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 estradiol 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 stressful situation 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.
Causes Of Early Menopause
Early menopause can happen if your ovaries stop making enough hormones, particularly oestrogen.
This is sometimes called premature ovarian failure or primary ovarian insufficiency.
The cause is often unknown, but can include:
- chromosome abnormalities, such as Turner syndrome
- autoimmune diseases, where the immune system starts attacking body tissues
- certain infections, such as tuberculosis, malaria and mumps in rare cases
Premature ovarian failure can sometimes run in families. This may be the case if a relative went through the menopause in their 20s or 30s.
General Recommendations For Ht
Current guidelines support the use of HT for the treatment of severe hot flashes that do not respond to non-hormonal therapies. General recommendations include:
- HT may be started in women who have recently entered menopause.
- HT should not be used in women who have started menopause many years ago.
- Women should not take HT if they have risks for stroke, heart disease, blood clots, and breast cancer.
- Currently, there is no consensus on how long HT should be used or at what age it should be discontinued. Treatment should be individualized for a woman’s specific health profile.
- HT should be used only for menopause symptom management, not for chronic disease prevention.
Before starting HT, your doctor should give you a comprehensive physical exam and take your medical history to evaluate your risks for:
- Heart disease
- Breast cancer
While taking HT, you should have regular mammograms and pelvic exams and Pap smears. Current guidelines recommend that if HT is needed, it should be initiated around the time of menopause. Studies indicate that the risk of serious side effects is lower for women who use HT while in their 50s. Women who start HT past the age of 60 appear to have a higher risk for side effects such as heart attack, stroke, blood clots, or breast cancer. HT should be used with care in this age group.
Women who should not take hormone therapy include those with the following conditions:
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Removal Of The Ovaries
If you have surgery to remove your ovaries , you will experience menopause immediately because the organs that produce hormones and release eggs are no longer present.
Menopause that occurs from the absence of ovaries is known as surgical menopause.
Conditions like endometriosis, tumors, and cancer may require a person to have their ovaries removed.
People who have an oophorectomy will experience typical menopause symptoms however, rather than having them come on gradually as they would with natural menopause, they will experience them all at once, which can be intense.
Hormone replacement therapies can be used to treat menopause symptoms. However, hormone therapy is not recommended for people being treated for breast cancer, as it may increase the risk of recurrence.
What Affects The Age You Start Menopause
Certain factors may affect when you begin menopause. Your family history, medical conditions, and hormones all play a role in when menopause is likely to occur for you.
Smoking may influence the age of menopause onset. Studies have found that smoking during the reproductive years was significantly associated with earlier menopause.
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Early And Premature Menopause
Menopause before the age of 45 is called early menopause. Menopause before the age of 40 is called premature menopause.
A spontaneous early menopause affects approximately 5% of the population before the age of 45.
Premature menopause, or premature ovarian insufficiency , is defined as being menopause that happens before the age of 40.
Premature menopause is estimated to affect 1% of women under the age of 40 years and 0.1% of women under the age of 30 years.
Premature menopause is different to menopause which occurs at around the average age , as premature menopause means that the ovaries arent working properly. They stop producing eggs years before they normally would.
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.
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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
Facts You Should Know About Menopause
- Menopause is defined as the absence of menstrual periods for 12 months. It is the time in a woman’s life when the function of the ovaries ceases.
- The process of menopause does not occur overnight, but rather is a gradual process. This so-called perimenopausal transition period is a different experience for each woman.
- The average age of menopause is 51 years old, but menopause may occur as early as the 30s or as late as the 60s. There is no reliable lab test to predict when a woman will experience menopause.
- The age at which a woman starts having menstrual periods is not related to the age of menopause onset.
- Symptoms of menopause can include abnormal vaginal bleeding, hot flashes, vaginal and urinary symptoms, and mood changes.
- Complications that women may develop after menopause include osteoporosis and heart disease.
- Treatments for menopause are customized for each woman.
- Treatments are directed toward alleviating uncomfortable or distressing symptoms.
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Symptoms Of Premature And Early Menopause
The symptoms of early menopause are the same as for menopause at the typical age and can include:
- menstrual cycle changes, including changes to the usual bleeding pattern, particularly irregular bleeding
- hot flushes
Easing The Transition To Menopause
A genetic test may one day determine a persons likelihood of early menopause. For now, though, only time will tell when youll start your transition.
See your doctor for regular checkups, and be proactive about your reproductive health. Doing so can help your doctor ease the symptoms or decrease your risk factors for early menopause.
Seeing a therapist can also help you cope with any pain or anxiety you may feel during menopause.
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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.
What Is The Difference Between Premature Menopause And Early Menopause
The difference between premature menopause and early menopause is when it happens. Premature menopause occurs before a woman is 40. Early menopause is when a woman undergoes menopause before age 45.
Many of the causes of premature menopause can also be causes of early menopause. The two types of menopause also share many of the same symptoms.
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Risk Factors For Early Menopause
Premature ovarian failure affects about 1 out of every 1000 women from ages 15 to 29 and about 1 out of every 100 women aged 30 to 39. It can be related to genetic factors, to illnesses like autoimmune diseases, thyroid disease, viral infection, hormonal disorders, and eating disorders. The risk of premature ovarian failure risk increases in women who have relatives with the condition.
What Are Menopause Symptoms And Signs
It is important to remember that each woman’s experience is highly individual. Some women may experience few or no symptoms of menopause, while others experience multiple physical and psychological symptoms. The extent and severity of symptoms varies significantly among women. It is also important to remember that symptoms may come and go over an extended period for some women. This, too, is highly individual. These symptoms of menopause and perimenopause are discussed in detail below.
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What Are The Symptoms Of Early Menopause
Symptoms of early menopause are similar to those of normal menopause:
- Changes to your menstrual cycle monthly periods become less frequent and stop.
- Hot flushes or night sweats a sudden feeling of heat in the neck and chest with changes to your heart rate.
- Problems sleeping and/or lower energy levels and tiredness.
- Pain in your muscles or joints.
- Vaginal and urinary symptoms as the vaginal lining becomes thinner and dryer, you may experience discomfort during sex and/or need to urinate more often.
- Mood changes you may feel anxious, upset, sad or angry in more situations.
When early menopause is due to surgery or cancer treatment, these symptoms may be more intense than normal menopause, and with a less gradual onset.
Menopause Age: 4 More Influences
Your mother’s age at menopause is a key factor, but not the only one. Here are four others to consider:
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How Is Early Menopause Treated Or Managed
Early menopause generally doesnt require treatment. However, there are treatment options available to help manage the symptoms of menopause or conditions related to it. They can help you deal with changes in your body or lifestyle more easily.
Premature menopause, however, is often treated since it occurs at such an early age. This helps support your body with the hormones that would normally be made until you reach the age of natural menopause.
The most common treatment includes hormone replacement therapy . Systemic hormone therapy can prevent many common menopausal symptoms. Or you may take vaginal hormone products, usually in low doses, to help with vaginal symptoms.
HRT does have risks though. It can increase your chances of heart disease, stroke, or breast cancer.
Talk to your doctor about the risks and benefits to your individual care before starting HRT. Lower doses of hormones may decrease your risk.
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.
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Calcium And Vitamin D
A combination of calcium and vitamin D can reduce the risk of osteoporosis, the bone loss associated with menopause. The best sources are from calcium-rich and vitamin D-fortified foods.
Doctors are currently reconsidering the use of calcium and vitamin D supplements. The U.S. Preventive Services Task Force advises that healthy postmenopausal women don’t need to take these supplements. According to the USPSTF, taking daily low-dose amounts of vitamin D supplements , with or without calcium supplements , does not prevent fractures. For higher doses, the USPSTF says there is not enough evidence to make a recommendation. In addition to possible lack of benefit, these supplements are associated with certain risks, like kidney stones.
However, calcium and vitamin D are important nutrients. Supplements may be appropriate for certain people including those who do not get enough vitamin D through sunlight exposure and those who do not consume enough calcium in their diet. They are also helpful for people who have been diagnosed with osteoporosis. Talk with your doctor about whether or not you should take supplements.
The National Osteoporosis Foundation recommends:
Vitamin D is necessary for the absorption of calcium in the stomach and gastrointestinal tract and is the essential companion to calcium in maintaining strong bones.
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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