Menopause & perimenopause

Early menopause — feeling good and finding your way

by Marcelle Pick, OB/GYN NP

When women in their early 40’s think they may be in early menopause, it can feel devastating. They feel unprepared for the intense hot flashes, night sweats, fatigue, anxiety, cravings, and more, and wonder what they may have done wrong. It makes sense that women going through early menopause feel surprised, angry and, most of all, confused.

Menopause — the complete absence of periods for at least a full 12 months — is defined as being “early” when it occurs between the ages of 40 and 45. It’s true that when our periods end, our fertility shifts, but this may also cause a shift in our sense of identity.

For the vast majority of women, menopause — even if it’s “early” — is a natural event, not so much the end of something as the entry point to a calmer, steadier stage of life. Given time and appropriate support for your physical and emotional needs, you and your body will adjust to this normal transition. Here’s some guidance for getting there.

• Different labels used for menopause
• Why me? Possible causes of early menopause
• The emotional impact of early menopause
• Tips for taking care of your health during early menopause

Experiencing early menopause does not mean there is anything wrong with you. Menopause — even early menopause — is not an illness. But the symptoms may catch you by surprise, leaving you wondering what the future holds. That’s why early menopause is an invitation to get to know your body, and understand what’s happening during this significant transition.

Yes, there are important considerations for you in early menopause, but it doesn’t have to be a time to force yourself to let go of the past, or to stifle regrets about childbearing. Instead, allow yourself the space to work through these concerns thoughtfully and gently, being kind to yourself along the way.

 

The different labels used for menopause

While the total number of women with early menopause represents a tiny percentage of the female population, statistics may be skewed because early menopause, premature menopause, and premature ovarian failure (POF) are often lumped together.

Many aspects of early menopause overlap with premature menopause and POF. Women can also move more quickly into menopause after undergoing certain kinds of surgery or medical treatments. Here are some common terms used to classify menopause:

• Surgical menopause occurs as a result of hysterectomy, oophorectomy (removal of ovary/ovaries), and some other pelvic surgeries.
• Medical menopause can occur following medical treatments such as radiation therapy and chemotherapy, and during the course of some drug regimens like tamoxifen (used mostly to prevent recurrence of breast cancer). In some cases, fertility may return after treatment ends.
• Premature menopause occurs before age 40 in approximately 1% of women. Premature and early menopause may occur more frequently in certain global regions due to the effects of poverty and malnutrition in those cultures. Scientists are also looking at environmental pollution and toxicity as causes.
• Premature ovarian failure (POF) is a term used to describe loss of ovarian function in women younger than 40. I think the word “failure” is unnecessarily harsh, but technically, POF refers to ovarian hypofunction (low function) — perhaps the ovarian follicles do not produce viable eggs, or there is a lack of eggs. Between 5–10% of women diagnosed with POF do go on to become pregnant without intervention. But other than that, POF and premature menopause are functionally the same.
• Early menopause occurs naturally between the ages of 40 and 45. If you think you may have early menopause, talk with your practitioner to rule out other possible health factors and to help you prepare for this transition.

 

Why me? Possible causes of early menopause

Many of our patients and Personal Program Members wonder why menopause came early for them. There are likely multiple contributors to the onset of early menopause, and we haven’t identified all of them yet. But researchers have some facts we can share.

• Your genes. Scientists have observed that women with a family history of early menopause are 60% more likely to go through menopause earlier themselves. As with most inherited traits, such as height and eye color, multiple genes contribute to the timing of a woman’s “ovarian aging.” But even though complex genetic factors are the main determinants, I think generational patterns of nutrition and lifestyle contribute silently as well.

You don’t have to be in perimenopause or menopause to have symptoms of hormonal imbalance. Consider Melissa’s story...

At age 40, Melissa thought she was entering early menopause, with irregular menstrual cycles and other menopause-like symptoms, including fatigue, frequent headaches, and joint pain. When she joined the Personal Program for Hormonal Imbalance, Melissa was able to provide the nutritional and lifestyle support her body needed. Her symptoms began to go away — and her cycles normalized.

Read more of Melissa’s story...

• Environmental toxins. I have long suspected that the increasing toxicity of our planet is affecting our reproductive health, and research is beginning to bear that out. It’s been demonstrated that developmental events occurring in utero (while the ovaries are forming) can result in a smaller number of egg-producing cells, which shortens a woman’s reproductive lifespan. While scientists aren’t sure whether genetics or environmental influences were programming this gestational event, I think we’ll find that environmental and toxic exposures, particularly in our homes and workplaces, are changing the reproductive status of both men and women.
• Lifestyle factors. Poverty, and the poor nutrition that often results from it are both clearly associated with early menopause. This underscores just how crucial basic nutrition is to a woman’s reproductive health. Studies show that smoking cigarettes may bring on earlier menopause — but only by a year or two. Smoking also generates a 30% increase in your risk of transitioning into the earliest stages of menopause, as represented by changes in your pattern of menstrual bleeding. As for alcohol intake, some science suggests it may be a significant predictor for entering natural menopause at a slightly younger age — though not early menopause per se.
• Medical treatments. In some cases, chemotherapy and radiation treatments can bring on menopause earlier than it might have occurred “normally.” In contrast, the use of oral contraceptives can reduce the risk for early menopause, according to some studies.

 

The emotional impact of early menopause: I’m not ready for this!

It’s more common now for women to wait longer before trying to get pregnant than it was when I was younger. Advances in reproductive medicine have helped countless women realize their dreams of biological motherhood, but early menopause changes things considerably, and this reality can be painful. I tell women who still want to become mothers that, although it may not happen the way they had hoped, there are many other paths to motherhood.

Even for a woman who isn’t contemplating pregnancy, unexpected early menopause can make her think, Well, now it’s impossible to have a baby — even if I wanted to! There can be a sense of powerlessness, along with the hollow feeling that fertility has been taken away, or even stolen. Some women have told me that early menopause made them feel “dried up” or as if they were losing the cornerstone of their womanhood.

For others, it’s the surprise of it all, especially if they weren’t aware of family members with early menopause. These women often say that early menopause has made them feel older than their chronological years.

Early menopause is a developmental milestone for women, it’s true. But it is also a time of reflection and insight. If you are patient with yourself, you’ll find there are some wonderful things on the other side of menopause (see the box at right). And I promise that if you respect your body and your emotional health, you will find your way to feeling good again.

 

Tips for taking care of your health during early menopause

In the years before menopause, the sex hormone estrogen provides us with some protective health benefits, especially for our bones and our hearts. If you experience early menopause as a result of your genes, those same inherited factors could raise your risk for osteoporosis and cardiovascular disease. But there are many natural, proactive measures you can adopt to help reduce risk for disease, especially with respect to bone and heart health.

First, feel better. It is very common to experience symptoms like hot flashes, night sweats, fatigue, cravings, and more while your hormones are shifting. As you make a plan for early menopause, start by feeling better. There are so many herbs that have now been studied and proven to help women with menopause symptoms. We offer gentle endocrine support in our Herbal Equilibrium, as well as a nutrition and lifestyle plan to minimize health risks while relieving symptoms. I use this combination at the clinic and see great results. Restoring hormonal balance naturally is a worthwhile goal during the menopause transition, both to feel better and to support your health as you move forward.

Preserve your strong bones. Your bones are meant to last your whole life — as long as they get the necessary support to stay strong and resilient. One way to support your bones is to add more daily vitamin D. It’s easy, inexpensive, and we think it makes a huge difference. Our bone health expert, Dr. Susan E. Brown, provides a road map for recovering and preserving bone health in menopause regardless of when it occurs. And we’ve developed a bone-building component to our Personal Program for Hormonal Imbalance, if this is concern for you.

Take care of your heart. Research shows that as women get older, their risk increases for cardiovascular issues, including stroke. But while early menopause ups your overall risk for heart problems, older age itself is the more significant risk factor. And you can significantly offset both these risks for disease with improved nutrition and fitness.

Women in early menopause can modify other risk factors for cardiovascular disease, too, by:

• Establishing a healthy weight
• Quitting smoking
• Exercising regularly

From what we now know about epigenetics (meaning control above our genes), we know that you can use nutrients, diet, and lifestyle changes to decrease your risks for disease. And I truly believe that you if you’re motivated and committed to making long-term adjustments, you will see results. I encourage all women to pay attention to blood pressure, blood sugar, and cholesterol levels, and to choose practitioners who will partner with you to keep track of your baseline numbers. (See our guide to women’s health testing to learn more.)

For all types of menopause-related symptoms, including yours — our Personal Program works!

Each woman’s menopause is a unique journey. Women to Women makes each path easier with research-based solutions that work naturally with your body to achieve effective symptom relief. We’ve also developed the kind of diet and lifestyle assistance that can make your results last — a key difference between our Program and any of the single-bottle options out there. Choose our Personal Program because it can make a genuine difference in the way you feel every day. See more now.

• Many women use our Hormonal Health Profile to find out what’s causing their specific symptoms. Try it yourself — it’s fast, easy, and informative and you can take it now.
• If you have a few moments, call and talk to us about your symptoms or the Program. We’re in Portland, Maine, and we’re ready to listen. Call us toll-free at 1-800-798-7902.

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