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It’s a temperate fall day with a mild breeze, but suddenly you feel like it’s 90 F and you’re dying to shed your clothes and guzzle a glass of ice water. If you’re a woman in your early to mid-40s, you might be going through early menopause.
While the average age for menopause in the United States is around 51 or 52, about 5% of women under age 45 will experience early menopause. In some cases, women under age 40 may also experience premature menopause, often referred to as primary ovarian insufficiency or premature ovarian failure.
“It’s important to differentiate between premature menopause and early menopause,” says Lindsey Davis, M.D., MPH, at ChristianaCare Greenville Obstetrics and Gynecology. “When a woman under age 40 experiences menopause, which is defined by her final menstrual cycle, it’s considered premature menopause and is a much more concerning condition requiring more immediate intervention. Typically, there is some sort of underlying condition that causes premature menopause, such as an autoimmune disorder, genetic mutation, various infections, a side effect of medical treatment such as chemotherapy or radiation, or surgery such as removal of the ovaries.”
Symptoms are typically the same for both, and include hot flashes, night sweats, difficulty sleeping, heart palpitations, vaginal dryness, weight gain, urinary tract infections, difficulty concentrating and memory lapses. Emotional changes such as mood swings, irritability, mild depression or anxiety are also common. When they occur before age 40, it’s important to seek medical advice.
“While less than 1% of women experience premature menopause, it can increase their risk of cardiovascular disease, osteoporosis, neurological disorders [dementia, mood disorders] and pain or discomfort around the genital region due to lower levels of estrogen,” Davis explains. “We often recommend hormone replacement therapy…as the benefits tend to outweigh the risks of the treatment.”
Women who begin skipping periods and experiencing the symptoms of menopause before age 45 are considered to be in perimenopause, the transition phase prior to a woman’s last menstrual cycle, where the ovaries start to produce less hormones. This causes fluctuations in estrogen and progesterone levels. If a woman experiences her final menstrual cycle prior to age 45, she is considered to be in early menopause.
“For women who are no longer having a menstrual cycle or are having irregular periods after age 40, we encourage them to meet with their medical provider to discuss what symptoms they’re having, what concerns they might have and put together an individualized treatment plan based on their needs, risk and benefits,” Davis says.
The first line of intervention suggested for women experiencing early menopause is lifestyle modifications. You can reduce symptoms by maintaining a healthy diet (more plant-based foods and healthy fats, plus less sugar, alcohol and caffeine) and exercising for 30 minutes each day. Incorporating estrogen-producing soy as well as supplements like purified pollen extract can also help ease symptoms like hot flashes and night sweats.
If that doesn’t bring relief, your healthcare provider can talk to you about hormonal and nonhormonal treatments. “Menopause is a major transition in a woman’s life,” Davis says, “but there are a variety of interventions available to help support them through the process.”