Signs and Symptoms of Early Menopause
Haven’t been feeling quite like yourself lately?
Been missing periods, or having periods which are especially long, heavy, or irregular in other ways?
Been waking up in the middle of the night drenched in sweat and feeling like there’s a furnace inside you?
Feeling fatigued, anxious or depressed, and dealing with unexpected aches and pains?
Symptoms like these may make you wonder if it is possible that you are going through early menopause.
But you might also find yourself thinking, “I’m too young to possibly be going into menopause.”
As somebody who was once asked by a doctor at the age of 21 if I was going through menopause, I can tell you two things:
- You can be quite young when you start experiencing the signs and symptoms of early menopause.
- There are a number of other health conditions which can easily mimic those same signs and symptoms.
For this reason, it is important not to jump to conclusions. You could be going into early menopause, but you could just as easily be experiencing symptoms relating to something else altogether.
In order to offer you some perspective and help you examine some of the possibilities, I will try to answer some questions about the signs and symptoms of early menopause in this article.
I will go over some information about the timing of menopause along the way.
But I will also discuss a few other possible causes of some of the signs and symptoms which you might associate with early menopause.
This may offer you some additional avenues to explore and prompt some more questions to ask the next time you see your health care provider.
Perimenopause: The Phase Leading Up to Menopause
In order to embark into a discussion about early menopause, you must first understand what perimenopause is and what differentiates it from menopause.
Menopause is defined as having gone an entire year without having a period. Additionally, your ovaries are no longer producing estrogen and progesterone.
When people talk about “menopause,” they often are referring to the phase which leads up to it, which is more correctly termed “perimenopause.”
During perimenopause, your ovaries are winding down production of estrogen and progesterone, but production has not stopped.
It is this transitional phase with all of its unpredictable hormonal fluctuations which causes most of the symptoms which are so unpleasant.
While the symptoms do continue for some women past menopause, most report that their symptoms calm down considerably after the transition is over.
So if you are concerned about the signs and symptoms of the early menopause, what you are actually wondering is whether you have entered into perimenopause.
How Early Can You Go Into Menopause?
To put some context around the possibility, you will need to understand two aspects involved with the timing of menopause.
The first is the earliest age at which menopause can occur, and the second is how long the transitional period beforehand can last.
The average age for menopause is 51.
But a lot of women reach menopause before that. When menopause occurs before the age of 40, it is referred to as “premature.”
As for how long perimenopause can last, the timeframe can vary considerably.
On average, perimenopause lasts for a few years. But it can be as brief as just a few months, or it might go on for around a decade.
This means that you could for example not have premature menopause, but still experience the symptoms of perimenopause even in your early 30s.
That would happen if for example you reached menopause in your early 40s, but were in perimenopause for around 10 years.
As you might imagine, with premature menopause, the symptoms can hit you even sooner.
It even possible that you could enter perimenopause in your 20s.
- The terms “menopause” and “perimenopause” often are used interchangeably, but they do not refer to the same thing. During perimenopause, your production of estrogen and progesterone is decreasing. When you reach menopause, the production of those hormones has essentially stopped, as have your periods.
- Menopause can occur before the age of 40. When it does, it is called “premature menopause.”
- Perimenopause is a phase which can last anywhere from a few months to around a decade.
- Because you can experience early menopause and/or a lengthy perimenopause, it is possible that you might experience the signs and symptoms of early menopause in your 20s or 30s.
- You might also experience the signs or symptoms of non-premature menopause in your 30s as well.
Signs and Symptoms of Menopause
You now have a better understanding of the possible timing scenarios involved with perimenopause and menopause.
But in order to determine whether it is likely that you are experiencing said signs and symptoms, you need to know how to recognize them.
So let’s talk about some of the possible ways in which perimenopause can manifest, regardless of your age:
- Your periods may become irregular. You might get them more frequently or less frequently, and they might last longer or shorter periods of time. They might be heavier or lighter than you expect, and may vary more from cycle to cycle.
- You may start experiencing hot flashes (also called “hot flushes”) and night sweats, probably the most notorious symptoms of perimenopause.
- You may have difficulties sleeping at night. These can be a result of hormone fluctuations and/or the discomfort of other symptoms.
- Another possible symptom is vaginal dryness along with a loss of elasticity in vaginal tissue. This can lead to irritation during intercourse, which may reduce some women’s libido.
- Dryness can affect other parts of your body during perimenopause as well. You might notice that your skin is drier, or your mouth or eyes.
- Libido may drop in some women experiencing perimenopause for hormonal reasons, not just those related to vaginal dryness.
- You might experience problems involving your bladder. There could be irritation, or you may have incontinence.
- Emotional changes are possible during perimenopause. These could involve abrupt mood swings, or you could struggle with depression and/or anxiety. These might be connected to hormonal changes, or they could be a response to your symptoms. They also might reflect difficulties processing the fact that you are going through a change of life.
- If your estrogen levels really are dropping because you are in perimenopause, you can expect to lose some bone mass as well. Women in post-menopause are more susceptible to osteoporosis as well as bone fractures.
- Fertility levels drop as you enter perimenopause, and continue to drop as you get closer to menopause.
- You might see an increase in LDL cholesterol as well as a corresponding decrease in HDL cholesterol. This may call for changes to your diet and lifestyle in order to protect your cardiovascular health.
- Fatigue may be a common symptom during perimenopause. This may occur because of a number of factors. Lost sleep, stress due to other symptoms, and hormonal fluctuations may all be contributing factors.
- Pain issues may flare during perimenopause. Hormones can have a huge impact on how a wide range of chronic pain conditions manifest. So anything from fibromyalgia to migraines could end up causing you severe distress during this phase of your life. It should be noted that pain issues may either get worse or better after menopause than they were during prime reproductive years.
If you are having a number of these signs or symptoms, that might mean that you are going into perimenopause, and that menopause is on the horizon.
Factors Which Can Contribute to an Early Menopause
It becomes even more likely that you are going to experience early menopause if any of the following factors are present:
- Genetics. Have a number of women in your family gone into menopause early? This makes it more likely that you will too.
- Smoking. If you are a smoker, you might enter menopause earlier than if you weren’t. That being said, this usually only leads to a change of 1-2 years. So instead of reaching menopause at age 51, for example, it might happen at age 49 or age 50.
- Having your uterus removed. Assuming your ovaries were left intact by the hysterectomy (at least one of them, at any rate), you won’t go into menopause immediately after surgery. But you may reach menopause earlier than you would have otherwise.
- Chemotherapy or pelvic radiation therapy. These cancer treatments may result in earlier menopause.
If these factors are not present, early menopause is still possible.
If they are present and you have the symptoms, it is more likely that you are correct about going into menopause early—but that is still not a guarantee you have given yourself an accurate diagnosis.
Other Conditions Which Might Cause Similar Symptoms
Even if you feel pretty confident that you are going into menopause, you really cannot say for sure without a doctor’s confirmation.
There are a number of other health conditions which can mimic perimenopause. Here are a few to consider:
1. Thyroid disorders
This is probably one of the top culprits you should suspect if you think you might be going into menopause early.
The North American Menopause Society talks about how both hypothyroidism and hyperthyroidism might cause symptoms which could be mistaken for menopause.
Hypothyroidism happens when your thyroid is underproductive.
The North American Menopause Society explains, “If untreated, it can lead to high cholesterol, osteoporosis, heart disease, and depression. Some symptoms of hypothyroidism are similar to symptoms reported during the menopause transition. These include fatigue, forgetfulness, mood swings, weight gain, irregular menstrual cycles, and cold intolerance.”
Hyperthyroidism is the opposite. It is the name for the condition where you have an overactive thyroid.
The society also comments on this condition, listing that it has symptoms such as, “hot flashes, heat intolerance, palpitations (short episodes of rapid heartbeat), tachycardia (persistent rapid heartbeat), and insomnia. The most common signs of hyperthyroidism are unplanned weight loss, goiter (an enlarged thyroid gland) and exophthalmos (bulging eyes).”
How likely is it that you might have a thyroid disorder? Well, they are pretty prevalent. The American Thyroid Association reports that, “More than 12 percent of the U.S. population will develop a thyroid condition during their lifetime … Women are five to eight times more likely than men to have thyroid problems.”
So this condition is well worth ruling out before you assume you are going into menopause. A doctor will probably want to test your thyroid-stimulating hormone (TSH).to do just that.
Polycystic ovary syndrome (PCOS) is another condition which could be mistaken for perimenopause.
If you have this condition, there are follicles which form on your ovaries. While PCOS often becomes apparent during early puberty, it may not manifest until adulthood in some.
Some symptoms of PCOS include:
- Ovarian cysts
- High androgen levels and corresponding symptoms (hirsuitism, male-pattern baldness, acne)
- Irregular menstruation
- Insulin issues
- Lower fertility
- Weight gain
It is easy to see why someone with PCOS might think they were going into menopause, especially since only two of the bolded symptoms above need to be present for a diagnosis (it is possible to have all three, of course).
Imagine for example that the two symptoms of PCOS which you had included the ovarian cysts and the irregular periods.
With none of the telltale symptoms involving high levels of androgens present, you might simply assume that these would be the initial signs of perimenopause.
So, this condition too might be worth looking into as another possible explanation for some of your signs and symptoms.
Endometriosis is another common disorder which might cause some signs and symptoms similar to those of premature menopause.
According to Endometriosis.org, ” Endometriosis affects an estimated 1 in 10 women during their reproductive years (ie. usually between the ages of 15 to 49), which is approximately 176 million women in the world [3-4].”
Here are some of the symptoms which endometriosis can produce:
- Periods which are irregular, extremely painful, or excessively heavy
- Chronic pain in the pelvic region
- Reduced fertility or infertility
- Painful intercourse
- Pain during ovulation
- Bloating, constipation, or other digestive symptoms
- Painful or bloody urination
- Unusual bleeding from the vagina
Notice that a number of these symptoms overlap with some of the signs and symptoms of early menopause.
Since 1 in 10 women have endometriosis, it is something to ask your doctor about if you suspect that it might be fit for your symptoms.
4. Cushing’s disease
Cushing’s disease is a condition where your body produces abnormal amounts of cortisol.
The disease is not common. It is believed that each year, only about 13 people out of 1 million will present with the syndrome.
This article tells the story of a woman named Elisabeth Nave. When she turned 62 years old, she started experiencing symptoms and complications that included:
- Weight gain
- Hair loss
- Kidney stones
Given her age and the fact that she had not yet experienced menopause, naturally, she assumed that she was finally entering perimenopause.
You might be thinking, “But I am significantly younger than Elisabeth, so this probably does not explain my symptoms.”
Actually, Elisabeth was herself a bit of an outlier. It is more common for the symptoms of Cushing’s to initially become noticeable between the ages of 25 and 40.
Of course, the fact that this is a rare disorder means that it is an unlikely explanation in most cases. But it may be something that you want to investigate.
Another more innocuous possibility to consider is anxiety or stress.
Intense acute or chronic stress or anxiety are both extremely common, but many people are not fully aware of the ways in which they can impact your body.
In fact, it would be impossible to list all of those ways in this article since manifestations diverge so wildly from person to person.
But I can tell you as a person who has a difficult time regulating stress and who has OCD (which is an anxiety disorder) as well as a few sleep disorders (delayed sleep onset, insomnia, and occasional night terrors), that the following symptoms can certainly have a psychological root:
- Night sweats
- Feeling abruptly very hot or very cold
- Shaking or tremors
- Digestive issues
- Other mood changes (including depression)
- Loss of libido
- Vaginal dryness
- Problems sleeping
- Pain flare issues
- Irregular periods
Yep—most of the symptoms you associate with perimenopause could feasibly be related to anxiety, stress, or sleep disorders.
Now, you shouldn’t let a healthcare professional (or anyone else) blow your concerns off as “just anxiety.”
But you should seriously consider the possibility, and start tracking how your thoughts and emotions correlate with your symptoms.
This can be especially challenging if you have alexithymia, a condition where it is difficult to recognize and name your own emotions (as well as those of other people).
You can even find yourself in a full-on panic attack without having a clue how you ended up there.
Of course, anxiety can develop as a perimenopause symptom, too, making actual symptoms of perimenopause worse …
So, it’s complicated, and all possibilities are worth a look.
6. Another condition associated with hormone imbalances
It would take me an age to run through all the health conditions which could possibly result in menopause-like symptoms, so I will simply link you to this page.
I doubt whether that list is exhaustive either, but at least it gives you a starting point if you want to deepen your research in this direction.
Just don’t forget that the internet can be a source of panic, and you should consider the most likely possibilities before you start running down the list of worst case scenarios.
7. Hormone imbalances which are harder (or impossible) to explain
Finally, it’s worth mentioning that there seems to be a category of hormone imbalances which have no obvious explanation.
Within the communities of those who experience certain collections of symptoms and who have failed to get any sort of actionable diagnosis, there are a few proposed names for specific types of imbalances.
For example, patients talk about “adrenal fatigue” and “estrogen dominance.”
Medical professionals are currently still debating whether these conditions exist or not.
Personally, I suspect that these conditions do exist in some form or fashion. There’s a lot which doctors do not understand about hormones.
I mentioned before that a doctor once asked me at age 21 if I was going into menopause.
Somewhat ironically, she asked me almost in the same instant if I might be pregnant.
At the time, I had no idea what to think. I had symptoms like:
- Skipped periods (I was skipping up to 3 months at a time)
- Painful periods
- Rapid weight gain
- Intense, intractable head pain
- Sleep disorders (including night terrors)
- Acne outbreaks deep under the skin
- Changes in libido
It’s easy to see why she asked me about both perimenopause and pregnancy.
As it turned out, in my case, I had neither issue.
What did I have? To this day, I have never figured it out. I certainly do not seem to have any of the likely culprits like PCOS or a thyroid disorder (tests have been run).
One doctor at one point did tell me that it is common at certain ages to go through periods of hormonal transition.
Menopause gets all the attention (and a name), but according to her, wild fluctuations in hormones can also occur at other times, for example in one’s early 20s.
My guess would be that I did indeed go through such a state of transition, which produced the symptoms I described.
Over the years since, many of those symptoms have subsided entirely, while others have become less prominent.
It might also be worth mentioning that I have discovered that a person’s hormone levels can be entirely within the normal range, and that person might still have symptoms which seem to point toward a hormonal imbalance.
I, for example, continue to have chronic pain which gets worse during certain parts of my menstrual cycle.
Obviously, this cycle is hormonal in nature, despite not indicating any sort of imbalance according to my tests.
The symptoms which I experience usually lead to the community label “estrogen dominance,” but I do not actually seem to have this.
I do however have a misaligned jaw and spine and I have developed myofascial pain syndrome.
The hormone specialist pointed out to me that “normal” hormone levels are not necessarily the same thing as “functional” hormone levels for someone who has my underlying conditions.
The bottom line here is that even if your signs or symptoms are tied to hormone fluctuations, an otherwise unrelated health condition could be feeding into your experiences in an unexpected way.
8. Idiopathic night sweats
Finally, one more thing which is worth mentioning from my personal experience is that it is possible to have night sweats which are idiopathic in nature.
“Idiopathic” can mean either of two things:
- Your condition is “spontaneous,” and has no underlying disease process as a medical root.
- It is impossible (or virtually impossible) to determine the underlying cause of your symptoms.
Idiopathic night sweats are seldom talked about, but I did find this blog which went into great detail regarding them.
I myself have had seemingly idiopathic night sweats as well since my mid-twenties, generally during the luteal phase of my menstrual cycle.
Lately, these night sweats have become a lot heavier, and are taking up many more nights out of each month.
Am I experiencing the earliest signs and symptoms of early menopause?
It is not outside the realm of possibility. But being as my hormones were tested just last year and the levels came up normal, I would guess that they are still idiopathic in nature.
Incidentally, night sweats also can be caused by certain medications, including one which I’m taking.
So if you are taking any medications, you might want to check into that. Medications can also cause many of the other symptoms associated with early menopause.
- Many conditions can mimic perimenopause.
- Some examples of conditions which can produce symptoms similar to perimenopause include thyroid disorders, PCOS, endometriosis, Cushing’s disease, anxiety, and other conditions involving hormonal imbalances. It is also possible to experience idiopathic symptoms such as night sweats with no explanation.
- Medications can cause some of the symptoms we associate with perimenopause as well (like night sweats, dryness, and so forth).
- It is important to rule out other health conditions and establish for sure whether your symptoms are due to early menopause or not.
How Can You Know for Sure If You Are Experiencing an Early Menopause?
If you want to know for sure whether you are going into early menopause or not, you will need to talk to your doctor.
If you are significantly younger than the average age of menopause, it is not enough to simply try to guess based on your symptoms what is going on.
Remember, perimenopause is associated with falling levels of estrogen and progesterone.
So what your doctor can do is test your hormone levels to see where they are at.
These are the hormone levels which are typically checked:
- Follicle-stimulating hormone (FSH)
FSH levels actually rise as you go into menopause while estradiol levels drop.
If no one has recently tested your thyroid-stimulating hormone (TSH), there is a chance your doctor will order that test as well, just to rule out thyroid disorders.
Hopefully, your tests will paint a clear picture of what is going on with your hormones, and thus let you know whether or not you are likely in perimenopause.
One thing to know about hormone tests though is that the data they provide is limited.
Because they only give you a snapshot of a moment, not the overall picture, there may still be some degree of uncertainty as to what your levels signify.
You can try and determine based on the point you believe you are at in your cycle what a normal range would be and what a perimenopausal range would be (your doctor can assist with this).
But variations in monthly cycles make it a challenge to pinpoint exactly where you are at, even when cycles are regular.
If your cycles are currently irregular, it gets even harder.
You and your doctor will need to decide based on the test results, your symptoms, and overall context (i.e. family history) what the diagnosis should be.
If you do determine that you likely have another underlying condition, you will need to work on identifying and treating that to get relief from your symptoms.
If, however, your doctor and you agree that early menopause is the likely explanation, you can treat yourself accordingly.
There are a lot of ways you can handle the symptoms of menopause. Some of your options include:
- Hormone replacement therapy (HRT). There are risks to weigh, so proceed with caution if you choose this route.
- Medications. Some medications which may be prescribed to treat hot flashes include antidepressants, seizure medications, and certain drugs for high blood pressure. Medications may also be administered to try and prevent bone loss.
- Take an herbal supplement to help balance hormone levels naturally.
- Use cooling pillowcases, bedding, clothing and so forth to cope with hot flushes.
- Work out, meditate, eat a healthy diet, get therapy if necessary, and take other lifestyle steps to improve your physical and psychological wellbeing.
- If you suspect early menopause, the best way to figure out whether that is a correct diagnosis or not is to get your hormone levels tested.
- Hopefully, that will provide the data you are looking for, but just keep in mind that hormone tests only give you a snapshot. So you might still be left with some questions.
- Your doctor may give you additional tests to rule out other conditions.
- Once you have a diagnosis from your doctor, you can proceed with a treatment plan for your symptoms.
The Key to Treating Your Symptoms Successfully is Not to Make Assumptions
When we don’t understand what is going on in our bodies, it is easy to jump to conclusions.
You might assume that you are experiencing signs of early menopause, but it could be another health condition.
It could even be idiopathic.
The converse could be true as well. You might assume you have another underlying health condition, when it actually could just be perimenopause.
If you take the wrong treatment approach based on incorrect assumptions, you may not see the results you are looking for.
Instead of proceeding based only on conjecture, see your doctor for tests, and bring a comprehensive list of your symptoms.
Ask family members questions about their menopauses as well. Make sure to ask not just how old they were when they stopped having periods, but how old they were when they first noticed symptoms and signs.
Your doctor will want to hear about this context while you are discussing your symptoms.
If family members have histories of thyroid problems or other disorders which could potentially cause similar symptoms, tell your doctor about those too.
Once you have a proper diagnosis—or at least some helpful, informed input—you can decide how you want to treat your symptoms.
Hopefully, with the right approach, you will get back to feeling like yourself soon.
Looking for more tips and tricks for getting through menopause (early or otherwise)? Be sure to check out the other articles in our archives.