What Other Factors Influence When Perimenopause Starts Or When A Woman Reaches Menopause
New research published online on April 12 in Menopause, the journal of NAMS, looked at the various factors that may affect the age when natural menopause occurs.
They found that there are factors that do seem predictive of when a woman will approach menopause, such as higher and follicle-stimulating hormone levels, which weve known for a while,” says Streicher. Irregular menstrual bleeding and hot flashes were also indicators of earlier menopause, she adds.
One new finding uncovered in the research was around alcohol consumption. The authors observed that participants tended to increase their alcohol consumption when approaching menopause, making it a potential clue that the change was coming.
That makes sense, says Streicher. This can be a time of added stress for women, and we know that any can cause someone to drink more, she says.
Although this study didnt find a strong association with smoking, other research has indicated that smoking is related to early onset of menopause, says Streicher.
What Can I Do To Help With Lack Of Sex Drive
Lack of libido or sex drive can be due to many factors but in women with endometriosis it can relate to pain during intercourse or an induced menopause causing lack of the male hormone testosterone which plays an important role in the sex drive. Vaginal estrogen treatment can help vaginal dryness and pain and can be used along with lubricants during sex. An HRT called Tibolone can also be helpful as it has some androgen in it along with estrogen and progesterone and may help with women with a reduced sex drive. In some cases, your doctor may suggest using a small amount of testosterone gel alongside your continuous combined HRT to increase libido. This may take several months to take effect.
Symptoms Of The Menopause
Most women will experience menopausal symptoms. Some of these can be quite severe and have a significant impact on your everyday activities.
Common symptoms include:
- reduced sex drive
- problems with memory and concentration
Menopausal symptoms can begin months or even years before your periods stop and last around 4 years after your last period, although some women experience them for much longer.
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Coping With Premature Menopause
For young women, the sudden onset of menopause symptoms — loss of the menstrual cycle and onset of hot flashes — is very difficult to accept, says Melissa A. McNeil, MD, MPH, chief of Women’s Health at the University of Pittsburgh School of Medicine.
“When hot flashes happen at 50, you expect it, you know it’s part of the deal,” she tells WebMD. “If you have them at 35, it’s demoralizing — especially if you still have children on the agenda. To find out unexpectedly that is no longer an option is extremely difficult.”
Mood changes and insomnia triggered by premature menopause can be especially challenging for younger women, she adds.
“If you have a 5-year-old at home — and you’re not sleeping, you’re having mood swings — it can be very difficult. We call them ‘dueling hormones.’ If your hormones are raging as much as your children’s are, it adds to family stress.”
Diagnosis Of Primary Ovarian Insufficiency
If you have irregular periods or have stopped your periods for more than three months, please see your doctor and make sure your doctor includes hormone tests to exclude early menopause.
Your doctor will need to do a full physical examination and investigate the cause of your symptoms.
The criteria for a diagnosis of POI are:
- at least three months without a period
- two blood tests to confirm whether the levels of follicle-stimulating hormone are more than 40IU/l the two tests need to be performed on the third day of your period and at least one month apart.
A doctor is likely to perform the following tests:
- pregnancy test, FSH and Oestradiol
- prolactin this is the hormone usually involved with breastfeeding, but when raised, it causes periods to stop
- transvaginal ultrasound this is an internal ultrasound of the vagina and uterus to check for evidence the ovary is functioning by:
- counting the number and size of the follicles or eggs in the ovary
- measuring the volume of the ovaries
- assessing the thickness of the lining of the uterus or endometrium
- checking for any blockage that is stopping menstrual blood flow.
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Is There A Risk Of Reactivated Endometriosis Transforming Into Cancer
Reactivation of endometriosis by HRT is very rare and it is impossible to say how likely it is for endometriosis to turn into cancer. However, there have been a few reported cases of it occurring. This means that while on HRT, if you develop new symptoms or old symptoms start to recur, it is important to discuss this with your healthcare professional who can start any investigations that are needed. From all the evidence it seems that there is very little risk of reactivation of endometriosis or cancer for women on HRT who have had a removal of both of their ovaries and all of their endometriosis removed. For women with some endometriosis who are under 45 or who have significant menopause symptoms the evidence suggests that the benefit of taking HRT to manage the menopause symptoms outweighs the small risk of worsening of the endometriosis or risk of cancer.
What Can My Health Professional Do To Help With These Symptoms
HRT is very effective at reducing menopause symptoms so starting HRT is the first thing your medical professional will offer to do. Its not clear from research when is the best time to start HRT for women with induced menopause. There can be a concern about the hormones keeping some areas of endometriosis active so sometimes it is not started for 3 to 6 months after induced menopause. However, if started immediately it can prevent bone loss and reduce menopause symptoms. This will be discussed with you.
The best HRT for women under the age of natural menopause with endometriosis contains at least two hormones, estrogen and progesterone, and is given continuously with no breaks. This can be given as tablets, patches or gel and sometimes alongside a hormone containing coil depending on what you would like and your situation. This combined HRT should be given for at least the first few years after removal of the ovaries but may be changed to oestrogen-only HRT later as it may have a better safety profile for women over the age of natural menopause. Ideally HRT should be continued until at least the age of 51 for all women in induced menopause.
For women with vaginal symptoms, vaginal estrogen tablets or cream are very effective and are safe to use alone or in combination with standard HRT in women with endometriosis. If your health professional is struggling to manage your situation they can refer you to a menopause specialist in your area to help you.
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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.
Are There Other Health Issues That Affect Women In Premature Menopause
Like all menopausal women, women in premature menopause experience lowered estrogen levels as the ovaries stop most of their production of this hormone. Low levels of estrogen can lead to changes in women’s overall health and may increase their risk for certain medical conditions, such as osteoporosis. Other health risks associated with the loss of estrogen include increased risk for colon and ovarian cancer, periodontal disease, tooth loss, and cataract formation.
However, compared with women who go through natural menopause, women undergoing premature menopause spend a greater portion of their lives without the protective benefits of their own estrogen. This puts them at an even greater risk for the above mentioned menopause-related health problems.
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Hot Flashes And Night Sweats
Estrogen deficiency throws off how the brain regulates body temperature, and this may lead to hot flashes. A hot flash is a sudden, intense feeling of heat or burning in the face, neck, and chest, often accompanied by redness.
A night sweat refers to a hot flash that occurs during sleep. Night sweats can negatively impact your sleep cycle, which may lead to tiredness during the day.
Do You Need To Take Calcium Supplements For Menopause
Menopause cannot be prevented however, steps can be taken to help reduce the risk factors for other problems associated with menopause. It is recommended that postmenopausal women consume 1,200 to 1,500 mg of elemental calcium and 800 IU of vitamin D daily.
The least expensive way to obtain calcium is through diet. Diet can easily provide 1,000-1,500 mg of calcium daily. The following foods contain calcium:
- One cup of milk — 300 mg
- One cup of calcium-fortified orange juice — 300 mg
- One cup of yogurt — about 400 mg on average
- One ounce of cheddar cheese — about 200 mg
- Three ounces of salmon — 205 mg
Dietary calcium supplements are a good option for women who cannot consume adequate calcium through diet. Calcium carbonate is the least expensive, although some women complain of bloating. Calcium citrate may be better absorbed by women who take acid-blocking medications, such as ranitidine or cimetidine .
Calcium products made from bone meal, dolomite, or unrefined oyster shells may contain lead and should be avoided. Products with “USP” on the label meet the voluntary quality standards set by the United States Pharmacopeia and are more likely not to contain harmful contaminants.
Women should carefully read the label of calcium supplements to check the exact number of milligrams of elemental calcium in each supplement. The intestinal tract generally does not absorb more than 500 mg of elemental calcium at a time, so calcium intake should be spread out during the day.
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Women’s Health Topics We Need To Talk About In 2020
Mood problems like depression can spike during perimenopause, especially among women who have previously experienced them. Many of our listeners wrote in to say that during perimenopause, they felt incredibly irritable and quick to anger in a way that they had never experienced before.
And of course, many â but not all â women experience hot flashes, though they may not recognize them. “It’s hard, because no one sits us down and teaches us, ‘Here’s what a hot flash feels like,’ ” Stuenkel says. “I’ve seen women who think they’re having panic attacks, or heart palpitations. That can be frightening.”
Other common symptoms include more frequent urinary tract infections, difficulty sleeping through the night, vaginal dryness that can make sex painful, night sweats and a decrease in libido.
What treatments are there for symptoms?
Some symptoms, like heavy or irregular periods, can be managed with an oral contraceptive, which can “shut down the body’s own erratic hormonal fluctuations,” says Stuenkel.
“This can kind of be a lifesaver,” she says. Such medication may help with hot flashes, too.
When Does Menopause Occur
The timing of actual menopause is different for each person. The average age for a person to have their last period is about 51. But its normal for menopause to occur any time from age 40 to 59. A person often goes through menopause at about the same age as their mother.
You may stop having periods early . If so, your doctor can do a blood test to see if youre actually going through menopause. If youre not, the doctor will look for another cause for your missed periods.
Menopause is a gradual process that can take several years. Youre not really through menopause until you havent had a period for 12 months.
People who have both ovaries removed during surgery will go through surgical menopause at the time of their surgery. If the uterus is taken out but the ovaries are not, a person will stop having periods, but they will not go through surgical menopause.
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What Else Affects When A Woman Will Finally Stop Having Menstrual Periods
Researchers continue to explore a number of factors that may influence the timing of menopause.
The level of education a woman has completed is one thing that seems to correlate with menopause timing, says Faubion. Women who have more education tend to go through menopause later, she says.
A study published in January 2020 in JAMA Network Open found that pregnancy and breastfeeding may reduce the risk of early menopause.
How frequently a woman has sex has also been correlated with early menopause. A study published in January 2020 in Royal Society Open Science found that women who had sex at least once a week were less likely to go through menopause compared with women who had sex less than once a month.
On Average Menopause Begins Around Age 52
Kathi Valeii is a freelance writer covering the intersections of health, parenting, and social justice.
Menopause occurs after a person stops having their period for 12 consecutive months. It naturally happens for many people when they are between the ages of 40 and 58. In the United States, the average age for menopause to start is 52 years.
Certain factors, like never having children and smoking, can make it more likely that menopause will occur earlier.
Before menopause, declining estrogen levels can cause people who menstruate to experience premenopausal symptoms. Menstrual changes, hot flashes, vaginal dryness, sleep problems, and other symptoms are the result of hormonal shifts that are taking place during this time, which is called perimenopause.
Perimenopause can last from two to eight years. On average, people experience perimenopause for four years before menopause begins.
While many people go through menopause in their early fifties, there are a number of unique factors that determine at what age a person will start menopause, as well as what their experience will be like.
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What Conditions Can Cause Early Menopause
Certain medical and surgical conditions can influence the timing of menopause.
Surgical removal of the ovaries
The surgical removal of the ovaries in an ovulating woman will result in an immediate menopause, sometimes termed a surgical menopause, or induced menopause. In this case, there is no perimenopause, and after surgery, a woman will generally experience the signs and symptoms of menopause. In cases of surgical menopause, women often report that the abrupt onset of menopausal symptoms results in particularly severe symptoms, but this is not always the case.
The ovaries are often removed together with the removal of the uterus . If a hysterectomy is performed without removal of both ovaries in a woman who has not yet reached menopause, the remaining ovary or ovaries are still capable of normal hormone production. While a woman cannot menstruate after the uterus is removed by a hysterectomy, the ovaries themselves can continue to produce hormones up until the normal time when menopause would naturally occur. At this time, a woman could experience the other symptoms of menopause such as hot flashes and mood swings. These symptoms would then not be associated with the cessation of menstruation. Another possibility is that premature ovarian failure will occur earlier than the expected time of menopause, as early as one to two years following the hysterectomy. If this happens, a woman may or may not experience symptoms of menopause.
Cancer chemotherapy and radiation therapy
Vaginal Dryness And Discomfort
Vaginal dryness, itching, and discomfort may start during perimenopause and continue into menopause. A person with any of these symptoms may experience chafing and discomfort during vaginal sex. Also, if the skin breaks, this can increase the risk of infection.
Various moisturizers, lubricants, and medications can relieve vaginal dryness and associated issues.
Learn more about atrophic vaginitis here.
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What’s The First Sign Of Perimenopause
The first perimenopause sign is typically a disruption of your menstrual cycle. For many women, your period starts earlier or later than normal. For example, if your menstrual cycle has always been 28 days, during perimenopause, your period could come as early as 21 or as late as 35 days. Some women start skipping months entirely and then experience heavier-than-normal periods when they do have them.
What Are The Effects Of Early Or Premature Menopause
But some women with early or premature menopause may also have:
- Higher risk of serious health problems, such as heart disease and osteoporosis, 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 treatments to help with symptoms if they affect your daily life.
- Sadness or depression 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.
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