. Rita developed an anal abscess and anal fissure when she was 20 that required surgery and antibiotic therapy. Over the next few years Rita had several more courses of antibiotics for toe infections and as a result of needing to self-catheterize due to difficulty urinating. Her bowels were sluggish and she experienced headaches without a daily bowel action. Indigestion was a problem exacerbated by stress.

She developed a huge rash on her face, which lasted from the ages of 14 to 16. Rita started smoking early and has smoked more than 20 a day since she was 16. She has felt 'burnt-out' since the age of 17.

She was experiencing bursts of anger. Concentration was a real problem and she often felt that she was daydreaming. Rita had used Prozac in the past and suffered with seasonal affective disorder (SAD). Her low health was affecting relationships and she was less inclined to socialize. Rita had some mercury fillings removed a year ago and she thinks her mood and energy have improved slightly since.

Her weight has fluctuated since she was 15. She is currently 9 stone 12 pounds and has been nearly 13 stone in the past. Sleep was of low quality and she was getting up feeling tired. Sugar cravings were a real problem, needing frequent intakes of biscuits, bread and chocolate. She panicked if she did not have ready access to water and experienced dizzy spells and blurred vision.

Rita is a massage therapist. A most debilitating symptom for Rita at work was a heavy pressure feeling in her legs. She had tried manual lymphatic drainage four years previously.

Rita would start her day with two slices of thick-cut white toasted bread with margarine and jam, followed by six biscuits and anything sweet or chocolatey that she could find. Lunch consisted of a bowl of organic brown rice and some good oil poured over the top and two bananas or a ham salad sandwich. Her often missed evening meal would be replaced with more toast and biscuits. Chocolate was eaten throughout the day and evening. She drank seven cups of tea with soya milk, and sweetened with an artificial sweetener. Rita could eat five pieces of fruit a day, and rarely ate vegetables.


Clearly Rita's health history is complex, involving gut/immune/neuro/ endocrine interactions. My primary concern was to exclude the possibility of Rita having an undiagnosed case of diabetes mellitus, giving her excessive thirst, excessive urination, blurred vision and dizzy spells in conjunction with her tendency to infections. Rita said that her GP was checking her blood glucose levels and her thyroid function, but the results had been lost. I recommended that she pursue the results.

In the meantime, I recommended a diet based on a 2:1 ratio of protein to carbohydrate at each meal, that she limited her intake of starch carbohydrates to the equivalent of two portions daily and that they were from unrefined sources. The diet included two portions of fruit daily and six to eight portions of vegetables either as salad, soup or cooked vegetables. I recommended that she include three portions of oily fish a week. Her programme included adding ground flaxseeds to a breakfast of organic soya yoghurt and red berries, and adding a flax-based oil to salads. The new diet was power-packed with micro- and phytonutrients. I did not suggest any change to her intake of artificially sweetened tea or smoking at the first visit. To support the dietary change I recommended a multi-nutrient with an emphasis on glucose balancing and antioxidant nutrients. As there was so much to be done with Rita's diet, and finances were an issue, I did not pursue any nutritional screening at this point.


Rita returned about eight weeks later reporting an improvement in energy. She was no longer feeling exhausted, was less tired after work and was feeling more refreshed in the morning. She had lost seven pounds. Her food cravings were largely under control and her vision was improved. She had not had any infections during that period. Her bowels had remained sluggish, her legs were still very heavy and her periods had not returned. She was still chasing the results of her blood test. I recommended that she now withdraw from drinking tea.

At the last review Rita reported even better energy levels. She had successfully given up tea. She had lost a further nine pounds in weight and this had stabilized over the last month. For the first time the heaviness in her legs had eased. She had not experienced her usual winter depression. Her cellulite was far less. She was able to exercise gently at the gym twice a week, improving her social life.

Her blood sugar result from the GP was well within the normal range (very likely a result of all her amazing compliance to the nutrition programme). She was still prone to constipation and indigestion. I introduced digestive support aids in the form of hydrochloric acid and pepsin, digestive enzymes and prebiotics.

The Future

The next step for Rita is to address smoking. She has set 7 January as the day to stop. We will then explore a detoxification programme and intensive hormonal support to address the loss of periods. I hope to keep you updated on Rita's progress.


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About Kate Neil

Kate Neil MSc (Nutritional Medicine) FBANT CNHC is Founding Director of CNELM (Centre for Nutrition Education and Lifestyle Management). CNELM has been teaching degree courses in nutritional science and personalised nutrition validated by Middlesex University, London since 2003. Prior to, Kate directed courses in nutritional therapy for other organizations. Kate’s practice focused on women’s health and in the mid-1990s was one of the first to publish articles and a book on balancing hormones naturally. Kate also supported parents with children within the learning disorder spectrum. She has published many articles and contributed chapters to books for nutrition professionals and is frequently asked for peer review. Kate’s early career was as a nurse and midwife. Kate is a Fellow of BANT, the Royal Society of Medicine and the Royal Society of Arts. She can be reached on Tel: 0118 9798686; 

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