Getting Support For Early Menopause
Going through the menopause early can be difficult and upsetting.
Permanent early menopause affects your ability to have children.
You may need fertility treatment using donated eggs. You can use your own eggs if you had some stored.
Surrogacy and adoption may also be options for you.
Counselling and support groups may be helpful:
- The Daisy Network a support group for premature ovarian failure
- Cancer.ie provides information about menopausal symptoms after cancer treatment
Content supplied by the NHS and adapted for Ireland by the HSE
Page last reviewed: 8 July 2021 Next review due: 8 July 2024
Psychological Wellbeing & Emotions
The diagnosis of a premature or early menopause can bring many changes and challenges: when menopause does not come at the age and stage of life you expected it to, it can have a major impact on your wellbeing. Women who experience premature or early menopause can be at greater risk of depression, anxiety and mood changes.
It can be very upsetting for some women to experience menopause in their 20s or 30s when they expected it to happen in their late 40s or 50s. Often this is a time of feelings of loss, sadness and grief. These feelings are very common, along with the feelings of losing your body image, fertility, femininity and sexuality, and feeling old before your time.
It can take some time to diagnose a premature or early menopause. Not knowing what is wrong, having no control over symptoms and not knowing what the future holds can be frightening. Some women with early menopause talk of ‘loss of womanhood’ and ‘loss of dreams’.
Associated illnesses, such as cancer and chemotherapy or surgery to remove ovaries, may also alter the course of your life. Plans, dreams and expectations must be re-thought and that can be very challenging and distressing.
During this time, women can experience a sense of loss of control, loss of ability to plan and loss of self-image, but often there is no one with whom to share the grief. Girlfriends might not understand because they are not yet experiencing menopause, and, for some, mothers haven’t yet reached menopause either.
Be Honest With Your Friends And Family About What You Are Experiencing
As a society, we have to talk more openly and honestly about menopause at home, work, in popular and high culture, online and in the news media. We have to know what to expect, writes journalist and author Gabrielle Jackson in her book Pain And Prejudice, which deals with cultures’ attitudes to women, their bodies and female pain. To echo Jackson: Now seems like a good time to give menopause a makeover.
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Emotional Impact Of Early Or Premature Menopause
Premature menopause can be emotionally devastating. Some of the common issues women may face include:
- grief at the prospect of not having children
- fear of ‘growing old before their time’
- concern that their partner wont find them sexually attractive anymore
- self-esteem problems.
Psychological counselling and support groups may help women come to terms with their experience of early or premature menopause.
As Menopause Nears Be Aware It Can Trigger Depression And Anxiety Too
“Technically, menopause is only one day in a woman’s life, which is exactly when she has not had a period for 12 months,” she says. “It’s the period of time leading up to menopause that causes all the trouble.”
And it can start earlier than you might think. Many listeners wrote to us in response to our call-out for individual experiences with menopause to say that they struggled to get medical support for perimenopause in their mid-30s and early 40s.
When Edrie went back to her OB/GYN with the fertility clinic’s conclusion, she says the doctor shrugged again and told her that menopause is a normal part of life. She wasn’t satisfied with that answer. “Yeah, it’s a normal part of life, but it would be great if we could talk about it and figure out strategies.”
With that spirit in mind, we reached out to endocrinologists, gynecologists and psychiatrists for advice about navigating this major life transition.
How early can perimenopause start?
It’s quite possible for women to start to notice things changing in their mid-30s. Most women arrive at menopause between the ages of 45 and 55, but perimenopause can start as much as a decade beforehand. And about 1% of women in the U.S. reach menopause at age 40 or younger.
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Treatment For Early Or Premature Menopause
There is no treatment available to make the ovaries start working again.
Rarely, the ovaries may spontaneously start working again, for reasons unknown. According to some studies, about one in 10 women who are diagnosed with premature ovarian insufficiency get pregnant, for reasons that are not yet clear.
Women with early menopause have a long period of postmenopausal life, which means they are at increased risk of health problems such as early onset of osteoporosis and heart disease. For this reason, it is recommended that they take some form of hormone therapy until they reach the typical age of menopause . This may be the combined oestrogen and progestogen oral contraceptive pill, or menopausal hormone therapy .
Either option treats menopausal symptoms and reduces the risk of early onset of osteoporosis and heart disease.
Predicting Natural Menopause: Why Does Age Matter
If theres not a lot that women can do to change when theyll experience menopause, why does predicting it even matter?
It would be helpful for every woman to know exactly when menopause will arrive. Beyond recognizing and addressing issues such as increased cardiovascular disease risk and risks related to bone health, if a woman knows her age of menopause and how long the perimenopause transition will last, it could help her make important health decisions, says Faubion.
If youre bleeding like crazy it would be helpful to know, she says.
As of now, research hasnt uncovered a way to determine when a women will go into menopause, but having that information could be useful in making decisions such as whether to have a hysterectomy or other invasive procedures, says Faubion. If menopause is going to be a few months or a year from now, you may choose to wait it out if it’s going to be five years from now, you might want to go ahead and have an invasive procedure, she says.
The ability to predict when menopause will occur could also help with managing menopause symptoms or deciding which type of birth control to use, adds Faubion.
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When To See A Gp
It’s worth talking to a GP if you have menopausal symptoms that are troubling you or if you’re experiencing symptoms of the menopause before 45 years of age.
They can usually confirm whether you’re menopausal based on your symptoms, but a blood test to measure your hormone levels may be carried out if you’re under 45.
Trapped In A Never Ending Menopause: For Some Women The Misery Of ‘the Change’ Can Last For Two Decades
- Penny Jaquet began the menopause at 42
- Her hot flushes were preceded by terrifying panic attacks
- She still suffers more than a decade later
- Jackie Hogarty also went through the change at 42
- She had mood swings and felt hot all the time
- Lesley Tanner had symptoms for 13 years
- Experts says more needs to be done to help women
- Many will suffer in silence
18:03 EDT, 13 November 2013 | Updated:
Distress: Penny Jaquet has been battling symptoms for 18 years
When Penny Jaquet began the menopause at 42, her hot flushes were preceded by terrifying panic attacks. Several times a day, she would suddenly feel flustered and distressed as she struggled to catch her breath and her heart pounded.
For a few awful moments, shed lose track of where she was and what she was doing, before the flush kicked in, turning her scarlet and leaving her dripping with sweat.
The symptoms seemed to abate three years ago. But then, to her horror, they began again. Penny is 60, and an astonishing 18 years after her menopause started, she’s still suffering from hot flushes.
Once or twice a week, the jewellery designer from Cheltenham finds her entire body burning.
‘I can’t believe the hot flushes have come back,’ she says. ‘My menopause went on for 15 years and drove me to despair, which manifested itself in panic attacks. I’ve given up hoping it’ll ever end.’
Hot flushes are caused by hormonal changes that disturb the hypothalamus, a part of the brain known as the body’s thermostat.
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What Is The Outlook For Women With Premature Ovarian Insufficiency
Around 1 in 10 women with POI which occurs without a known reason become pregnant. This is because their ovaries start working again.
IVF with egg donation is usually undertaken for those women who are keen to become pregnant. Your doctor will be able to describe this to you in more detail.
With hormone treatment, the risk of both ‘thinning’ of the bones and heart disease reduces. Taking the correct dose and type of hormone treatment will also improve any symptoms you may be experiencing.
What Is Premature & Early Menopause
‘Premature menopause’ is when the final menstrual period occurs before a woman is 40. ‘Early menopause’ is when the final menstrual period occurs between 40 and 45 years. Up to 8% of women have had their final period by the time they are 45. The number of women reaching menopause by this time may be increased in relation to treatment after cancer, or removal of the ovaries.
This may happen because:
- periods stop spontaneously due to primary ovarian insufficiency this affects up to 1% of women
- menopause is induced by a secondary cause such as:
- surgery when ovaries are removed surgically
- chemotherapy or radiotherapy treatment for cancer.
This video explains the causes of and treatments for premature and early menopause.
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What Hormones Are Affected By Pcos And Menopause
Women with PCOS usually have higher levels of male hormones, including testosterone. PCOS also makes your body less responsive to insulin. That causes high blood sugar levels. High blood sugar levels can further increase male hormones, making your symptoms of PCOS worse.
Women with PCOS may also have low levels of the female hormone progesterone. Progesterone helps regulate menstruation and maintain a pregnancy.
Years before menopause begins, you naturally start to produce less estrogen and progesterone. The drop in female hormones eventually causes you to stop ovulating. Youve reached menopause when you havent had a menstrual period in a year.
PCOS and menopause both affect the levels of progesterone in your blood, but they affect your hormones in different ways. Thats why menopause doesnt treat or cure PCOS.
An Early First Menstrual Period May Lead To Premature Menopause
How do you know if you’re starting perimenopause?
The most telling symptom is changes in your menstrual cycle, says psychiatrist Hadine Joffe, the executive director of the Connors Center for Women’s Health and Gender Biology at the Brigham and Women’s Hospital in Boston.
“It’s the menstrual cycle pattern that really defines this lead-up to menopause,” she says. During perimenopause, periods “might be shorter, then a long one, or then a skipped one, or then the flow might be different,” says Joffe.
There’s no blood or hormone test that can “diagnose” perimenopause. Joffe says a hormone test isn’t helpful because hormonal cycles become erratic and unpredictable during this stage.
“There’s not really one point in time when a hormone test is done that can be definitive,” she says. Even if you took several tests over time, “you might get a very different readout.”
Surprisingly, sometimes doctors aren’t prepared to help women recognize the start of this life phase. Edrie was upset at her doctors’ responses â or lack thereof. “I felt so disappointed in the medical industry. How many women has my OB/GYN seen and not recognized the symptoms of perimenopause?”
What symptoms to expect
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Spontaneous Premature Ovarian Failure Or Early Menopause
Premature ovarian failure , also now referred to as primary ovarian insufficiency or primary ovarian dysfunction , is a syndrome of amenorrhea, low sex steroid levels, and elevated gonadotropin levels among women younger than age 40 years. POF is most frequently idiopathic but may also be due to autoimmune disorders, genetic causes, infections or inflammatory conditions, enzyme deficiencies, or metabolic syndromes . POF is reported to affect approximately 1% of women under age 40 years and spontaneous early menopause is reported to affect approximately 5% of women between ages 40 and 45 years .
POF has been found to be associated with intermittent ovarian function in nearly half of the women affected . While spontaneous or induced return of ovarian function is possible, most women with POF experience sustained sex steroid deficiency for longer periods compared with women who experienced spontaneous menopause around the median age. Thus, POF and other causes of premature spontaneous menopause are generally classified together when evaluating long-term health outcomes.
What Are The Symptoms Of Premature Menopause
Symptoms of premature menopause are often the same as those experienced by women undergoing natural menopause and may include:
- Irregular or missed periods
- Periods that are heavier or lighter than usual
- Hot flashes
These symptoms are a sign that the ovaries are producing less estrogen.
Along with the above symptoms, some women may experience:
- 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
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How Is Premature Menopause Treated
The symptoms and health risks of premature menopause, as well as the emotional issues that may result from it, can be managed with the methods similar to those used for natural menopause. Women dealing with infertility that is brought on by premature menopause may want to discuss their options with their doctor or with a reproductive specialist.
Second Puberty In Your 20s
Your 20s can be a significant time. People in their 20s are often trying to navigate through their personal and social lives. Thats why its easy to overlook the physical changes the body is going through. Sometimes, these changes are called a second puberty.
Some of these changes may include things like:
- Psychological and emotional changes Many people at this age start to live an independent life and might experience new challenges in their social and personal spheres. The adjustment period can take some time, and some symptoms of anxiety or depression may appear as a natural reaction to this new phase of life.
- Bone mass and muscle strength peak Changes in bone mass and muscle strength can appear in your 20s. Bone mass and strength tend to reach their maximum at this age.
- Weight Some people notice changes in their weight in their 20s. You can consult with a health care provider to determine a healthy weight range for you.
- Stretch marks Some people in their 20s notice lines and stretch marks, which is a natural part of growth. Make sure to drink plenty of water for the elasticity and health of your skin.
- Acne Some people notice that they have more acne than usual. The American Academy of Dermatology found that 45 percent of females between the ages of 21 and 26 experience adult acne. This happens due to changes in hormones, stress, smoking, alcohol use and/or poor eating habits. This can also occur as a result of medications such as hormonal birth control.
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What Are The Potential Health Concerns Of Premature Menopause
Premature menopause poses some health risks. Its a good idea to talk with a healthcare professional about these risks so that you can take steps to protect your physical and emotional health going forward. Here are some potential health issues that can arise:
- Heart disease. Lower estrogen levels can cause changes in your blood vessels and your heart, possibly leading to a higher risk of heart problems.
- Anxiety, depression, and other mood changes. Hormone changes can also cause some significant emotional shifts. Anxiety, depression, and lower self-esteem are not uncommon.
- Eye conditions. Around 79 percent of menopausal women in a
Induced Menopause Following Cancer Therapy
Ovarian damage from cancer therapy depends on the age at treatment and on the type of treatment. Women younger than age 40 years and children are at lower risk for ovarian failure than older women however, exposure to higher doses of alkylating agents and higher doses of radiation to the ovary are more likely to induce ovarian failure . Based on the Childhood Cancer Survivor Study , a cohort study of survivors of childhood cancer treated at 25 cancer centers throughout North America between 1970 and 1986, approximately 6% of childhood cancer survivors experienced acute ovarian failure during cancer treatment or shortly after completing cancer treatment . Another 8% retained ovarian function during treatment but later developed premature menopause . This is believed to be an underestimate of the true population incidence of premature menopause because the median age attained in this group at the time of analysis was only 29 years .
Follow-up of childhood cancer survivors has identified an increase in miscarriages, an increase in small for gestational age offspring, and a reduction in live births . Longer term health outcomes, beyond cancer free survival, are not yet available however, these subjects are expected to be at increased risk for osteoporosis, cardiovascular disease, psychosexual dysfunction, and decreased quality of life .
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