Whenever I heard the words “menopause” or “postmenopausal women” I used to picture gray-haired abuelitas. I never expected menopause could sneak up on you in your 40s! It turns out that a number of reasons, from medical treatments to genetics or lifestyle choices, may bring about the early onset of menopause. If you haven’t turned 40 yet when this happens, it is medically described as premature menopause. If you are between 40 and 45 years of age, it is called early menopause.
The average age for natural menopause in the United States is 51, which means I was wrong about the gray-haired grannies! Whatever the timing is, when it occurs naturally, the process is divided into three stages: peri-menopause, menopause and post-menopause. The first stage, usually lasting a few years, is easy to detect for most of us because things begin to feel different. Typically a woman will experience irregular periods, increased menstrual discomfort, vaginal dryness, mood swings, decreased sex drive and even hot flashes.
During this time, the decline in fertility does not eliminate entirely the possibility of getting pregnant, so watch out if you are not planning for another baby! After this transition, the absence of menstrual periods for 12 consecutive months signals a woman has entered menopause. This marks the end of her fertile years and only at this point is it safe to stop using birth control.
Nowadays, when childbearing is prolonged well into our 40s, early or premature menopause can be devastating news for many hopeful mamis who are still counting on having children. Premature menopause cannot be reversed, so women who are planning a family must seek the help of fertility experts.
While in the great majority of cases there is no apparent cause for the early timing of menopause, in others it may be linked to one of the following factors:
- Family History/Genetics: Women tend to experience menopause around the same age as mother and sisters, so if your mother went through menopause at an early age, chances are you will as well.
- Not Giving Birth: Some studies show that women who haven’t delivered a baby have a greater chance of going through “the change” at a younger age.
- Smoking: Among women who smoke, menopause can occur a year or two earlier than in non-smokers, as several studies conducted in the U.S. have confirmed.
- Childhood Cancer Treatment: Girls who have been treated for cancer in their childhood with chemotherapy or radiation therapy in the pelvic area tend to go through menopause earlier than the average woman, according to Mayo Clinic.
- Autoimmune Disorders: Lupus, Graves disease, hypothyroidism or rheumatoid arthritis are the probable cause of up to 30% of early menopause cases, as a result of the immune system mistakenly attacking the ovaries.
- Viral Infections: It is thought that a virus, such as mumps or cytomegalovirus (CMV), can trigger early menopause, although the evidence is still inconclusive.
Read Related: Great Sex Through the Ages
Unlike the natural process, when the ovaries gradually reduce the production of estrogen and progesterone, menopause can be caused by surgery or triggered by cancer treatment, as in my case. When induced, symptoms appear suddenly and are often more severe compared to the natural process.
- Surgical Menopause: Removing a woman’s ovaries, in an operation called bilateral oophorectomy, will abruptly alter hormone levels. This is usually performed to treat ovarian, cervical or uterine cancer, but can also be prescribed for uterine fibroids or endometriosis.
- Hysterectomy: An operation which removes the uterus but spares the ovaries does not necessarily cause the immediate onset of menopause, but can often lead to the woman experiencing this sooner than average.
- Medical Treatments: Chemotherapy and radiation therapy can damage the ovaries and interrupt menstrual periods. Depending on the age of the woman and the specific drugs and dosage received, this damage may be permanent, resulting in early menopause, or only temporary. Hormonal therapy for breast cancer can have the same side effect.
- Primary Ovarian Insufficiency: In the past, the terms POI and premature menopause have been used interchangeably but they are not exactly the same. The first tends to occur at an earlier age, even during the teens, and generally causes irregular periods. There is still a slim chance of getting pregnant with POI, but not for women who have gone through menopause.
MORE THAN HOT FLASHES
We have all heard women complain about hot flashes and night sweats, which can be very disruptive. But they are only a small piece of the puzzle. The lower estrogen levels after menopause lead to changes in women’s overall health. However, for those with premature or early menopause, there is a greater risk of suffering from serious conditions related to the lack of estrogen, including osteoporosis, heart disease, stroke, cataracts, gum disease and some types of cancer.
Menopause—dread it or welcome it, we need to learn how to live with it! Some relaxation techniques will help with emotional symptoms and relieve hot flashes. For many conditions related to menopause, the right lifestyle choices, including a healthy diet and exercise, will really make a difference. If you experience spotting or bleeding after menopause, you should see a doctor as soon as possible, because it may be a sign of a serious condition.