12 Signs of Premature Menopause and How to Treat It
For months now, you haven’t been feeling like yourself. You’ve been getting hot flashes, night sweats, mood swings, and fatigue. In fact, if you didn’t know better, you would say that you are going through menopause.
But that can’t be right. You’re not even 40 years old! Nobody else you know in their 30s is going through menopause. And last you checked, menopause was supposed to hit around age 51. You’re nowhere near that!
Actually, a lot of people are unaware of this, but menopause can sometimes take place early—even before age 40. When that happens, it is known as “premature menopause.”
First Of All, What Is Menopause?
Before we talk about what causes premature menopause, signs you might be going through it, and how you can treat your symptoms, let’s talk about what menopause actually is.
“Menopause is when I stop ovulating and lose my reproductive ability, right?” you might say.
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That is true, but it is very useful to know that menopause has not formally occurred until:
- You have gone an entire year without a period.
- Your ovaries have stopped producing estrogen and progesterone.
Prior to that happening, you will probably experience irregular periods for an extended time, often years.
So if you miss a few periods in a row, you cannot necessarily say that you are in menopause, even if you used to be really regular. You could be perimenopausal, but you are not yet in menopause.
When Is Menopause Defined as Premature?
Menopause is considered to be premature if it occurs before the age of 40. If you are older than 40 and going through menopause, it is earlier than the average, but is not “premature.”
Wait … What is Perimenopause?
It seems like there is a common misperception that you just jump straight into menopause. But it does not work that way. First you enter into a transitional phase called “perimenopause.”
Perimenopause happens when your ovaries start producing declining amounts of estrogen and progesterone in preparation for menopause.
The signs and symptoms of perimenopause are very much like those of menopause. This makes sense when you realize that both perimenopause and menopause are points along a continuum.
Incidentally, hormonal imbalances may also display the same signs and symptoms, so in some cases, you may not be perimenopausal or menopausal at all, even if you do display those signs and symptoms.
The typical age for perimenopause to begin is around 47. Perimenopause can last longer or shorter periods of time for different women (as short as a few months or as long as a decade), but it is usually around 4 years.
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Menopause can happen prematurely, which means perimenopause can too.
If you are in your 30s or even your 20s and are experiencing signs of perimenopause, it could be perimenopause.
In fact, I once had a doctor ask me if I was in menopause when I was 21 years old.
It turned out I wasn’t—I have a hormonal imbalance.
But this just goes to show how tough it can be to figure out what is going on in your body.
Reasons Why You Might Experience Premature Menopause
If you do suspect you might be menopausal or perimenopausal and you are under 40, you probably are wondering why this is happening to you so soon.
There are a number of factors which could be involved:
- Genetics. If you have family members who started menopause early, you are more likely to have premature menopause as well. Genetic mutations can occur too, so this could be responsible for your premature menopause if everyone else in your family reached menopause at a more average time.
- Ethnicity. Early menopause is more common among Hispanic and Black women. Asian women are more likely to have late menopause.
- Medical history. If you have had chemotherapy or ovarian surgery, the damage caused by these procedures can result in premature menopause.
- Smoking. Heavy smokers are more likely to experience premature menopause since smoking damages the ovaries.
- Hormonal conditions. Some hormonal imbalances may lead to premature menopause.
- Auto-immune disorders. Some auto-immune conditions may make premature menopause more likely.
Factors Which Do Not Cause Premature Menopause
There are a few factors which you might assume would impact your menopause age, but which actually do not. These include the following:
- Birth control. It does not matter if you have used birth control or not. It has nothing to do with premature menopause.
- Pregnancy and breastfeeding. Whether you have ever been pregnant or breastfed has no impact on when you go into menopause.
- The age of your first period. Starting your periods earlier does not mean you will reach menopause earlier.
Is Premature Menopause Bad?
Whether going into early menopause is a “problem” or not is partly subjective. If you want to have a baby and you still haven’t, naturally you will be upset about going into premature menopause.
If you are still in perimenopause, you could still get pregnant, though it may not be as easy as it would have been in the past.
If however you are actually in menopause, you cannot get pregnant anymore.
As far as your physical health is concerned, you may have a higher risk for osteoporosis if you have an early menopause. But you also will be exposed to less estrogen over your lifetime, which could reduce your risk for certain forms of cancer.
12 Signs You Might Be Experiencing Premature Menopause (or Perimenopause)
Now that you know more about premature menopause, we can talk about signs that you might be experiencing it—or heading into perimenopause early.
1. Irregular periods, skipped periods, or no periods.
One of the most common signs that you are in perimenopause is an increasing amount of irregularity with regards to your periods. You might skip months or go longer between each period.
Of course, if being “irregular” has always been “normal” for you (there is a lot of variation here from one woman to the next), then you will need to evaluate for yourself whether or not there has been a change.
If you have no periods for 12 months, you might be in menopause. At that point, it is time to check your estrogen and progesterone levels to confirm.
2. Abnormally light or heavy periods.
Really light or really heavy periods may be an indication of perimenopause. Again, your mileage may vary. If you have extra heavy or light periods often, having a few more may very well be meaningless. If however they are unusual for you, something might be up.
3. Hot flashes and night sweats
Hot flashes are one of the main symptoms which characterize menopause as well as perimenopause. These unpleasant heat waves can happen anytime during the day or night, and may be bad enough to wake you up. Soaking through your sheets is common too.
4. Vaginal dryness
Vaginal lubrication declines going into menopause (which is one indirect cause of a decreased interest in sex for some women). You might also experience additional irritation during vaginal sex owing to the decreasing elasticity of the vagina.
5. Bladder issues
You may start experiencing incontinence (loss of bladder control) during perimenopause or menopause. This happens because your urethra is thinning and your pelvic muscles are simultaneously weakening. Some women find this embarrassing, especially if it becomes problematic during sex, but there is really nothing to be embarrassed about.
6. Mood swings
Mood swings, depression, rage, and anxiety may all arise in response to changing hormone levels.
7. Dryness of the mouth, skin, or eyes
Vaginal dryness is not the only dryness you may experience in response to decreasing hormone production. You may also discover that your eyes, mouth, and/or skin are extra dry.
8. Sleep difficulties
Changing hormone levels can cause difficulties falling asleep, as can disruptive symptoms like hot flashes and night sweats. Insomnia is a common issue for many women in perimenopause or menopause.
9. Decline in sex drive
A drop in libido is a common (though not universal) response to the decline in hormone levels in your body. It may also result simply from the inconvenience of your other symptoms, which may distract you from activities you typically enjoy.
Some women experience a great deal of fatigue during perimenopause and/or menopause. This may be especially true if you are losing sleep because of your symptoms.
This is not a universal symptom of menopause, but it is a fairly common one. What is interesting about menopause and headaches is that the relationship between the two can vary quite unpredictably between individuals.
Some women who experience hormonal migraines may actually find that their migraines reduce or disappear during or after menopause. Others however may have the exact opposite experience. Their headaches could be much worse through the transition.
12. Breast tenderness
Your breasts can become sore during perimenopause or menopause, much as they might before or during your periods.
Note: Many Of These Symptoms Show Up With Hormonal Disorders
If you are ticking a lot of boxes above, you may be experiencing premature menopause. But that is not necessarily the case.
Point in case, when I was 21, I experienced all of the following:
- Irregular and skipped periods
- Sleep difficulties
- Mood changes
- Breast tenderness
… Plus a slew of other symptoms like weight gain and night terrors. I routinely get night sweats as well (to the point of having to mop myself off with a towel).
My periods are regular (for me) again however, and my hormone levels show no indications of perimenopause.
Instead, I likely have a condition called “estrogen dominance.”
My point is that you cannot make assumptions about your health. The only way to know how to proceed is to do some research, get your hormone levels measured, and take things day by day.
Getting a Diagnosis of Premature Menopause
Tired of guesswork and wondering how you can get a formal diagnosis of premature menopause? If so, it is time to head to the clinic and request an evaluation.
After you talk to your provider, you will probably receive blood tests to rule out similar conditions (i.e. thyroid disease).
Once those conditions are ruled out, your estradiol levels may be measured.
If your levels are low, you may be in perimenopause. If they are under 30, you could even be in menopause.
You will also probably be given a blood test to measure follicle stimulating hormone (FSH).
FSH levels above 40 mIU/mL generally are a strong sign you have reached menopause.
What Can You Do About It?
Say you do discover that you have premature menopause—or you are experiencing perimenopause early. What can you do? Is there a way to stop it or reverse it? Or do you just need to treat your symptoms and accept that this change of life is irrevocable?
Sadly, there is nothing you can do to stop premature menopause or reverse it. While you can take some steps to try and avoid premature menopause (like quit smoking, or never start), you cannot control the exact age at which menopause happens.
This leaves you with two main issues:
- The unpleasant symptoms discussed before (hot flashes, etc.)
- You can no longer get pregnant after menopause
Dealing with Premature Infertility
Whether losing the ability to reproduce at a younger age is an issue for you or not depends entirely on your life plans.
If you do want to have children, there are a couple of options open to you:
- You can make an appointment with a reproductive specialist to discuss your declining fertility (assuming you are still in perimenopause). The specialist can work with you to maximize your chances of getting pregnant and successfully delivering.
- Consider having some of your eggs frozen if you are not ready to have children yet, but know that you want to eventually.
- Think about adoption. Nothing is more rewarding than giving a good life to a child who would not have one without you.
It can feel like the end of the world to know your biological clock is about to run down to zero, but it really isn’t. There are multiple routes to motherhood.
Treatment Options for Premature Menopause Symptoms
Now let’s talk about what you can do to manage the symptoms of premature menopause or perimenopause.
First of all, I want to mention one thing you may not want to do. Your first thought is probably to turn to hormone replacement therapy (HRT). Can HRT help alleviate menopause symptoms? Yes, but potentially at a price. Research is mixed (and complicated) when it comes to HRT.
I recommend checking out this article. See this link as well. There are some legitimate concerns about HRT, and there will likely be a lot more back-and-forth from doctors about whether or not it is safe.
Personally, the only thing I know from my own experiences is that hormones are incredibly potent things. And they can be quite destructive if they are present in inappropriate amounts.
Menopause is a natural transition, and while it is uncomfortable, there are other safer methods for managing it. Here are a few things to try.
1. Take herbal treatments to balance out your hormones.
There are a number of herbal supplements which may be helpful to you during menopause:
- Black cohosh
- Red clover
- St. John’s Wort
- Vitex (chasteberry)
- Wild yam
- Dong Quai
All of these can help restore hormonal balance, either by replacing your dwindling estrogen supply with phytoestrogens or by stimulating your body’s production of estrogen and/or progesterone.
There is not a “one size fits all” solution when it comes to herbal treatments. You may need to be willing to do some experimentation, since everybody is different. You might find one herb is all you need to manage your symptoms, or you might discover that a blend like EU Natural’s own Staying Cool works best.
2. Use other herbal remedies for your symptoms as needed.
Actually, some of our other herbal supplements may also be helpful to you during menopause or perimenopause. If you are struggling to sleep, you might find that Serenity Natural Sleep Aid is helpful. If you have migraines, try My Brain! We actually have Vitex included as an ingredient in My Brain!, making it particular suitable for hormonal headaches.
3. Use cooling garments, pillows, etc.
For hot flashes and night sweats, try cooling products for menopause like specialized pillows, mattress pads, towels, bras, bandanas, nightgowns, and so forth. We have a comprehensive guide on this topic here.
If you need to rapidly cool down, do not forget you can always step into a cool shower, grab an ice pack, or open a window.
4. Avoid hot flash triggers.
Do you know your hot flash triggers? You could be inadvertently worsening your symptoms by unnecessarily exposing yourself to any of the following:
- Spicy foods
- Tight clothing
Steer clear of these triggers to the best of your ability, and the frequency and severity of your hot flashes may decrease.
5. Get rest, de-stress, and see a therapist if needed.
It is important not to push yourself too hard during this time. Your life is changing in a huge way, and that is going to be stressful at times. The last thing you need to do is make your symptoms worse by not giving yourself a break now and again when you need it.
So find ways to kick back and pamper yourself and enjoy a little “me” time. You might actually find that this reduces some of your hot flashes, headaches, and other symptoms. It might also help you manage the mood swings. With your mood already potentially all over the map, you do not need to add to your own frustration through overwork or by ignoring your own needs!
6. Don’t give up on your sex life.
Never in the mood for sex anymore? There are a number of possible factors which can contribute to this—everything from a natural reduction in libido (due to hormonal changes) to mood swings to vaginal dryness.
But you do not have to give up on your enjoyment of sex. There are a number of things you can do to get back to pleasurable sex. Taking herbs to balance out your hormones may help with the libido issues. You can also use lubricants to deal with vaginal dryness. I go into these recommendations in detail in the linked article.
I also suggest learning to switch from a “passive” to an “active” approach to sexuality. You may never just spring into the mood like you did when you were younger. But that does not mean you cannot choose to engage with your sexuality. You just need to make it a deliberate act.
Conclusion: Premature Menopause May Catch You Unprepared, But You Can Treat Your Symptoms and Get Back to Feeling Like Yourself
Discovering you are in perimenopause or menopause in your 20s or 30s can be surprising, confusing, and even upsetting—but it does not mean anything is “wrong.” You just are experiencing a major life transition ahead of your peers because of genetics or other factors.
You might wish you could slow that transition down or even reverse it, but you must accept that this is now a part of your life. Thankfully, there is a lot you can do to get your symptoms under control, and if you are hoping to have children, there are still viable options out there.
Keep exploring the articles on our site to learn more about menopause and discover other tips and tricks for minimizing your discomfort and maximizing your enjoyment during this life change!