What Age Is Considered Early For Menopause
If you reach menopause before age 40, that is considered premature menopause, says Faubion. This occurs in about 1 to 2 percent of women, she says.
Experiencing menopause at 40 to 45 years of age is called early menopause, and that occurs in about 5 to 7 percent of the population, so its safe to say that at least 7 percent of women are going to go through menopause early or prematurely, says Faubion. Menopause at age 46 or older is considered normal, she says.
From Relief To Feelings Of Devastation And Loss Women Tell Us What It Was Like To Experience Premature Menopauseillustration By Sophie Cunningham
How often does the menopause cross your mind? It’s something far off, in the distant future, to worry about once you’ve finished building your career, your family, and whatever else you’ve got planned, right? For most of us, the menopause will strike at some point roughly between the ages of 47 and 53, but premature menopause affects one per cent of women before the age of 40. And, for the one in a thousand women under 30 who are affected, it can be especially devastating.
Emily is 17 years old and was recently diagnosed as going through an early menopause. As someone who’s always wanted to have children, she says, it’s been heartbreaking. She feels like shes lost a fundamental part of who she is. She says its isolating, there isn’t anyone to talk to about it, because it’s not a common problem, so it’s always this little thing I’m hiding.
Throughout puberty, Emily says she’s always felt different from her friends. ‘I was the last of my friends to get my period. It was something I longed for so I was excited when, in year 9, I started,’ she says. ‘I was irregular for the next 9 months, but my mum reassured me that was normal and then they just stopped. My physical appearance has taken a long time to develop too, so I have very small boobs and no hips.’
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Induced Menopause Following Prophylactic Bilateral Oophorectomy
Approximately 1 in 9 women aged 35â45 years has undergone hysterectomy, with 40 percent undergoing bilateral oophorectomy at the same time, resulting in the abrupt onset of menopause . The practice of prophylactic oophorectomy has increased over time and more than doubled between 1965 and 1990 . Meanwhile, reports now link induced menopause from bilateral oophorectomy with serious health consequences including premature death, cardiovascular and neurologic disease, and osteoporosis, in addition to menopausal symptoms, psychiatric symptoms, and impaired sexual function.
4.2.1. Mortality and cardiovascular disease
The Mayo Clinic Cohort Study of Oophorectomy and Aging involved a population-based sample of 4,780 women and reported increased all-cause mortality in women who underwent prophylactic bilateral oophorectomy before age 45 years . The increased mortality was mainly observed in women who did not take estrogen after the surgery and up until age 45 years . Cardiovascular mortality was also increased in the women who underwent bilateral oophorectomy before age 45 years and did not take estrogen .
In summary, data consistently show an increased risk for cardiovascular disease in women who undergo bilateral oophorectomy inducing premature menopause or early menopause. Estrogen replacement proximate to bilateral oophorectomy appears to be particularly important for reducing premature coronary heart disease and death in this group of women.
4.2.2. Neurologic outcomes
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Menopause When Youre On Birth Control
ThereÃ¢s no test to tell if youÃ¢ve gone through menopause yet or not. The best way to tell is through your period.
YouÃ¢ve most likely gone through menopause if youÃ¢re over 50 years old and havenÃ¢t had a period in more than 1 year, or if youÃ¢re under 50 years old and havenÃ¢t had a period in more than 2 years. But you may not be able to tell if youÃ¢ve reached menopause if youÃ¢re still on birth control.
Hormonal birth control may hide some of the symptoms of menopause, such as an abnormal period, hot flashes, or night sweats. If you take combination pills , even after menopause, you may continue to bleed similarly to how you would on your period. This can make it hard to tell if youÃ¢ve gone through menopause and whether youÃ¢re still able to get pregnant.
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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 its 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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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.
Induced Premature Menopause Or Early Menopause
Induced menopause may result from premenopausal bilateral oophorectomy or from cancer treatments including chemotherapy and radiation. Premature menopause from these causes has increased over time because of the improved success in the treatment of cancer in children, adolescents, and reproductive-age women. Similarly, the practice of prophylactic bilateral oophorectomy at the time of hysterectomy has increased over time . However, evidence for the long-term risks and adverse health outcomes following induced menopause is starting to accumulate.
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Can I Still Get Pregnant After Being Diagnosed With Premature Menopause Early Menopause Or Primary/premature Ovarian Insufficiency
Unless the ovaries have been surgically removed, it can be difficult to diagnose a woman younger than age 45 with menopause as opposed to primary ovarian insufficiency . Women with POI can have intermittent ovulation, which may or may not be accompanied by a menstrual bleed. Other women may be able to get pregnant through in vitro fertilization with egg donation. It is important to work with a fertility specialist to explore options.
Options available to you will vary depending on whether you have interest in having children in the future. In some cases, fertility may be restored and pregnancy could be possible. Assisted reproductive technology , including in vitro fertilization might be considered.
If you do not want to get pregnant while on hormone-replacement therapy, your doctor will talk to you about contraceptive options.
Talk to your healthcare provider about possible causes of premature or early menopause and your questions regarding fertility.
How Can I Treat The Symptoms
There are a bunch of ways.
Lifestyle changes. A healthy diet and regular exercise program will help manage your symptoms and boost your health. This is a great time to finally kick any old, unhealthy habits like smoking or drinking too much alcohol. To help with hot flashes, dress lightly and in layers. Avoid triggers like caffeine and spicy foods. And if you stay sexually active, that may help preserve your vaginal lining.
Prescription medication for hot flashes. If you still have your uterus, your doctor might prescribe treatment with estrogen and progesterone. This is called combination hormone therapy or hormone replacement therapy . It helps with hot flashes and night sweats, and it may help prevent osteoporosis. If you donât have a uterus, you might get estrogen alone.
Hormone therapy isnât for everyone. Donât take it if youve ever had breast cancer, uterine or endometrial cancer, blood clots, liver disease, or a stroke. Also dont take it if you might be pregnant or you have undiagnosed vaginal bleeding.
If you cant or dont want to take hormones, other medications can ease symptoms. They include antidepressants, antiseizure drugs, or blood pressure medications to help with hot flashes and mood swings.
Prescription and OTC medication for vaginal dryness and sleep problems. You can try topical estrogen, lubricants, and non-estrogen prescriptions for dryness and painful sex. OTC or prescription sleep aids can help if you have trouble falling asleep.
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What Are The Effects Of Early Or Premature Menopause
Women who go through menopause early may have or similar to those of regular menopause.
But some women with early or premature menopause may also have:
- Higher risk of serious health problems, such as and , since women will live longer without the health benefits of higher estrogen levels. Talk to your doctor or nurse about steps to lower your risk for these health problems.
- More severe menopause symptoms. Talk to your doctor or nurse about to help with symptoms if they affect your daily life.
- Sadness or over the early loss of fertility or the change in their bodies. Talk to your doctor if you have symptoms of depression, including less energy or a lack of interest in things you once enjoyed that lasts longer than a few weeks. Your doctor or nurse can recommend specialists who can help you deal with your feelings. Your doctor or nurse can also discuss options, such as adoption or donor egg programs, if you want to have children.
Can Early Menopause Be Reversed
Early menopause cant usually be reversed, but treatment can help delay or reduce the symptoms of menopause.
Researchers are investigating new ways to help women who are in menopause to have children. In 2016, scientists in Greece announced a new treatment that enabled them to restore menstruation and retrieve eggs from a small group of women who were in perimenopause.
This treatment made headlines as a way to reverse menopause, but little is known about how well it works.
The scientists reported treating more than 30 women, ages 46 to 49, by injecting platelet-rich plasma into their ovaries. PRP is sometimes used to promote tissue healing, but the treatment hasnt been proven to be effective for any purpose.
The scientists claimed the treatment worked for two-thirds of the women treated. However, the research has been criticized for its small size and lack of control groups. Though the research might have potential for the future, its not a realistic treatment option right now.
HT comes in several forms:
- Oral tablets or pills
- Vaginal ring
- Topical gel or spray
HT pills and skin patches are considered âsystemicâ therapy because the medication delivered affects the entire body. The risk for blood clots, heart attacks, and certain types of cancers is higher with hormone pills than with skin patches or other transdermal forms.
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The Complete List Of 35 Symptoms Of Menopause
Some symptoms ofmenopause can occur years before a woman experiences her last period, whileothers can last for years afterwards as well. Since hormones vary from onewoman to another, menopause affects all women differently. Some may experiencevery few symptoms while others could experience most of them. Symptoms can alsovary in frequency and severity.
So, what are these symptoms that signal menopause is upon you? Lets talk about all the 35 symptoms of menopause to look out for.
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I Went Into Menopause In My 30s
My boyfriend and I had been living together for about four years. I had wanted to have a child for my entire life, but he was really on the fence. Somewhere along the way I started mirroring him, and telling my friends, Im not really sure if I want to have a kid . But when I hit 38, I got back in touch with what I really wanted: to have a child.
I started going to a new gynecologist who was pretty casual about my chances: You are older but youre very healthy, she said. Start taking these vitamins and lets see. Id gone on the pill when I was 17 and stayed on it for 22 years without any breaks, until the spring of 2012. But about a month after I stopped the pill, I started getting terrible hot flashes and nausea. I felt terrible.
Meanwhile, my boyfriend, whos an actor, decided he was going to do a play on the West Coast over the summer. He left, and I stayed in New York, going through what I would imagine withdrawal is like: sweaty, nauseous, unwell, feeling like I needed to lay down. It happened every day, and it could last five minutes or it could last all afternoon.
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How Does Ovulation Work
Before we begin to understand ovarian failure we need to understand ovulation. In brief, a female is born with about 2 million ovarian follicles. As she gets older and reaches puberty she will only have about 300,000-400,000 left. The body does not make any more. These follicles are very important because they mature to be eggs that will be released during ovulation. Now, 300,000 may sound like a lot, but not every follicle becomes a mature egg.
When your menstrual cycle begins, your estradiol levels are low. Your hypothalamus sends out a message to your pituitary gland which then sends out a follicle-stimulating hormone .
This FSH triggers a few of your follicles to develop into mature eggs. Remember only one follicle will be the lucky one to become a mature egg. As the follicles mature they send out another hormone, estrogen. Estrogen sends a message to the hypothalamus to stop producing FSH. If the follicles do not mature and produce estrogen to stop the production of FSH, FSH will continue to produce and rise to high levels.
This is why women with POF are checked for high levels of FSH. Once the levels of estrogen are high enough, the hypothalamus and pituitary gland know that there is a mature egg. A luteinizing hormone is then released this is referred to as your LH surge.
What Are Premature Menopause Early Menopause And Primary Ovarian Insufficiency
Premature menopause and early menopause are conditions where a woman goes through menopause at an earlier age than is typically expected. Both conditions can result in women being unable to become pregnant. If there is no obvious medical or surgical cause for the premature menopause, this is called primary ovarian insufficiency . Primary ovarian insufficiency is also referred to as premature ovarian insufficiency.
The name premature ovarian failure is no longer used because women who are told they have early menopause can have intermittent ovulation, menstrual bleeding or even pregnancy after being told they have ovarian failure.
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Other Drugs Used For Menopausal Symptoms
Despite its risks, hormone therapy appears to be the most effective treatment for hot flashes. There are, however, nonhormonal treatments for hot flashes and other menopausal symptoms.
The antidepressants known as selective serotonin-reuptake inhibitors are sometimes used for managing mood changes and hot flashes. A low-dose formulation of paroxetine is approved to treat moderate-to-severe hot flashes associated with menopause. Other SSRIs and similar antidepressant medicines are used “off-label” and may have some benefit too. They include fluoxetine , sertraline , venlafaxine , desvenlafaxine , paroxetine , and escitalopram .
Several small studies have suggested that gabapentin , a drug used for seizures and nerve pain, may relieve hot flashes. This drug is sometimes prescribed “off-label” for treating hot flash symptoms. However, in 2013 the FDA decided against approving gabapentin for this indication because the drug demonstrated only modest benefit. Gabapentin may cause:
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
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Treatments For Early Menopause
A GP will probably recommend you take this treatment until at least the age of natural menopause , to give you some protection from osteoporosis and other conditions that can develop after the menopause.
If you have had certain types of cancer, such as certain types of breast cancer, you may not be able to have hormonal treatment.
The GP will talk to you about other treatment options and lifestyle changes you can make to help protect your health.
If you’re still getting symptoms, the GP can refer you to a specialist menopause centre.
Going through the menopause early can be difficult and upsetting.
Permanent early menopause will affect your ability to have children naturally.
You may still be able to have children by using IVF and donated eggs from another woman, or using your own eggs if you had some stored. Surrogacy and adoption may also be options for you.
Counselling and support groups may be helpful.
Here are some you may want to try:
Page last reviewed: 02 February 2021 Next review due: 02 February 2024