Here’s What Women Need To Know About Early Menopause Which Occurs Between Ages 40 And 45 And Premature Menopause Which Occurs Before Age 40
For Leslie Mac, it started with irregular menstrual periods. Mac, a digital strategist and organizer, didn’t think much of it, but once she started going months without menstruating, she decided to see her doctor. “Something must be wrong,” she remembered thinking.
“I didn’t even know it was possible to start the process so early,” Mac explained. By 34, she received a diagnosis of menopause, which is officially diagnosed when a woman goes a year without a menstrual period.
Menopause is a normal part of a woman’s life and signals the end of the reproductive years. In the U.S., this typically occurs around age 51, but 5% of women have early menopause, which occurs between ages 40 and 45, and 1% experience premature menopause, which occurs before age 40.
While age of diagnosis may differ, premature and early menopause follow the same process as usual menopause. As women age, the levels of the hormones estrogen and progesterone in their body begin to decline. In premenopausal women, the ovaries produce these hormones in a regular cycle, and they’re important for both reproductive and overall health.
“You have estrogen receptors everywhere in your body,” explained Dr. Barb DePree, director of the Women’s Midlife Services at Holland Hospital, founder of MiddlesexMD and a member of HealthyWomen’s Women’s Health Advisory Council.
What Happens After Menopause
As you wind down from the menopause, your body continues to go through a lot of changes. While your hormone levels adjust to a new normal, you can face changes to different parts of your body, and your health.
Common post menopause symptoms:
1. Your hot flushes will stop – eventually
As your hormones settle down, so will perimenopausal symptoms like hot flushes. Hurrah! However, they may continue for up to 8 years – and things might get worse before they get better. “Leading up to menopause, your oestrogen levels fluctuate. When they’re high, you don’t have symptoms,” gynaecologist Dr. Kevin Audlin explains. “But when you go into menopause and there’s a complete lack of oestrogen, you start to notice those symptoms more.”
2. Your breasts may look different
Postmenopausal breasts may shrink, change shape, lose firmness and become more prone to lumps. This is because weight can fluctuate during the menopause, meaning your breasts lose their elasticity. Time to go for that bra fitting.
3. Your weight distribution will change
Fat is less likely to settle on the hips and thighs post menopause – but more likely to settle on the waistline. It’s thought that the body attempts to hoard’ oestrogen in fat cells around the belly area, but experts warn that this kind of fat has been associated with diabetes, heart disease, stroke and even some cancers. Discover our tips to help you deal with menopause weight gain here, if you are concerned.
4. Sex may become more painful
Menopause: Changes And Challenges
Alta Bates Summit Medical CenterBerkeley, California
US Pharm. 2018 43:13-16.
Menopause is the cessation of menstruation in a woman, typically occurring between the ages of 45 and 55 years. Smokers and women with chronic diseases may experience earlier menopause.1 This is a natural biological process, not a disease.
Menopause and perimenopausethe period of transition beginning 2 to 8 years before and lasting up to 1 year after a womans final menstrual periodoccur because as women get older, the ovaries begin to shut down.1 Eventually, ovaries stop producing estrogen and other hormones. Since the body has depended on these hormones for years, when hormone levels decrease, the changes are noticeable and may result in emotional reactions and bodily changes.2 These may include physical symptoms, such as hot flashes, decreased energy levels, and sleep disruption, as well as mood-related symptoms, such as anxiety and depression. Over time, these symptoms gradually disappear.1 Although menopause ends fertility, women can stay healthy, vital, and sexual. This article will briefly review the physiology and types of menopause, signs and symptoms, and symptomatic treatment.
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What Happens And How Does It Feel
For some women this loss of reproductive ability may be deeply felt, and for all women the menopause is a personal experience, not just a medical condition. However, the diminishing release of oestrogen from the ovary as women advance into their 40s is often the cause of symptoms which can be distressing and may need medical attention.
Hot flushes are the most common symptom of the menopause, occurring in three in every four menopausal women. Other common symptoms include night sweats, sleeplessness, vaginal dryness, irritated skin, more frequent urinary incontinence and urinary tract infections, low mood and a reduced interest in sex. Symptoms vary hugely in duration, severity and what impact they have on women.
All the common symptoms of the menopause are associated with a decrease in the bodys production of oestrogen. Oestrogen lack can affect many parts of the body, including the brain, causing changes in emotional well-being, and the skin, influencing its elasticity and thickness.
There is also some evidence that oestrogen deficiency is the cause of some chemical changes in the body which make women after the menopause especially vulnerable to heart disease and stroke.
So How Do You Know If You’re Going Through It
It is possible to take a blood test to measure levels of a hormone called FSH but it’s not very accurate, particularly over the age of 45.
Experts say hormone levels go up and down all the time, even during the course of a day, so the test can’t really pin down what’s going on.
A better way is to talk to a GP or nurse about the pattern of your periods and any symptoms you are experiencing.
Knowing what symptoms to look out for is important – feeling low and irritable needs to be recognised as much as hot flushes and night sweats.
A change in periods – becoming more heavy or more irregular – is one of the first signs of the menopause approaching.
Until you are period-free for a year, you won’t know you’ve actually gone through the menopause.
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How Long Will Menopausal Transition Symptoms Last
Menopause is technically one full year without bleeding, and perimenopause is the stage before the final menstrual period, also known as the menopausal transition. Puberty and perimenopause are similar in that they both involve hormonal changes, and the transitions can take place over several years. Some medical organizations, such as the American Osteopathic Association, refer to perimenopause as reverse puberty in women.
According to NAMS, this phase can last four to eight years, and it comes with symptoms caused by hormone fluctuations, such as mood swings, poor sleep, and hot flashes.
The age at which a woman begins perimenopause can help predict how long the transition to menopause will last, according to research published in the journal Menopause in February 2017. The authors found that perimenopause lasted longer in women who started the transition at a younger age, and the women had more symptoms, such as hot flashes.
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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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How Can I Reduce My Risk Of Perimenopause Complications
Irregular periods are the most common symptom of perimenopause. But its important to know when to talk to your healthcare provider about your periods. Sometimes, irregular bleeding can point to an underlying problem.
You can lower your risk of complications by seeking treatment when necessary. Talk to your healthcare provider if you:
- Bleed for more than seven days in a row.
- Bleed between periods.
- Change pads or tampons every one to two hours.
- Have periods more frequently than every 21 days.
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.
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How Do I Know If I Am Going Through Early Or Premature Menopause
You know you have gone through menopause when you have not had your period for 12 months in a row. If you think you may be reaching menopause early, talk to your doctor or nurse.
- Your doctor or nurse will ask you about your symptoms, such as hot flashes, irregular periods, sleep problems, and vaginal dryness.
- Your doctor or nurse may give you a blood test to measure estrogen and related hormones, like follicle-stimulating hormone . You may choose to get tested if you want to know whether you can still get pregnant. Your doctor or nurse will test your hormone levels in the first few days of your menstrual cycle .
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For people who cannot take estrogen therapy, or choose not to, Stuenkel says some drugs in the antidepressant family, such as SSRIs and SNRIs, can help with hot flashes. Stuenkel says, While theyre not perfect, they can take the edge off and help enough so that women can get a better nights sleep.
There are an abundance of nonhormonal, nondrug treatment options for managing symptoms, some of which have significantly more evidence backing them than others. In 2015, a North American Menopause Society panel found that cognitive behavioral therapy and hypnosis were significantly effective in treating hot flashes. The same panel also found that popular herbal remedies are unlikely to help, although some NPR listeners who wrote in said they got relief from some of those treatments.
For depressive and anxiety symptoms, women may want to seek out professional counseling or a psychiatrist.
When do I need to see a doctor?
You might not need to at all. Some people sail right through menopause with little trouble. But if you are experiencing symptoms that are interfering with your life, its worth making an appointment. Some of these symptoms could indicate other problems that need treatment, such as fibroids or even cancer.
Ways to cope with symptoms
For people approaching this stage of life or who are already going through it, here are four steps for making this transition more manageable.
1. Get educated
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“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.
Are There Any Tests For Menopause
The most accurate way to tell if it’s happening to you is to watch your menstrual cycles for 12 months in a row. It helps to keep track of your periods and chart them as they become irregular. Menopause has happened when you have not had any period for an entire 12 months.
Your doctor can check your blood for follicle stimulating hormone . The levels will jump as your ovaries begin to shut down. As your estrogen levels fall, youâll notice hot flashes, vaginal dryness, and less lubrication during sex.
The tissue in and around your vagina will thin as estrogen drops, too. The only way to check for this is through a Pap-like smear, but itâs rarely done. As this happens, you might have urinary incontinence, painful sex, a low sex drive, and vaginal itching.
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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.
Vaginal Dryness And Atrophy
When your estrogen levels drop, your vaginal tissues start drying and become less elastic. Sex becomes uncomfortable you may be more prone to infections your vagina is frequently itchy and easily irritated, and, on the emotional side, you may feel older.
Your vagina is usually very elastic, able to easily stretch for sex and childbirth. But as estrogen levels go down, your vaginal walls get thinner and lose some of their elasticity. Your vagina becomes dryer and takes longer to become lubricated. Finally, it may atrophy becoming somewhat smaller in width and length.
If you experience a sudden drop in estrogen , these vaginal symptoms might appear more suddenly than if you go through a natural premature menopause. Either way, though, its a very unpleasant side effect of going through menopause and often very emotionally upsetting when youre in your 20s or 30s.
You may find it takes longer and longer to get sexually aroused. Sexual stimulation that you used to enjoy may become unpleasant. Intercourse can be very uncomfortable, even painful. In a worst case scenario, your vagina may even tear during intercourse.
All in all, sex may become less and less pleasurable making you feel even worse about being in premature menopause. I remember I began thinking that, at the not-so-ripe age of 38, my days of enjoying sex were over and was very glad when I learned that I was wrong.
How To Cope
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Trouble Focusing And Learning
two-thirds of women may have difficulty with concentration and memory.
Keeping physically and mentally active, following a healthful diet, and maintaining an active social life can help with these issues. For example, some people benefit from finding a new hobby or joining a club or a local activity.
Are You Headed Toward Early Menopause
There are many negative health consequences linked to early menopause, including a higher and fracture, heart disease, cognitive impairment and dementia, and early death, says Dr. Faubion.
If you have questions about when youll experience menopause and if you can do anything to change it, keep reading for answers.
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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.
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 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 or deciding which type of birth control to use, adds Faubion.
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