You haven't had a period in a while, but pregnancy tests keep coming up negative. The only other explanation is menopause — but you're way too young for that. After all, you're still carting kids off to peewee football games and Daisy meetings. Menopause is a good 15 years in the future.
Or maybe not.
The average age of menopause is 51 in the US, but it can come a lot earlier for some women. According to the Mayo Clinic, about 5 percent of women experience "early" menopause, or menopause that occurs between the ages of 40 to 45.
Menopause — also called the change of life — marks the end of a woman's menstrual cycle and fertility. It's a natural, normal process that occurs as your body ages and your ovaries produce fewer and fewer amounts of the female hormones estrogen and progesterone, which are responsible for your monthly period. Menstruation typically starts becoming irregular as a woman enters her mid 40s to mid 50s (this phase, which can last an average of seven years, is called perimenopause). When you haven't had a period for 12 consecutive months, you have reached menopause.
Early menopause can be caused by a number of factors, some within your control and some not. But regardless of its causes, an early menopause can leave you feeling worried, sad—and old. It can be particularly devastating if you were still planning to have children. Why would your hormone levels bottom out a decade or more before their time? And how will this early menopause impact your overall health?
You can't reverse menopause, even if it occurs early, but you can understand its causes and symptoms and arm yourself with the information you need to keep yourself healthy and happy during this transition and beyond.
Menopause symptoms don't vary by whether or not you experience it late, early, or somewhere in between. While every woman's menopause is different, certain symptoms—which can occur sporadically in the years before menstruation finally stops for good—are commonplace. They can include:
Irregular periods. This means periods that are early or late, heavy or light, or even MIA for months at a time. These changes are due to fluctuating amounts of estrogen and progesterone produced in the body.
Hot flashes. These are intense and sudden feelings of warmth that mainly affect the chest, face, and head. They can also be accompanied by sweating (when they occur during sleep they are called night sweats) and heart palpitations. Experts aren't exactly sure what causes them, but they suspect that estrogen may play a role in regulating body temperature.
One thing is pretty certain though: Most menopausal women will experience hot flashes. In fact, an estimated 75 percent of them suffer with these feelings of warmth, sometimes for years after their last period.
Mood swings. According to the North American Menopause Society, up to 23 percent of peri- and postmenopausal women will experience mood swings, which might show up as anxiety, irritability, and anger. The reason: Your hormones help to regulate the brain chemical serotonin, otherwise known as the "feel good" chemical. What's more, sleep interrupted by night sweats, concerns about aging, and body image problems can all cause your mood to head south.
Vaginal dryness. Estrogen helps keep the vagina lubricated and supple. Without it, your vaginal tissue becomes dry and tight—and that can make sex painful.
Early menopause can be brought on for a variety of reasons, some that occur naturally and some that don't.
Premature ovarian failure (POF). POF is one of the main culprits behind early menopause. Your ovaries are made up of follicles, small sacs where eggs are stored while they mature. Some women can have problems with their follicles due to genetics, autoimmune diseases (examples include rheumatoid arthritis and lupus, conditions in which the body's immune system fights healthy tissue), and simply being born with a low number of follicles. But experts estimate that in up to 90 percent of POF cases, no known cause is ever found.
Being underweight. For reasons that aren't entirely clear, it appears as though women who are underweight (having a body mass index of 18.5 or lower) in early or mid adulthood have up to a 50 percent greater risk of early menopause compared to women who are of normal weight or who are overweight.
Ovarian cancer. Treatment options for ovarian cancer include surgery to remove the ovaries and chemotherapy and/or radiation to reduce tumors and the likelihood of cancer recurring. All these things can affect the health and function of the ovaries.
Tips on How to Cope With Menopause
1. See your doctor. If you're 45 and under and have stopped menstruating for more than a few months in a row, get checked out. You may be at the start of early menopause or you may have another health condition, such as polycystic ovarian syndrome (aka cysts on your ovaries), which can affect menstruation.
2. Consider hormone replacement therapy (HRT). Many doctors will recommend HRT for women undergoing an early menopause. HRT may come in the form of pills, patches, suppositories, and creams that contain estrogen, progesterone, or a combination of both. Estrogen, in particular, seems to have some protective effects on the heart (keeping arteries open and cleared of cholesterol), brain (it may ward off dementia), and the loss of bone mass. Losing estrogen before your time means that your body must live longer without its benefits. Research shows that women who enter menopause before age 45 are much more likely to die younger than women who have menopause at a later age — and many of those deaths are due to heart disease. As such, your doctor may recommend HRT to help reduce your increased risk of things like heart attacks, the bone-thinning disease known as osteoporosis, and other health complications. An added bonus: HRT can help lessen typical menopause side effects like hot flashes, vaginal dryness, etc.
3. Make lifestyle changes. To combat hot flashes, for example, turn the heat down in your home or office and sleep with a fan and light blankets. You can fight osteoporosis by eating a healthy diet rich in calcium, doing weight-bearing exercises, and taking a vitamin D supplement. And you can make sex more comfortable by using an over-the-counter vaginal lubricant and encouraging your partner to give you lots of foreplay.