While the menopause or perimenopause is something, most women only begin to feel coming on around their mid-forties or later, some women may start to see the signs much earlier. We're going to break these signs down for you so that you can have a better understanding of what they may mean and take the necessary steps to stay healthy and comfortable.
What exactly is early or premature menopause?
There are two definitions for the menopause occurring earlier than usual, and they are based on the age of onset. Early menopause is considered to be when a woman stops ovulating before the age of 45, whilst premature menopause is considered to be the onset of menopause before the age of 40.[1] According to the NHS, around 1% of women in the UK experience the menopause before the age of 40.[2] Furthermore, women who suspect they're going through premature menopause may be experiencing premature ovarian insufficiency, which is often confused as one and the same but isn't. Also known as premature ovarian failure, this condition causes the ovaries to stop functioning normally before the age of 40, but not to cease functioning altogether as premature menopause does.[3]
Why does premature menopause happen?
While early or premature menopause can sometimes occur for no apparent reason, there are often many factors that can be responsible for it, including genetics and specific health conditions, medications, and surgeries. If the women in your family, especially your mother or her mother or siblings, experienced early or premature menopause, it is more likely that you would too. Smoking is another factor that may speed up the onset of the menopause. Undergoing treatments such as chemotherapy or pelvic radiation, or surgical procedures such as a hysterectomy (removal of the uterus) or an oophorectomy (removal of an ovary) may result in an earlier onset of the menopause, whereas a bilateral oophorectomy (removal of both ovaries) with result in an immediate onset. Conditions such as thyroid disease, rheumatoid arthritis, Turner's syndrome, and HIV can also cause early or premature menopause.[4]
What are the signs of early menopause?
The signs of early or premature menopause are much the same as those of the menopause, but they will occur earlier. Understanding your symptoms and getting the necessary medical investigations done is essential to ruling out the possibility of other underlying conditions and managing your health and wellbeing.
Irregular menstrual cycles
The definitive symptom of the menopause is the irregularity of your period. Women who are experiencing the menopause, prematurely or otherwise, will notice that they menstruate less frequently than they used to, a sign that their ovarian function is declining. If, however, you are also experiencing significant weight changes or stress, or you are doing endurance exercise such as marathon running, this may be the reason for your menstrual irregularity. Other conditions that can result in irregular or absent periods include polycystic ovarian syndrome (PCOS), thyroid disorders, cervical or uterine cancers, endometriosis, and pelvic inflammatory disease, all of which your doctor can help you rule out with the appropriate investigations.[5]
Hot flushes
Fluctuating or declining levels of oestrogen can often bring on hot flashes due to the role oestrogen plays in your body's temperature regulation. They can come on fast, leaving you sweaty and flushed, and you may even experience palpitations. However, hot flushes can also be triggered by extreme stress, high caffeine or alcohol levels, smoking, illness, certain medications, and other conditions, including hyperthyroidism and diabetes.[6] If your symptoms persist, it would be best to see a doctor to rule out these possibilities.
Night sweats and lousy sleep
If you keep waking up in the middle of the night, drenched in sweat, it may be a symptom of early menopause. It could, however, also be due to certain medications, hypoglycaemia (low blood sugar levels), or even the result of a high intake of alcohol. You may also experience lousy sleep in general, though this may be due to underlying mental health concerns such as stress or conditions such as obstructive sleep apnoea (OSA). To better understand your symptoms, keep track of your sleep, and when the night sweats happen and consult your GP to get to the bottom of it.
Vaginal dryness
Vaginal dryness is not uncommon, and most women will experience it at some stage of life. If you are going through early or premature menopause, your declining oestrogen levels can cause your vaginal tissue to lose lubrication and elasticity, leaving you feeling dry, itchy or sore, and unenthusiastic about sex. However, you may be experiencing vaginal dryness due to other factors such as medications, UTIs, or the overuse of perfumed soaps, washes, or vaginal douching products; surgical procedures and treatments such as hysterectomies and chemotherapy can also cause dryness.[7]
Anxiety, low moods, and brain fog
Anxiety and mood swings during early or premature menopause occur due to the fluctuating levels of hormones in your system and can leave you feeling fatigued and unable to concentrate. If your anxiety is resulting in physical symptoms such as exhaustion, an increased heart rate, headaches, or nausea, you should consult your GP to help rule out any possible underlying conditions that may be causing these. In sporadic cases, poor memory may also be a symptom of early-onset Alzheimer's disease, which may occur in your forties, so if you are experiencing significant lapses in memory, it would be advisable to consult your doctor.[8]
Diagnosing premature menopause
Diagnosing early or premature menopause starts with consulting your GP, who will assess your symptoms and family history, and carry out a series of blood tests to check your hormone levels. If they suspect that you are indeed going through premature menopause, they may refer you to a specialist who can help you better manage your situation.
While this may all seem very daunting, the key is to stay calm and not jump to any conclusions that may do nothing more than cause you unnecessary anxiety. Premature menopause is a manageable condition, and with the correct diagnosis and treatment, your quality of life can remain as great as ever.
[1] https://www.healthline.com/health/menopause/causes-early
[2] https://www.nhs.uk/conditions/menopause/
[4] https://www.womenshealth.gov/menopause/early-or-premature-menopause
[5] https://www.medicalnewstoday.com/articles/178635.php#complications
[6] https://www.nhs.uk/conditions/menopause/hot-flushes/
[7] https://www.nhs.uk/conditions/vaginal-dryness/
[8] https://www.mayoclinic.org/diseases-conditions/alzheimers-disease/in-depth/alzheimers/art-20048356
