Dr. Eboni Green
May 10, 2021
Coping with menopause can be hard no matter your age, but it’s especially difficult for women who are in their early 40s – or even younger than 40. If you think you might be experiencing premature or early menopause, check out this guide to learn about symptoms and menopause relief options.
Menopause occurs when 12 months have passed since the date of your last period. Most women enter menopause between the ages of 45 and 55. Early menopause occurs between the ages of 40 and 45, while premature menopause occurs before the age of 40. You might also hear the terms “premature ovarian failure” or “primary ovarian insufficiency” used to refer to early menopause. Premature menopause is a relatively uncommon condition. Only about one percent of women begin going through menopause before the age of 40.
The symptoms of early menopause are much the same as those for “regular” menopause — it’s really about the timing of your symptoms. Perhaps the most common one is skipped, missing, or irregular periods. If you haven’t had your period in three to four months, contact your doctor to see what the cause might be. Keep in mind that there are many reasons why your period might stop coming, including stress, pregnancy, illness, change in diet or exercises, and medications or contraceptives.
Periods will often become irregular before they stop altogether. Your period might skip a month (or several months) and then return. Your cycle also tends to shorten so your periods happen closer together. You can still get pregnant during this time, so if you’ve skipped a few periods and aren’t certain if you have entered menopause yet, you might want to take a pregnancy test first.
Besides skipped or missing periods, here are some other symptoms to be aware of:
Later on in the menopause process, you may notice additional symptoms, including fatigue, depression, racing heart, headaches, joint and muscles aches, and changes to your sex drive.
During a woman’s reproductive years, the growth of eggs is regulated by follicle-stimulating hormones, aka FSH. As you get older, your eggs become more resistant to FSH, and your ovaries make less and less estrogen. This causes fewer eggs to be grown and released, resulting in periods that become irregular and eventually stop.
Early menopause may be triggered by follicle depletion and follicle dysfunction (meaning that the eggs either don’t mature or aren’t released). While these processes are a normal part of aging, in most women, they don’t occur until later in life. Besides aging, other factors can contribute to follicle depletion or dysfunction, including:
Your doctor will talk through your symptoms to eliminate other causes of your missing or skipped periods (i.e., pregnancy). You should also be prepared to discuss your history of exposure to toxins, since radiation and chemotherapy can trigger menopause.
Then, your doctor will conduct a physical exam, including a pelvic exam, and also perform a pregnancy test to rule that out. Next, you will have some blood samples taken so it can be tested for the presence of certain hormones, including FSH, estradiol, prolactin, and anti-Mullerian hormone (AMH). Your doctor may also want to test your DNA for genetic markers of early or premature menopause.
Menopause at any age can be difficult to cope with, physically and mentally. It can be especially difficult to weather early in life, especially if you were hoping to have children later. If you’re having trouble coping with menopause, you should talk to your doctor about your menopause relief options (and your pregnancy options, if you were planning to have a child).
You might be a candidate for hormone replacement therapy (HRT), in which you take supplemental estrogen and progestin to help replace some of the reproductive hormones your body can no longer make on its own. HRT is often used to manage the unpleasant side effects of menopause until the age of 50 or so. HRT itself does have some side effects, such as an increased risk for stroke, blood clots, and breast cancer, so not everyone is a good candidate for it.
One of the side effects of menopause is increased risk of osteoporosis, or bone loss. To help combat this, your doctor might have you take supplemental calcium and vitamin D if you don’t already get enough of these nutrients in your diet. You might also need to start doing strength-bearing exercises to help build your bones and prevent further loss. In addition to bone loss, you might also experience muscle loss or weakness, especially in the pelvic floor area. Doing pelvic floor exercises with Kegel balls can help strengthen those muscles.
As for mentally and emotionally coping with menopause, finding a therapist and doing talk therapy can help you process these big life changes your body is going through. You should also seek out other women who also have experience with premature or early menopause. You’re not alone, even if it feels like it now.
Menopause is a difficult transition, but many women have made it before you. Make sure to reach out to your doctor as well as other women if you think you’re experiencing early menopause.
