What to Know About Early and Premature Menopause
A few years ago, I went with a friend to the pharmacy after we dropped off our middle schoolers. Staring at the pregnancy tests, I could feel her nerves. At age 42, she hadn’t been pregnant in more than a decade and thought her days of raising babies were over for good, but not having had a period in eight weeks could only mean one thing. The test was negative, so she bought another a few days later, which was also negative. Then a trip to her doctor brought her news she simply was not ready to hear.
“ ‘You may be menopausal.’ That’s what my doctor told me, and I thought she was surely joking,” she told me later that week. “I’m young. My period has always been like clockwork, and I feel fine.”
My friend’s doctor was right, and her period never returned. To make things more confusing, one of the moms in our circle was unexpectedly pregnant at 46. We all spent a lot of time outside the school that year talking about how entirely strange fertility can be, and how just when you think you know what to expect from your body, you can easily get a surprise in more ways than one.
Average Age of Menopause
According to the American College of Obstetricians and Gynecologists (ACOG), the average age in the United States is 51, but menopause can occur between 40 and 60. It happens when your ovaries stop making estrogen, your periods stop, and your body moves out of its reproductive years. When this happens between 40 and 45, it’s considered early menopause, and before age 40, it’s known as premature menopause.
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According to Yale Medicine, approxiamtely 5% of women experience early menopause, and about 1% of women go through premature menopause, which can happen in their 30s and in some rare cases, even earlier.
“There are certain genetic reasons and autoimmune conditions that can lead to early or premature menopause, but sometimes we never really quite know why it happens,” says Hugh Taylor, MD, chair of Yale Medicine Obstetrics, Gynecology & Reproductive Sciences.
Causes of Early and Premature Menopause
Possible causes include
- Autoimmune disease
- Chemotherapy treatment
- Hysterectomy (which sends a woman into instant menopause)
- Smoking
- Genetic component
- History in the family
There isn’t a single test that definitively diagnoses menopause. Instead, doctors officially diagnose it after you’ve gone 12 straight months without a period. The stretch of time leading up to that point, when symptoms start popping up and cycles become unpredictable, is called perimenopause. It can last a few months or stretch out for years, with most people spending about four years in this transition.
Still, it’s a good idea to have certain hormones tested at your annual visit. The Mayo Clinic recommends that women test follicle-stimulating hormone, estrogen, and thyroid-stimulating hormone. Follicle-stimulating hormone levels increase and estradiol levels decrease as menopause occurs, while an underactive thyroid (hypothyroidism) can cause similar symptoms.
Signs and Symptoms
Signs and symptoms that you may be headed toward menopause include:
- Irregular periods (very heavy, longer, or shorter than usual)
- Vaginal dryness
- Hot flashes
- Night sweats
- Sleep problems
- Mood changes
- Stubborn weight gain
The vast majority of women report symptoms, and up to 70 percent of women experience hot flashes for years, but there are those who do not. Some women experience no symptoms other than the absence of a monthly period. Others can have unusual symptoms like urgent and painful urination, brain fog, shoulder pain, bone and muscle aches, and dry skin.
“I felt fine throughout,” my friend recently told me. She has not had a period in three years and is considered post-menopausal now. “Once I knew I wasn’t pregnant and got over the shock of what was happening, I was actually relieved. I didn’t have any debilitating symptoms, and I honestly don’t miss my period at all!”
If your periods are changing or you’re noticing symptoms that could point to menopause, look for a gynecologist who specializes in hormone testing and menopause care, bring a list of questions, and get clear answers. You’ll feel so much better knowing what’s actually going on instead of wondering.
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