Are your periods becoming more irregular and your periods stopping sooner than expected? These changes could be signs of early menopause, a stage that affects women before the age of 40 and can impact fertility and overall health.

In this article you will discover the causes of this condition, the symptoms to look out for, and what solutions exist to maintain your hormonal balance and well-being.

What is early menopause?

Early menopause, or premature menopause, is a rare disorder that refers to the permanent cessation of menstrual cycles before the age of 40.

Menopause is the stage of life when you can no longer get pregnant. Most women experience this natural process between the ages of 45 and 55. In the case of premature menopause, which affects about 1% of women, the ovaries stop producing estrogen and progesterone much earlier.

This can affect your fertility, bone density, and cardiovascular health, as well as your emotional state and quality of life.

The difference between premature menopause and primary ovarian insufficiency

Primary ovarian insufficiency is a dysfunction of the ovaries that usually occurs in women between the ages of 18 and 29 and involves the loss of the ovaries' ability to produce normal amounts of hormones. Although premature menopause and premature ovarian failure are terms often used to describe the same disorder, there are important differences.

Menopause marks the definitive cessation of menstrual cycles and is the result of the depletion of ovarian follicles, which is essentially irreversible. When it occurs prematurely, it occurs before the age of 40.

In contrast, premature ovarian failure is characterized by intermittent ovarian function in about half of affected young women. According to PubMed, PMID 10818427, these women may occasionally produce estrogen and even ovulate, and pregnancies, although rare, are possible even years after the initial diagnosis.

However, so far there are no safe treatments that restore fertility after a diagnosis of primary ovarian insufficiency.

Common causes of early menopause

Often the exact cause of menopause before the age of 40 remains unknown. Early onset can be determined by a variety of factors, from genetic predisposition to medical conditions or lifestyle influences.

However, specialists have highlighted several main categories that increase the risk of premature menopause:

Genetic factors of early menopause

When no obvious medical cause is established that led to the occurrence of early menopause, the most likely explanation is the genetic factor. It can be inherited, which is why women who have close relatives (mother, sister) with early menopause have an above-average risk of experiencing the same situation before the age of 40.

Autoimmune diseases

Autoimmune diseases, such as Hashimoto's thyroiditis or rheumatoid arthritis, can cause the immune system to mistake its own cells, tissues, and organs for invaders and attack them. When the inflammation caused by these diseases affects ovarian tissue, it can affect estrogen production and lead to premature menopause.

Chromosomal abnormalities

Some women are born with chromosomal changes that affect the function of their ovaries. For example, people with Turner syndrome are born with an incomplete chromosome, which can lead to inefficient ovarian function and early menopause. Other subtle genetic abnormalities can also reduce the reserve of ovarian follicles from a young age.

Viral infections

Although less common, certain viral infections can damage ovarian tissue and contribute to early menopause. Research suggests that viruses such as parvovirus B19 can reduce the activity of thyroid hormones and estrogen in the body, affecting the ovaries if left untreated.

Aggressive medical treatments

Chemotherapy, radiation therapy, and surgery involving the ovaries have been repeatedly linked to an increased risk of early menopause. While these treatments can be life-saving for serious illnesses like cancer, they can also hasten the onset of menopause.

Lifestyle and environmental factors

Smoking, chronic stress, exposure to toxins or certain environmental chemicals can affect estrogen levels and negatively influence ovarian function. Poor nutrition, a sedentary lifestyle, and lack of sun exposure can also contribute to hormonal imbalances that favor early menopause.

Symptoms and signs of early menopause

Early menopause can be difficult to recognize at first because the first symptoms can be subtle. Irregular menstrual cycles and periods that last longer or shorter than typical can easily be blamed on other conditions.

As menopause sets in, the signs become more pronounced and include both physical manifestations and emotional and cognitive changes that affect your quality of life and well-being.

Onset of Menopause - Physical Symptoms

The most obvious symptom of early menopause is that periods become less frequent or stop altogether, without pregnancy or other obvious explanation.

But there are other physical signs that can appear even before menopause sets in, and it's important to see a gynecologist as soon as you notice them. Talk to a doctor if you experience:

• Hot flushes
• Night sweats
• Sleep disorders
• Spotting
• Vaginal dryness (may cause discomfort or pain during sexual intercourse)
• Decreased libido
• Changes in menstrual cycle (irregular, shorter or longer periods than usual)
• Absence of menstruation ( amenorrhea )
• Other symptoms (weight fluctuations, headaches, thinning hair, dry skin, palpitations)

Early Menopause - Emotional and Cognitive Symptoms

In addition to the physical symptoms, early menopause can affect your emotional state and ability to concentrate. Some of the most common symptoms include:

• Anxiety (persistent states of worry or tension)
• Depression
• Irritability, accompanied by exaggerated emotional reactions or rapid mood swings
• Difficulty concentrating and remembering

Early Menopause - How to Diagnose

The gynecologist is the one who establishes the diagnosis, based on a combination of clinical evaluations, hormonal tests, and imaging investigations.

Irregular menstrual cycles and the absence of menstruation for 12 consecutive months can be clear indicators, so go to a specialist consultation as soon as possible if you suspect that you are in a situation of entering menopause earlier than you should. Early detection helps you prevent complications and choose the most appropriate solutions.

Recommended hormonal tests for early menopause

Blood tests are performed at the doctor's recommendation to evaluate ovarian function and hormone levels. The most commonly recommended tests are those that measure the levels of:

• FSH (follicle-stimulating hormone): for evaluating ovarian function;
• LH (luteinizing hormone): together with FSH, can confirm ovarian failure;
• Estradiol (estrogen): a low level suggests the onset of early menopause;
• Anti-Mullerian hormone: for evaluating ovarian function;
• TSH (thyroid stimulating hormone): to check the health of the thyroid gland;
• Additional tests , depending on your history and any associated conditions.

Transvaginal ultrasound for early menopause

If the doctor deems it necessary, he or she may perform a transvaginal ultrasound to assess the structure and size of the ovaries, as well as the follicular reserves.

Ultrasound results combined with hormonal tests provide a clearer picture of ovarian function and reproductive system health.

Medical history and clinical evaluation regarding early menopause

The complete evaluation also includes a pelvic examination and, if necessary, additional tests to rule out other causes of menstrual disorders.

Your doctor will also consider your menstrual history, family history, and any associated conditions to make a diagnosis. That's why it's important to tell them about all your symptoms, any medical treatments you've had, any surgeries you've had, and whether you suffer from autoimmune diseases.

The impact of early menopause on health

Early menopause affects you beyond fertility and the absence of monthly bleeding. The premature onset of this stage in your life can have consequences for your overall health, both physically and psychologically.

The early decline in estrogen levels affects numerous systems in the body, from the skeletal and cardiovascular to the mental state and emotional balance. Therefore, we remind you that early menopause is associated with a number of risks such as:

Osteoporosis risk

Estrogen plays a key role in maintaining bone density. Drastically dropping its levels before the normal age of menopause can accelerate bone loss, increasing the risk of osteoporosis and fractures.

Cardiovascular diseases

In women of childbearing age, estrogen helps protect the cardiovascular system. It helps increase the level of "good" cholesterol (HDL) in the body and keep the level of "bad" cholesterol (LDL) under control.

When menopause occurs earlier, the early decrease in estrogen levels may be correlated with increased LDL levels and, implicitly, with the risk of hypertension and heart disease.

Decreased cognitive ability

Low estrogen levels can negatively impact cognitive functions such as memory, attention, and processing speed. Studies suggest that early menopause may increase the risk of long-term cognitive decline.

Depression

In addition to the emotional changes caused by early menopause, the reduction in estrogen also affects neurotransmitters such as serotonin, which are involved in mood regulation. This can increase the risk of depression, anxiety, and irritability. Psychological support, counseling, and, in some cases, medication treatments can help manage symptoms.

Early Menopause - Treatment

Premature menopause is not reversible, but treatment aims to improve symptoms and reduce long-term risks. This is determined together with the gynecologist, depending on the severity of symptoms, general health and individual goals, such as the desire to become a mother or preventing osteoporosis.

From hormone therapies to lifestyle recommendations, there are many ways you can manage the symptoms of early menopause:

Hormone replacement therapy (HRT)

The decision to start this treatment is made only on the recommendation of a doctor, taking into account the associated risks.

Hormone replacement therapy consists of administering estrogen to compensate for the decrease in natural production in the body, thus replacing some of the hormones that the ovaries are no longer able to produce. It is considered one of the most effective methods of relieving menopausal symptoms such as hot flashes, vaginal dryness, and night sweats.

It may also reduce the risk of osteoporosis and cardiovascular disease.

Non-hormonal treatments

For women who cannot or do not want to take hormone therapy, there are non-hormonal options that are effective in relieving symptoms.

These include medications to reduce hot flashes and night sweats, as well as calcium and vitamin D supplements that support bone and heart health.

Patients who experience the effects of early menopause more strongly on an emotional level may be recommended antidepressants or anxiolytics.

Natural remedies and complementary therapies

Changes in daily habits and certain complementary therapies can help manage symptoms, but these should be discussed with your gynecologist first.

Red clover and black cohosh are herbs often used in herbal medicine to reduce hot flashes. Relaxation and mindfulness techniques can be helpful in controlling anxiety and depression, while exercise and yoga can help maintain bone mass and improve sleep.

Last but not least, a balanced diet is essential for overall health and hormonal balance.

Lifestyle recommendations for women with early menopause

Along with the drug treatments recommended by your doctor, adopting a healthy lifestyle is equally important for managing the symptoms of early menopause.

It's about making simple changes and implementing healthy habits related to diet, exercise, and stress management. Repeated day after day, these can contribute enormously to maintaining your hormonal balance and overall well-being at any stage of life, especially when you enter menopause early.

Balanced diet

A nutritious diet, rich in protein, complex carbohydrates, quality fats, and as many vitamins and minerals as possible from vegetables and fruits, supports bone, heart, and brain health.

Proper hydration and limiting the consumption of sugar, trans fats, and ultra-processed foods are equally important for optimal body functioning and skin health.

It is also recommended to include dairy products, green leafy vegetables, fatty fish, and fortified foods such as cereals and soy in your diet. These can provide you with an adequate intake of calcium and vitamin D, helping to maintain bone density and prevent osteoporosis.

Regular physical activity

An active lifestyle supports the maintenance of bone mass and muscle mass, while also protecting your cardiovascular health.

Strength training with light weights is recommended to take care of bone and muscle health. Cardiovascular exercises such as walking, running or swimming support heart and lung health, while stretching and yoga are effective for flexibility, balance and reducing muscle tension.

Stress management

Chronic stress can worsen early menopause symptoms and hormonal imbalances. To manage your emotions and induce a relaxed state, you can try numerous mindfulness techniques such as deep breathing and meditation, or even recreational activities that put you in a positive mood.

It is also recommended that you create a regular sleep schedule to give your body time to recover. Support from family and friends can also be very helpful at this stage of life.

Frequently asked questions about early menopause

Although early menopause marks the end of natural fertility, it is important for every woman to understand that life does not stop there. This new stage does not define your worth or define you, but only reminds you to take better care of your health.

Additionally, there are many options that can help you manage your symptoms and maintain your hormonal balance, taking care of your body and mind. If you still have questions and want to learn more about how to get through this period as smoothly as possible, we hope the section below will provide you with the answers you need.

Can you get pregnant during menopause?

In most cases, early menopause marks the end of natural fertility. Although not impossible, it is very rare for pregnancy to occur from occasional ovulation after menopause sets in. If you want to have children, there are options such as in vitro fertilization that you can discuss with a specialist.

At what age can early menopause occur?

While normal menopause usually occurs between the ages of 45-55, premature menopause occurs before the age of 40. Depending on the causes, there are situations when it can even occur around the age of 30.

Does early menopause affect fertility?

Yes, early menopause is characterized by the cessation of menstrual cycles and the loss of the ability to get pregnant. If you want to have children, it is important to consult a specialist as soon as possible and explore different fertility preservation options.

Are there natural remedies for treating early menopause symptoms?

Some herbs and supplements, such as red clover and certain vitamins and minerals, are thought to help relieve symptoms of early menopause. However, their effectiveness is not guaranteed, and it is always recommended to consult your doctor before trying any type of natural remedy.

Can lifestyle prevent early menopause?

A healthy lifestyle can't always prevent early menopause, especially when the causes are genetic or medical. But a balanced diet, an active lifestyle, and stress management can help improve symptoms and reduce long-term health risks.

How does early menopause affect bone health?

Estrogen protects your bone density during your childbearing years. But its levels drop dramatically in women who go through menopause prematurely, which can accelerate bone loss and increase the risk of fractures and osteoporosis. Regular exercise and a diet rich in calcium and vitamin D can help keep your bones strong and healthy.

Is there a link between stress and early menopause?

Stress is not a direct cause of early menopause, but it can exacerbate associated symptoms such as hot flashes, insomnia, and mood swings. Relaxation techniques, meditation, and maintaining a balanced lifestyle can help you reduce its negative effects.

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