You’ve probably heard your mother, grandmother, or an older coworker complain about hot flashes, night sweats, and the inevitable weight gain that comes along with menopause. If you have particularly painful periods, you may silently think that you’d rather get a little overheated than be curled up in the fetal position with cramps so bad it hurts to breathe. If your periods are more on the normal side, you probably just think, “phew, glad I don’t have to worry about that for 20 or 30 more years!”
Menopause is typically painted as something that happens to older women but there’s another menopause experience that isn’t discussed nearly as often: early menopause.
Early menopause, sometimes called premature menopause, is a condition that all women should be aware of because it can severely affect a woman’s quality of life, future fertility, and overall health.
What is the difference between menopause and early menopause?
The American Society for Reproductive Medicine (ASRM), defines menopause as “the natural cessation of ovarian function and menstruation. It can occur between the ages of 42 and 56 but usually occurs around the age of 51, when the ovaries stop producing eggs and estrogen levels decline.” Early menopause is essentially the same, except that it starts before a woman is 40. And while menopause is a natural part of the lifetime reproductive cycle, early menopause is considered abnormal and can be both caused by and the cause of other health problems.
What causes early menopause?
Often, when the cause of something is known, prevention and treatment become more plausible. When it comes to early menopause, there are several known causes but, still, many women never get a definitive answer about why they, specifically, started menopause before turning 40. Some of the potential causes of early menopause include:
- Genetic predisposition: If your mother started menopause early, you’re more likely than average to start early, too. When no other reason(s) can be found for premature menopause, doctors usually chalk it up to genetic reasons. Not sure what your family history is? Call your mom or another family member from your mom’s side and do some digging.
- Premature ovarian failure: Premature menopause and premature ovarian failure are often mistakenly used interchangeably. However, women who have premature ovarian failure can have irregular periods and, though unlikely, can still become pregnant. Women who go through menopause early stop having periods and cannot become pregnant. Premature ovarian failure—when your ovaries shut down and stop producing eggs—can cause early menopause.
- Lifestyle: Just as with any other health condition, your lifestyle can play a significant role in the onset of early menopause. Here are some of the lifestyle factors that can affect you when you go through “the change”:
- Studies have found that women who smoke cigarettes are more likely to go through menopause at a younger age.
- Since estrogen is stored in fat tissue, women who have a lower than advised body mass index (BMI) are more susceptible to early menopause.
- Stress is something we all deal with on a daily basis, which could be bad news for your ovaries. Too much stress impacts hormone levels and, ultimately, can cause menopause to come in your 30s.
- Alcoholism isn’t just bad for your heart, your relationships, and your career. It can also, according to a study by the National Institutes of Health, lead to early menopause by interfering with reproductive hormones and by increasing the likelihood of other disorders like liver disease.
- Autoimmune diseases: Autoimmune diseases like thyroid disease and rheumatoid arthritis cause the immune system to mistake different parts of the body as threats and attempt to fight it off. When this happens, inflammation occurs and, subsequently, the ovaries can be affected. Since menopause (both early and “normal”) occurs when the ovaries stop working, the inflammation that is caused by autoimmune diseases can cause the ovaries to shut down.
- Epilepsy: Only about one percent of the population is affected by early menopause. However, a study found that a disproportionate number of women with epilepsy—14 percent—enter menopause prematurely.
- Chromosome defects: Turner’s Syndrome, when a female is born with just one X chromosome, is one chromosome defect that can cause premature menopause. Trisomy 13 and 18, which occur when a female has an extra chromosome, are also likely to cause it.
- Cancer: Ovarian cancer, specifically, can cause the ovaries to stop functioning in the way they should. From a broader perspective, any type of cancer treatment (like chemotherapy or radiation) can damage the ovaries.
Symptoms of early menopause
Early menopause only happens to about one in every 100 women, so your odds are relatively low. Still, to stay in control of your body and reproductive health, it’s important to understand and be able to identify when or if you experience any of the associated symptoms. Common symptoms of early menopause include:
- Irregular periods
- Periods that are shorter or longer than they once were
- Heavy bleeding
- Periods that last longer than one week
- A period after a full year of not having one
- Low libido
- Trouble sleeping
- Vaginal dryness and/or pain during intercourse
- Loss of bladder control
- Hot flashes
- Night sweats
- Unexplained weight gain
Complications related to early menopause
So, if you go through early menopause, then you just have to deal with the symptoms and then, voila, it’s over and no more periods? Not quite. The female body is complex (though, unsurprisingly not as mysterious as some men find it to be—the clitoris is literally right there, dude). All of its many elements are inextricably linked and, when one thing goes awry, so do a host of others. Women who go through early menopause (and menopause, in general) experience a decline in the hormone estrogen which can cause:
- Parkinson’s symptoms
- Heart disease
- Increased risk for colon and ovarian cancer
- Periodontal (gum) disease
- Tooth loss
- Cataract formations
Going through menopause prematurely doesn’t necessarily mean that you will have these complications but the risk does increase, so it’s important to stay mindful and communicate openly with your doctor.
How is premature menopause diagnosed?
If you have even the slightest suspicion you’re going through early menopause, you should head to your doctor’s office for some testing. There are several ways your doctor can determine whether or not you’re starting menopause, including a physical exam and a blood test that will rule out pregnancy and thyroid disease. The best test, however, is one that measures the levels of follicle-stimulating hormone (FSH) in your system. When your ovaries start to shut down, your estrogen levels decrease. When estrogen declines, your FSH levels will be higher—a pretty clear sign that you’re in menopause.
Is there a treatment for early menopause?
Unfortunately, there is no treatment for early menopause once it has begun. That being said, you can still manage your symptoms through hormone replacement therapy (HRT) or menopausal hormone therapy (MHT) but keep in mind that these treatments can increase your chances of breast cancer, heart disease, and stroke. Alternatively, you can manage your symptoms with mindfulness meditations, yoga, and a healthy diet. As with anything, prevention is your best bet but, of course, you don’t always have control over your finicky ovaries.
The emotional and mental toll of early menopause
Research aside, this narrative just wouldn’t be complete without addressing a very real part of early menopause: how it affects your emotional and mental wellbeing. Just as with other parts of being a female, menopause carries with it a social stigma. While activists have long been trying to dismantle all of the harmful stigmas that women deal with, early menopause is still relatively unaddressed. Not only can early menopause have you breaking out in a sweat, forgetting where you left your keys, and generally just feeling physically terrible, it can also take a toll on how you see yourself, especially if other people aren’t accommodating toward your changing needs.
Women are under so much pressure to maintain a certain level of discretion about their natural bodily functions that it can feel scary to start talking about something as seemingly taboo as starting menopause before you were “supposed” to. Talking about what you’re going through can actually bring a lot of comfort and help you build a support system that can walk with you through this life change. The first step in receiving that support is asking for it (and, while you’re asking, maybe see if someone can turn on the air conditioner).