Early And Premature Menopause
Sometimes people go through the menopause before they turn 40. We call this premature menopause, or premature ovarian insufficiency. 4 Premature menopause can either happen without an obvious cause or as a side effect of some treatments.
If you think you might be going through the menopause, its a good idea to speak to your GP. They might decide to do some tests to check your hormone levels and will talk to you about your symptoms and family history.
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 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.
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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.
Do All Menopausal People Experience A Decrease In Sexual Desire
Not all people experience a decreased sexual desire. In some cases, its just the opposite. This could be because theres no longer any fear of getting pregnant. For many, this allows them to enjoy sex without worrying about family planning.
However, it’s still important to use protection during sex if not in a monogamous relationship. Once your doctor makes the diagnosis of menopause, you can no longer become pregnant. However, when you are in the menopause transition , you can still become pregnant. You also need to protect yourself from sexually transmitted infections by wearing a condom. You can get an STI at any time in your life . STIs like HPV can lead to cervical cancer.
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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.
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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What You Can Do
- Vaginal moisturizer. An over-the-counter vaginal moisturizer can help keep your vagina lubricated and can make sex more comfortable. You use this every few days.
- Vaginal lubricant. A water-based, over-the-counter vaginal lubricant can help make sex more comfortable. You use this before or during sex.
- Prescription medicine. You can also talk to your doctor about other ways to treat your vaginal dryness, including hormonal birth control, menopausal hormone therapy, or a prescription estrogen cream, gel, or ring that is inserted into your vagina. Learn more about menopause treatments. All medicines have risks so talk to your doctor first.
What Is Premature Menopause
Menopause that occurs before a person is 40 years old is considered premature. It is also called primary ovarian insufficiency .
Premature menopause may be due to:
Premature menopause can also be induced by:
- A bilateral oophorectomy
- Medical treatments such as cancer or endometriosis treatment
- Illnesses such as
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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.
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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As Menopause Nears Be Aware It Can Trigger Depression And Anxiety Too
“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.
Can I Get Pregnant If I Have Gone Through Menopause
No, you cant get pregnant after menopause because ovulation is no longer occurring. Once you have gone 12 months without a period, you are considered to have reached menopause.
A note from Cleveland Clinic
Menopause is a natural and normal part of the aging process. Once you are in menopause, you have gone 12 months without a menstrual period. It is common to experience symptoms like vaginal dryness and hot flashes. Be open with your healthcare provider about the symptoms youre experiencing and how they impact your quality of life. They can recommend treatments to manage your symptoms and make you more comfortable.
Last reviewed by a Cleveland Clinic medical professional on 10/05/2021.
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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.
Can Menopause Cause Depression
Your body goes through a lot of changes during menopause. There are extreme shifts in your hormone levels, you may not sleep well because of hot flashes and you may experience mood swings. Anxiety and fear could also be at play during this time. All of these factors can lead to depression.
If you experience any of the symptoms of depression, talk to your healthcare provider. During your conversation, your provider will tell you about different types of treatment and check to make sure there isnt another medical condition causing your depression. Thyroid problems can sometimes be the cause of depression.
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Antidepressants And Other Medications
Antidepressant medications: The class of drugs known as selective serotonin reuptake inhibitors and related medications has been shown to be effective in controlling the symptoms of hot flashes in up to 60% of women. Specifically, venlafaxine , a drug-related to the SSRIs, and the paroxetine , desvenlafaxine , citalopram , and escitalopram have all been shown to decrease the severity of hot flashes in some women. However, antidepressant medications may be associated with side effects, including or sexual dysfunction.
Other medications: Other prescription medications have been shown to provide some relief for hot flashes, although their specific purpose is not the treatment of hot flashes. All of these may have side effects, and their use should be discussed with and monitored by a doctor. Some of these medications that have been shown to help relieve hot flashes include the antiseizure drug gabapentin and clonidine , a drug used to treat high blood pressure.
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 The Symptoms Of Menopause
You may be transitioning into menopause if you begin experiencing some or all of the following symptoms:
- Hot flashes .
- Night sweats and/or cold flashes.
These symptoms can be a sign that the ovaries are producing less estrogen or a sign of increased fluctuations in hormone levels. Not all people get all of these symptoms. However, those affected with new symptoms of racing heart, urinary changes, headaches or other new medical problems should make sure there is no other cause for these symptoms.
What Hormonal Changes Happen During Menopause
The traditional changes we think of as “menopause” happen when your ovaries no longer produce high levels of hormones. The ovaries are the reproductive glands that store eggs and release them into the fallopian tubes. They also produce the female hormones estrogen and progesterone as well as testosterone. Together, estrogen and progesterone control menstruation. Estrogen also influences how your body uses calcium and maintains cholesterol levels in the blood.
As menopause nears, your ovaries no longer release eggs into the fallopian tubes, and youll have your last menstrual cycle.
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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.
How Do I Know If I Am In Menopause
Menopause is defined as 12 consecutive months without having a menstrual cycle. If you are currently not having periods, but it has not yet been 12 full months, you might be in menopause, but you cannot be sure until you have gone a full year without having a period.
Some cancer treatments like chemotherapy and radiation can also lead to medical menopause, which can be temporary or permanent.
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The purpose of the Southern Cross Medical Library is to provide information of a general nature to help you better understand certain medical conditions. Always seek specific medical advice for treatment appropriate to you. This information is not intended to relate specifically to insurance or healthcare services provided by Southern Cross. For more articles go to the Medical Library index page.
Suffering Bothersome Menopause Symptoms We Have Treatment Options
Menopause is the time in a womans life that marks the end of her reproductive years. Youve officially reached that milestone when you havent menstruated for 12 consecutive months. Perimenopause is the time leading up to menopause, with symptoms starting between ages 45-55 and lasting about four years: The exact timing is different for each person.
Perimenopause is a time when reproductive hormone levels, including estrogen, progesterone, testosterone, follicle-stimulating hormone , and luteinizing hormone , start to fluctuate. At this time women also experience the loss of active ovarian follicles, the structures that produce and release eggs from the ovary walls. Periods become intermittent and blood flow irregular.
At Medical Care for Women in Astoria, New York, Dr. Andrea D. Olanescu and her team understand that the transition through both perimenopause and menopause, with their many physical symptoms and psychological stress, can be difficult to go through. And while theres no way to circumvent the process itself, they do have treatment options for getting rid of the bothersome symptoms. Heres what you need to know.
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