If you’re a woman, menopause is unavoidable — but it can also be super confusing. Not everybody reaches it at the same time, and it can be tough to pin down exactly where you are in the process.
If you’re in your late 30s and your periods are irregular, for example, it wouldn’t be out of line to wonder if you’re going through perimenopause or even early menopause. (That said, there are plenty of other causes of wonky cycles, and menopause is not the most likely if you’re only in your 30s, unless you’ve had your ovaries surgically removed.)
Before we address that very important question, let’s back up a bit.
Menopause becomes official hit when you haven’t had a period in a full year; it also means you’ve stopped ovulating. Before your cycles stop completely, you’ll likely experience a phase called perimenopause, which can begin as soon as your early 40s and usually lasts about a year. This is when most people start experiencing less than comfortable symptoms as their reproductive hormones wane.
The early 50s seem to be when most women are fully period-free. Early menopause — sometimes called ovarian insufficiency — typically happens between ages 40 and 45 (compared to premature menopause, which happens before age 40). About 5 percent of American women experience early menopause, or a sudden stop in menses, for a full year due to health conditions, medical procedures, or lifestyle factors that affect ovulation.
What causes early menopause?
Understanding your risk factors for early menopause can also help you understand where you are in the process. Early menopause can be caused or affected by a variety of factors, from genetic conditions and lifestyle choices to medical procedures and surgeries.
The most common cause of early menopause is surgical procedures that specifically remove, or “disable,” sex-organ functions. If your ovaries are taken out, you’ll go into menopause immediately. If you have a hysterectomy (which removes your uterus but not your ovaries), you might experience menopause a few years earlier than you would otherwise.
Cancer treatments such as chemotherapy and radiation are also risk factors. The damage done to ovarian cells can decrease or end the production of estrogen, which can lead to early menopause.
Medical conditions that affect the immune system, the sex organs, and hormone production or regulation often contribute to an increased risk of both early onset menopause and late onset menopause. Autoimmune disorders that cause the immune system to attack healthy cells — rheumatoid arthritis, thyroid disorder, and scleroderma, for example — can also affect the reproductive system.
Some lifestyle factors and habits can contribute to the development of early menopause. Things like diet and nutrition, exercise habits, and alcohol consumption have a strong impact on how the body regulates itself (one more reason to follow your doctor’s orders).
Smoking is the most significant lifestyle factor that can contribute to the development of early menopause, because it ages the ovaries faster. Women who smoke are 30 percent more likely to experience early menopause, so consider quitting to head it off (and to protect yourself from loads of other health issues).
How do I know if I’m in early menopause?
Early menopause is a diagnosis of exclusion — meaning, if you’re not at the age of menopause and you haven’t had your ovaries surgically removed, it could be something else (and your doctor will probably want to check it out). But can you tell if you’re approaching early menopause? Sometimes.
Perimenopause symptoms are one major clue. Typically your period will become irregular as your body prepares to stop ovulating. If you’re of conception age, you might have a hard time getting pregnant, because your body isn’t producing as many mature eggs.
The more familiar symptoms also apply. If your periods are unpredictable or scant and you experience any of the following perimenopause symptoms, you might be approaching early menopause:
- Urinary issues
- Hair thinning or loss
- Joint and muscle pain
- Hot flashes
- Vaginal dryness/atrophy
- Night sweats
- Insomnia and sleeplessness
- Decreased sex drive/low libido
- Weight gain
- Brain fog
- Dry, itchy, and sensitive skin
- Mood changes (depression, rage)
- Breast Tenderness/Swelling
Because menopause is defined in retrospect, it’s hard to know for sure if you’re nearing it. A blood test on the third day of your period can identify hormonal markers often found in early menopause. If your follicle-stimulating hormone, or FSH, is high, that means your body has to work harder to ovulate and you’re probably in perimenopause.
“If you have a double-digit FSH, it’s pretty unlikely you’ll be able to get pregnant, and menopause may be in the next two to five years,” says La Follette. “We don’t know the exact timing, but we know your body is working hard to get an egg out.”
When should I talk to a doctor about early menopause?
If your cycles are irregular or are experiencing uncomfortable symptoms, check in with a healthcare provider to rule out medical issues (such as pregnancy or thyroid problems).
Early menopause isn’t just inconvenient; the earlier your cycles stop, the sooner certain health risks, such as early dementia, bone loss, or mood disorders, may enter the picture. Being aware of your body and understanding your risk factors can only be advantageous: It enables you to take greater agency over your health and gives you a leg up on ensuring your well-being in the years to come.
Not sure where you are in the process? That’s totally normal. While many changes have already taken place in your body, it may take a while before you notice any clear signs.
“The definition of menopause is one year after your last period, so it’s all retrospective,” says Lizellen La Follette, M.D., a board-certified OB-GYN in Marin County, California. “That basically means you don’t have a clue where you are, and you have to figure it out.”
You may not be able to control when menopause happens to you, but you can empower yourself with awareness. If you’re not 100 percent sure what’s going on in your body, talk to your gynecologist or primary care provider, who can help you understand your risk factors for early menopause or tell you if it has already begun. The important thing is to be in tune with your body so you can then take care of yourself physically and emotionally, no matter where you are on the journey.
Your healthcare provider can help you pinpoint where you are in the menopause process, but so can a basic awareness of symptoms and risk factors. Here’s what you need to know about early menopause and how to figure out if you’re going through it.