Early Menopause- Signs and Its Management

Most women hear about menopause, but nobody knows that there is early menopause, which also needs to be understood. Also, during that phase, 35% to 40% of women went through depression, anxiety, and other issues, like a rollercoaster of hormonal changes, and physical and emotional imbalance. That is why early detection is key for managing symptoms and long-term health.

Let’s start with menopause and then understand the signs of early menopause, what things to watch and how to manage it.

Menopause is defined as a cessation of menstruation, and also indicates that the era of the menstrual cycle is ending. When a woman has gone 12 consecutive months without any period cycle, then this indicates that she has entered the phase of menopause. Menopause usually occurs between the ages 45–55. If it begins before 40, it’s called premature menopause; between 40–45 is early menopause. Although hormonal changes after 30 are most common, and because of the decreased number of eggs and estrogen, women start to experience many changes in themselves.

Let’s break down the phases of menopause.

• Premenopause- a phase where women still get their period, regular or sometimes irregular. But, she went through some hormonal changes that might not be noticeable.
• Perimenopause- this stage indicates that the body has officially entered the phase of menopause. The level of estrogen fluctuates and makes women difficult to get pregnant. 
• Menopause- a phase where a woman’s body naturally stops the reproductive phase, leading to no menstrual cycle. This usually happens after 50 years age of, but typically it varies from woman to woman.

What is Early Menopause?

When a woman goes through the phase of menopause at an earlier age, between 40 and 45. More than 5% of women get early menopause, while around 1% get menopause before 40 years age of. It can happen either naturally or because of some medical condition.

Women need to understand that it is possible for them that their menstruation might end before 45, and this indicates the sign of premature menopause. It can be because of genetics, medical conditions, surgical interventions, medical treatments, or other unknown causes, which your doctor can tell after consultation.

Common Causes of Early Menopause

There are some common causes which every woman should. Even if women are in their mid or late 20s, they should know about the changes their bodies will make in upcoming years. Because knowledge can help you or your loved ones.

Family history

According to the National Institutes of Health (NIH), the chances of having early menopause increase 6-fold if a mother has a similar problem. And it will pass on from generation to generation. The involvement of DNA repair like CHEK2 and BRC2 highly influences the severity of the issue.

Autoimmune disorders

In this situation, our body’s immune system mistakenly attacks ovaries which results in premature ovarian failure. Thyroid, rheumatoid arthritis, and some other autoimmune disorders impair the production of hormones, and that is when women started to experience health concerns.

Surgical removal of ovaries

It is also known as bilateral oophorectomy, where regardless of age, a surgical procedure is used to remove both ovaries. Ovaries help to produce progesterone and estrogen, which are essential for fertility, the menstrual cycle, and other bodily functions. But this surgical process leads woman towards their menopause phase early in their life.

Chemotherapy or radiation

Chemotherapy is induced with an agent like cytoxan, which directly impacts the pelvis and damages the ovaries. As per NIH research, almost 42% of women with cancer reached menopause before 31 of age. While women under 40 have a 30% to 40% of risk having premature menopause because of radiation and chemotherapy.

Chromosomal abnormalities

Turner syndrome, fragile X syndrome, and autosomal translocation directly impact the reproductive health of a woman and lead to early menopause. The extent is highly dependent on the type and stage of cancer. These have abilities to impair the functions of the ovaries, carry a premutation of the FMR1 gene, and can cause premature ovarian failure.

Also, women who are born with missing chromosomes or have issues with that go through early menopause. Moreover, women with HIV and AIDS get more intense symptoms of early menopause than others, and even the medicine is unable to control their experience to some extent.

Smoking or poor lifestyle factors

There is a direct link between early menopause to lifestyle factors. Women who are on an intense diet, eating low calories, and not fulfilling the body’s natural calorie needs may lower the production of estrogen and its storage in fat tissues. This can trigger the issue. Also, long-term or regular smokers are more vulnerable to early menopause, and the chances of getting 2 years earlier than they should be is higher. Cigarettes disrupt hormonal balance, reduce estrogen, and damage ovarian cells, and follicles.

Signs & Symptoms of Early Menopause

The symptoms and signs of early menopause are somehow similar to the ones who have natural menopause. Here are some of the signs and symptoms-

• Irregular or missed periods- ovaries produce less progesterone and estrogen, which leads to unpredictable periods. Even some experience heavy flow, while some get very lighter or shorter periods. Also, because ovaries are unable to release an adequate amount of eggs, this leads to missing periods.
• Hot flashes or night sweats- this is one of the signs that indicate the problem. Due to hormonal shifts, the hypothalamus has an impact (which is a control center of the brain’s temperature), and this mistakenly generates heat in the body. This triggers events that try to cool down the body, but end up having sensations of heat, sweat, and hot flashes.
• Mood swings, anxiety, or depression- hormonal fluctuation is the one that results in the issues. Some women even complain about low energy, feelings of hopelessness, and constant anxiety. Moreover, due to vaginal dryness, they even face difficulty in sleeping which also leads to irritated moods. Around 35% of women have depressive symptoms during this phase.
• Vaginal dryness or discomfort during sex- a lower level of estrogen in the body reduces the thickness of the vaginal wall and reduces elasticity and lubrication. Due to the reduction in the body’s natural lubrication, women experience pain and discomfort during intercourse.
• Sleep disturbances- due to vasomotor symptoms and hormonal shifts created issues that lead to disturbed sleep patterns, and the body’s circadian rhythm. Also, hot flashes worsen the sleep pattern.
• Reduced fertility or difficulty conceiving- hormonal changes in the 30s are early menopause symptoms, and this disturbs the period cycle and ability of ovaries to release eggs, which creates difficulty in analyzing the ovulation phase. This reduces the chances of conceiving.
• Memory lapses or brain fog- hormonal imbalance causes cognitive changes including difficulty in concentrating, brain fog, memory lapse, unable to remember things, mental fatigue, and emotional rollercoaster.
• Loss of libido- due to vaginal dryness, difficulty during intercourse, irritation due to sleeping issues, and lower level of estrogen cause issues with sexual function and desire. Sometimes, this also creates consequences between couples and causes relationship turmoil.
• Hair thinning or dry skin- as per experts, half of the women experience hair thinning and itchy skin due to dryness while transitioning into the menopause phase. The earlier the level of estrogen drops, the earlier the issue of hair thinning and dry skin starts.

How Early Menopause is Diagnosed?

If women experience any of the issues of menopause, then there are some tests that can help to diagnose early menopause-

• Hormone blood tests- through a combination of hormonal blood tests with clinical assessment, the issue can be detected. Follicle-stimulating hormones, estrogen, and anti-mullerian hormones can help like higher FSH produces fewer eggs, AHM helps to analyze the number of remaining eggs, and estrogen level helps to predict how far a woman is before her menopause phase.
• Thyroid and prolactin tests- the test is conducted to analyze the level of hormones. A thyroid function test helps to know about underactive thyroid which mimics menopausal symptoms, prolactin level helps to analyze the irregularity of periods.
• Pelvic ultrasound- this helps to evaluate ovarian reserve and analyze the size of ovaries, presence of follicles, and other concerning features.
• Menstrual history evaluation- this is one of the core analyses of the situation. Thorough medical history examination including, menstrual history, family medical history, or other medical conditions are analyzed to know the condition.

Potential Health Risks

One might not know that, but several health issues are linked with early menopause. Let’s understand the issues-

• Osteoporosis- early menopause increases the risk of Osteoporosis. As the level of estrogen drops, women start to lose their bone density, making bones weak and brittle. This also increases the risk of hip fractures.
• Heart disease- estrogen plays an important role in protecting health, but the reduction of levels increases cholesterol levels, blood pressure, and body fat, and levels up the risk related to heart diseases.
• Infertility- disturbance in the menstrual cycle, inability to track ovulation and decreased body’s natural lubrication causes difficulty in conceiving naturally.
• Mental health changes– not only physically, but early menopause also creates issues with mental health. Depression, anxiety, issues in remembering things, and insomnia are some of the issues that women experience.

Treatment & Management

It is not like you cannot treat the issues. Early navigation and detection can help to treat early menopause or reduce the risk involved with it. Here are some of the treatment options-

• Hormone Replacement Therapy (HRT)- under this treatment, doctors replace estrogen and progesterone which directly improves the menstrual cycle and reduces the issue of hot flashes, and vaginal dryness. It also produces relief in menopausal symptoms.
• Calcium & Vitamin D supplements- they don’t treat properly, but eventually they help to manage the potential issues. Vitamin D helps the body absorb calcium and improve bone density, support immune function, and regulate moods. , Vitamin C works as an antioxidant that combats fatigue, produces collagen, supports joints, and improves skin texture.
• Lifestyle changes- this might sound mundane, but changes in lifestyle can make significant beneficial results. Weight exercise can help to reduce body fat percentage, aerobics can help to reduce the frequency of hot flashes and release happy hormones. This helps to regulate mood. Incorporating a healthy diet improves brain function, and heart health and makes improvements in menopausal symptoms.
• Stress management techniques- this doesn’t treat directly, but yes it can help to manage symptoms and improve overall bodily functions. Meditation, yoga, deep breathing, and mindfulness help to relax muscles and calm your mind, which aids in managing stress and depression symptoms.
• Medical intervention- based on the condition, doctors recommend birth control pills. These are induced by progestin and estrogen, which helps in regulating hormonal levels.

Emotional & Psychological Support

Due to hormonal fluctuation emotional and mental turmoil happened, but there are some strategies which you can opt for to manage the emotional burden.

• Support groups or therapy- you can either get help from a psychologist or join a support group that is going through a similar phase. It is advised to consult with experts like Cradle Children Hospital, who focus on the needs of women.
• Educating partners/family- support from family and significant partners is really important. Try to educate them about the situation, so that they can help you throughout the phase without any judgment. Because support from family and friends matters the most.
• Counseling for fertility-related anxiety- if you are planning to conceive and trying for several months, it is advised to get counseling. They can help you to know about your fertility situation and let you know about the options you have. First of all, don’t feel shy while consulting, because they can only help when you openly express your problem.

Why Cradle Hospital for Menopause Care?

According to NIH, more than 30% of women avoid visiting specialists when it comes to menopause care. But they don’t know, if they are able to handle perimenopause signs and diagnose early symptoms, then they can smoothen their journey of menopause. Cradle Children’s Hospital provides effective menopause care, and treatment with personalized solutions because everyone phases different situations. We provide-

• Holistic gynecological care- with personalized care, preventive steps through detection and management, addressing emotional and physical issues, empowering women, and ensuring overall health, Cradle Children Hospital focuses on providing the best to everyone.
• Hormonal evaluation & advanced diagnostics- menopause is all about hormonal fluctuation. That is why, we provide a full assessment with cutting-edge technology to ensure advanced diagnosis of the issues.
• In-house endocrinology & fertility experts- focus on issues like infertility and hormonal imbalances. Fertility experts help to analyze every possible situation so that they can give the best advice.
• Compassionate support- not just in menopause, the team of experts and professionals focus on providing comprehensive guidance in every stage of their phase. Whether it is a gynecological issue or emotional health, our experts are always there to help you.

Conclusion

The starting of the menstrual cycle is a journey of womanhood, but having early menopause doesn’t mean that it is the end of the era of womanhood. It is a chapter that everyone should enjoy. Yes, for some it can be very challenging, for some not, but having an experienced gynecologist by your side can solve a number of problems.

If you are facing issues related to reproductive health, or you have noticed any of the symptoms mentioned in this article, it is advised to reach out to a specialized gynecologist. Expert guidance can help your several health complications. Cradle’s gynecology team is here to support your journey with expert care, and adequate guidance. For more information, feel free to consult with us and start your journey towards healthy living.