What Is Perimenopause Its When Menopause Symptoms Begin
Perimenopause or pre-menopause is a word that means around menopause. Perimenopause describes what happens to your body leading up to menopause. This stage typically starts about four to eight years before menopause.
When you enter perimenopause youll probably start to notice some early menopause symptoms like changes to your period or mood shifts. These changes happen because your bodys estrogen and progesterone levels are starting to naturally decline. As your ovaries produce lower amounts of these hormones, your body adapts. Its basically the reverse of what happened to your hormones as a teenager.
Home Remedies: Plant Estrogens
Isoflavones are chemical compounds found in soy and other plants that are phytoestrogens, or plant-derived estrogens. There is a perception among many women that plant estrogens are natural and therefore safer than HT, but medical researchers havent proven this scientifically. Most scientific studies have not shown a benefit of phytoestrogens in controlling hot flashes. In addition, there is concern that some phytoestrogens might act like estrogen in some tissues of the body. Therefore, many experts recommend that women who have a history of breast cancer avoid phytoestrogens.
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 Does Perimenopause Affect My Body
During perimenopause, estrogen levels decrease. Estrogen is a key female hormone. It plays a role in maintaining many body systems, including the female reproductive system. Estrogen levels may continue to be irregular throughout perimenopause.
When you reach menopause, your body makes so little estrogen that your ovaries no longer release eggs. At this point, you stop having your period.
Risks Of Premature & Early Menopause
The risks of developing osteoporosis and cardiovascular disease are higher for women with premature or early menopause than for women reaching menopause at the expected age. For this reason, it is important that you seek advice and treatment from your doctor.
According to community studies, women who go through premature or early menopause without hormone treatment have a reduced life expectancy by about two years.
The advice below is based on current expert opinion, as there are no studies on women with premature or early menopause that establish which prevention strategies are effective.
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When Does Perimenopause Start
Before you experience menopause, youll go through a transitional period, known as perimenopause. This phase can last for months or years, and usually starts when youre in your mid-to-late 40s. On average, most women experience perimenopause for about four years before their periods stop completely.
What Causes Early Menopause
As mentioned previously, menopause before the age of 40 are considered to be in premature, or early, menopause. One medical causes of premature menopause is known as premature ovarian failure. Technically, premature ovarian failure is not the same as premature menopause. In premature ovarian failure, the ovaries stop functioning normally before the age of 40. Women with premature ovarian failure may still occasionally have menstrual periods, but they typically experience infertility. Premature ovarian failure is usually accompanied primary ovarian insufficiency. Premature ovarian failure is usually accompanied by the symptoms of premature menopause.
Premature menopause can also be caused by treatments for cancers or other conditions that involve chemotherapy and/or radiation therapy to the pelvis. These treatments can damage the ovaries and result in ovarian failure.
Surgery to remove the ovaries, either for benign or malignant conditions, results in premature menopause if both ovaries are removed. Surgery to remove the uterus results in menopause only in the sense that menstrual bleeding does not occur. In that case, the ovaries will continue to produce hormones.
Other infrequent causes that may lead to premature menopause include drugs, chronic diseases, pituitary and hypothalamic tumors, psychiatric disorders, and other relatively rare or undefined conditions.
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What Is Early Menopause
Early menopause is when a womans last monthly period occurs between the ages of 40 and 45 years. Up to 1 in 12 women have their last period by the time they are 45 years. When menopause occurs before the age of 40, it is considered to be premature menopause. Most Australian women experience normal menopause between the ages of 45 and 60 years.
Dealing With Early Menopause
What is early menopause?
As women age, their bodies produce less estrogen and progesterone, the main hormones involved in female reproduction. When these hormones reach a low enough level, a woman will permanently stop having a menstrual cycle.
Menopause officially begins 12 months after a womans last period. Most women begin menopause between the ages of 45 and 55, with an average age of 51 in the United States. But for some women, menopause comes early.
If youre between the ages of 35 and 45 and have missed your period for three months or more, you may be going through menopause earlier than normal. Read on to learn why this happens and what treatments are available.
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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
What Causes Menopause Does Every Woman Go Through Menopause
Yes, every woman will experience menopause. Menopause occurs due to a complex series of hormonal changes. Associated with the menopause is a decline in the number of functioning eggs within the ovaries. At the time of birth, most females have about 1 to 3 million eggs, which are gradually lost throughout a woman’s life. By the time of a girl’s first menstrual period, she has an average of about 400,000 eggs. By the time of menopause, a woman may have fewer than 10,000 eggs. A small percentage of these eggs are lost through normal ovulation . Most eggs die off through a process called atresia .
- Normally, FSH, or follicle-stimulating hormone , is the substance responsible for the growth of ovarian follicles during the first half of a woman’s menstrual cycle. As menopause approaches, the remaining eggs become more resistant to FSH, and the ovaries dramatically reduce their production of estrogen.
- Estrogen affects many parts of the body, including the blood vessels, heart, bone, breasts, uterus, urinary system, skin, and brain. Loss of estrogen is believed to be the cause of many of the symptoms associated with menopause. At the time of menopause, the ovaries also decrease their production of testosterone — a hormone involved in libido, or sexual drive.
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Ht Forms And Regimens
HT comes in several forms:
- Oral tablets or pills
- Vaginal ring
- Topical gel or spray
HT pills and skin patches are considered “systemic” 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.
Vaginal forms of HT are called “local” therapy. Doctors generally prescribe vaginal applications of low-dose estrogen therapy to specifically treat menopausal symptoms such as vaginal dryness and pain during sex. This type of ET is available in a cream, tablet, or ring that is inserted into the vagina.
“Bioidentical” hormone therapy is promoted as a supposedly more natural and safer alternative to commercial prescription hormones. Bioidentical hormones are typically compounded in a pharmacy. Some compounding pharmacies claim that they can customize these formulations based on saliva tests that show a woman’s individual hormone levels.
The FDA and many professional medical associations warn patients that “bioidentical” is a marketing term that has no scientific validity. Formulations sold in these pharmacies have not undergone FDA regulatory scrutiny. Some of these compounds contain estriol, a weak form of estrogen, which has not been approved by the FDA for use in any drug. In addition, saliva tests do not give accurate or realistic results, as a woman’s hormone levels fluctuate throughout the day.
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.
What Are The Complications And Effects Of Menopause On Chronic Medical Conditions
Osteoporosis is the deterioration of the quantity and quality of bone that causes an increased risk of fracture. The density of the bone normally begins to decrease in women during the fourth decade of life. However, that normal decline in bone density is accelerated during the menopausal transition. Consequently, both age and the hormonal changes due to the menopause transition act together to cause osteoporosis. Medications to treat osteoporosis are currently available and pose less risk than hormone therapy. Therefore, hormone therapy is not recommended for prevention or treatment of osteoporosis.
Prior to menopause, women have a decreased risk of heart disease and stroke when compared with men. Around the time of menopause, however, a womens risk of cardiovascular disease increases. Heart disease is the leading cause of death in both men and women in the U.S.
Coronary heart disease rates in postmenopausal women are two to three times higher than in women of the same age who have not reached menopause. This increased risk for cardiovascular disease may be related to declining estrogen levels, but in light of other factors, medical professionals do not advise postmenopausal women to take hormone therapy simply as a preventive measure to decrease their risk of heart attack or stroke.
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What Treatment Is Available For Early Menopause
Once youve been diagnosed, there are plenty of different treatments available to help with both the physical and mental symptoms of early menopause.
If you have early menopause you are at higher risk of premature coronary heart disease and osteoporosis, so treatment is really important, Dr Wild explains.
Having access to the right medication or understanding how to manage symptoms can have a life-changing impact on women during this transition in their lives, at whatever age it occurs.
Having access to the right medication or understanding how to manage symptoms can have a life-changing impact
To help balance hormones and relieve symptoms, doctors will often prescribe the combined contraceptive pill or HRT, which can be taken in several ways, including in a tablet, or through patches and gels.
You will likely take this until you reach the age of natural menopause , Dr Wild adds.
There are also a number of self-help measures which can be used to ease menopause symptoms, including eating a healthy diet and exercising regularly.
If you are worried that youre going through early or premature menopause, you should always speak to your GP, Dr Wild recommends. Theyll be able to help diagnose the menopause and offer you the right treatment to ease your symptoms.
Remember GPs are there to help and no problem is too embarassing.
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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.
How Young Can A Woman Be To Go Through Menopause
How young can a woman be to go through menopause
- What is the youngest a woman can go through menopause?
- This usually takes place between 44-51. However due to the increased levels of chemicals added to foods and hormones pumped into chickens and beef to plump them up and create large quantities of milk, woman do get menopause a little early,
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Why Menopause Comes Early
Premature menopause may be spontaneous or may follow:
- Surgery to remove both ovaries .
- Treatment for cancer, such as chemotherapy or radiation to the pelvis.
Natural premature or early menopause is sometimes called ‘premature ovarian insufficiency’ or . See Australasian Menopause Society for more information.
Although premature or early menopause means that fertility is reduced, pregnancy can sometimes occur and women who wish to avoid pregnancy should still use contraception.
Younger menopausal women who do not have medical reasons preventing them from using menopausal hormone therapy are generally advised to take MHT until around the age of 50 years. In addition to treating menopausal symptoms, MHT also prevents bone loss and fracture.
Younger women may also find premature or early menopause distressing because of the impact it has on their fertility and quality of life. Visit the Daisy Network website for support services and advice.
The Timing Of The Age At Which Natural Menopause Occurs
The age at the final menstrual period holds intrinsic clinical and public health interest because the age at which natural menopause occurs may be a marker of aging and health. Later age at natural menopause has been associated with:
longer overall survival and greater life expectancy and reduced all-cause mortality
reduced risk of cardiovascular disease, and mortality from cardiovascular and ischemic heart disease, stroke, angina after myocardial infarction, and atherosclerosis
less loss of bone density, and a reduced risk of osteoporosis and fracture
but an increased risk of breast,, endometrial, and ovarian, cancers.
Although menopause is a universal phenomenon among women, the timing of the onset and the duration of the menopausal transition and the timing of the final menstrual period are not. Most of our knowledge and perceptions of menopause have been based largely on studies of white women, and many have been studies of clinic-based, rather than population-based, samples of women. Thus, until recently, much of the knowledge about the timing of the natural final menstrual period has been affected by the nature of the samples of women studied and a number of other methodologic differences in the studies of this phenomenon, which must be considered in comparing and summarizing their results.
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Heart & Cardiovascular Health
Women experiencing a premature or early menopause may have an increased risk of heart disease, compared to women who reach menopause at the expected age, although this remains controversial.
A recent study suggested women with premature or early menopause may also be at greater risk of stroke. This might be because of the loss of the beneficial effects of oestrogen on the blood vessels and the lipid profile of younger women. Further understanding in this area is still needed.
There are also other cardiovascular disease risk factors, such as family history, high blood pressure and high cholesterol levels.
A healthy lifestyle can help reduce the risk of cardiovascular and heart problems. Stopping smoking, eating a healthy, balanced diet with plenty of fruit and vegetables, maintaining a healthy body weight and doing regular physical activity reduces the risk of heart disease in women of all ages.
There is some evidence that suggests menopausal hormone therapy, or MHT use in women with premature or early menopause reduces the risk of cardiovascular disease.
It is recommended that you have annual monitoring of blood pressure, weight, smoking status and cholesterol and sugar levels, as well as a discussion with your doctor, to help keep a check on your risks of cardiovascular disease.
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Is Estrogen Therapy A Good Treatment For Me
For many women, estrogen therapy relieves symptoms of vaginal dryness, night sweats and hot flashes. It can also reduce the risk of osteoporosis.
Hormone therapy has fewer risks for younger women. In general, healthcare providers recommend that women who opt to use hormone therapy start it within 10 years of beginning menopause symptoms and use it for less than five years.
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