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When we think of menopause, we tend to default to the stereotype of a woman in her midlife, aged 50 and beyond, rather than during her 20s or 30s. In fact, around 4% of women in the US experience early menopause, and between 1-3% of women under 40 experience Primary Ovarian Insufficiency, commonly known as POI.
It’s important to know that Menopause can occur at any age – we just don’t talk about it often. When it occurs before the age of 45, it’s generally referred to as ‘Early Menopause’, and for women under 40, it’s referred to as ‘Premature Menopause’.
This means that your periods have stopped for at least a year, and you are unable to conceive ‘naturally’. You are likely to experience typical menopausal symptoms such as hot flashes, brain fog and may have trouble sleeping – but these are only the most commonly reported, and there are many more symptoms that you may experience too.
Navigating early menopause – and POI – can be tricky and you might be left mystified by a lot of it. Here’s 6 facts that you need to know about early menopause and POI.
1. Early menopause is not the same as perimenopause
Menopause most often occurs around the age of 51-55 for women in the US, with many women reporting perimenopause symptoms that gradually increase up to ten years prior. For those of us experiencing early menopause, it can be quite a shock to experience menopausal symptoms such as hot flashes and brain fog during our 20s and 30s, and to find that periods become more irregular and stop.
It’s important to note that perimenopause is a normal phase for women, whereas early menopause isn’t and typically has an underlying cause.
2. POI doesn’t always cause early menopause
Primary ovarian insufficiency (POI) the term used to describe when a woman’s ovaries stop working normally before she reaches the age of 40.
POI occurs when the ovaries stop functioning properly. This is because of deficient estrogen, and decreased ovarian follicles that speed up the onset of menopause and causes your periods to become irregular or stop altogether.
While the exact cause of POI is still unclear, it doesn’t always mean you’ll experience early menopause as 5-10% of women with the condition are able to conceive spontaneously after diagnosis.
3. Research is still limited into the cause of early menopause and POI
This is unlikely to surprise you much, but research into the causes of early menopause and POI is still very limited. What we do know is that there are thought to be many contributing factors that are similar for both conditions.
These include genetics, autoimmune diseases, and certain medical treatments such as chemotherapy and radiotherapy. It’s also thought that smoking, extreme weight loss or weight gain, and even excessive exercise can also be factors that contribute to a diagnosis of either condition.
4. It’s not just brain fog and hot flashes
As we know with menopause in midlife, the symptoms women experience aren’t confined to the most commonly known like hot flashes and brain fog. In fact, there are now an agreed 34 symptoms of menopause (and even more anecdotally!) that are experienced by women, ranging from mood changes, sleep disturbance and low libido, to tinnitus, chest pain, dental issues, and even vertigo.
5. Advocating for yourself helps speed up diagnosis
If you suspect that you are experiencing symptoms connected to POI or early menopause, it’s important to seek specialist help as soon as you can. Speak to your primary care physician in the first instance, but it’s important to seek assessment from a gynecologist and/or reproductive endocrinologist for specialized care. Being able to articulate your symptoms is important; if you can, keep a diary and take notes with you to your consultation so you can advocate for yourself.
In order to reach a diagnosis, your gynaecologist or endocrinologst will expect to run various tests. A blood test that measures Follicle Stimulating Hormone (FSH) levels is standard. Elevated FSH levels often indicate decreased ovarian function. Other tests might include an estradiol level check, karyotype, and anti-Müllerian hormone (AMH) test.
It’s important to verify your coverage with your insurance provider before undergoing treatments or tests. Many insurance companies will cover diagnostic tests, but treatments like hormone replacement therapy (HRT) might be out-of-pocket.
6. Diet and supplementation can complement HRT to manage symptoms
Hormone Replacement Therapy (HRT): This is the most common treatment, helping replace reduced estrogen and manage symptoms and is considered to be the gold standard for women’s healthcare to treat and manage menopause symptoms. HRT offers you long term benefits against heart disease, osteoporosis and has been shown to lower the risk of bowel cancer in women.
There are also lifestyle changes you can make, and we often underestimate the importance of diet and nutrition for the management of menopause symptoms. Estrogen boosting foods, such as soy, fruits (plums/ pear/ apples) and green leafy vegetables all contain phytoestrogens which help increase our estrogen levels naturally. Adding nuts and seeds such as almonds, peanuts, sesame and flaxseeds are also great sources of phytroestrogen.
Lastly, using a supplementation product such as Menopause SOS helps to soothe symptoms such as hot flashes, bloating, brain fog and low libido by helping to restore your hormone imbalance.
Natural Approaches: While not a replacement for medical treatments, certain dietary choices and supplements can offer relief. Omega-3 fatty acids, black cohosh, and vitamin E have been reported as beneficial. Always consult with a healthcare provider before starting any supplementation.
It’s important to remember that research is ongoing to understand early menopause and POI better. For example, current studies are looking at the genetic relationship with POI, and how it increase an individual woman’s risk of developing the condition. Environmental factors are also being researched, and there’s also increased interest in understanding the psychological impacts of early menopause on younger women.
Kate is a content writer, community creator, and ‘Endo-Warrior’ with Stage IV Endometriosis. She’s mum to three kids, two dogs and unsurprisingly; a lover of wine. Kate lives with her family in Hastings, UK.