When Does Perimenopause Really Start?

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When does menopause typically start?

Menopause is a huge transition in a woman’s life and yet it’s shrouded in myth and mystery. One of the most unhelpful myths is how early menopause can start. Our State of Menopause Report revealed that 75% of women underestimated when menopause begins, leaving many unprepared for a transition that profoundly impacts their health, well-being, and careers.

The average age of natural menopause is 51, but menopause occurring between 45 and 55 is considered normal(1). Menopause is defined as the day 12 months after a woman’s last period. But symptoms often start years earlier during perimenopause when estrogen levels begin to decline.

Perimenopause lasts around 7 years but can last up to 10(2). So it’s completely normal for a 35-year-old woman to be in perimenopause. 8% of women experience early menopause or premature menopause which can start before 40(3).

Why Knowing When Menopause Can Start Matters

Knowing when menopause starts and recognising early and premature menopause is key to managing your health. Our research uncovered an educational gap among women entering perimenopause and menopause, leading to years of needless suffering before seeking treatment.

Our State of Menopause survey revealed 59% of women didn’t know what was happening when they first started experiencing symptoms. 64% said they felt "completely unprepared" for how bad the symptoms would be.

While no woman’s menopause experience is the same, it’s important to have a good idea of what to look for. “The paths we take may look different” according to Dr. Mary Claire Haver, author of New York Times bestseller The New Menopause, “but no one should ever feel lost”. Staying informed and knowing what to expect can enable you to manage your health and navigate this transition better(4).

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What is Early and Premature Menopause?

Early Menopause

Early menopause occurs when a woman has gone 12 months without a period and she is between 40 and 45 years old(3). In these cases, perimenopause could have started in the early 30s(3).

This earlier start can bring extra concerns, especially around fertility and long-term health as it extends the time a woman lives with low estrogen levels(8).

Early menopause symptoms can be more severe than menopause as the hormonal changes are sudden.

Premature Menopause

Premature menopause occurs before 40(3). It can happen spontaneously or due to medical treatments like chemotherapy or surgery that affect the ovaries(9). Premature ovarian insufficiency (POI) is a condition where the menstrual periods stop suddenly at an earlier than expected age which can lead to premature and early menopause.

Both premature and early menopause bring unique challenges including prolonged low estrogen levels which can impact overall health(9).

Managing conditions like Primary Ovarian Insufficiency (POI) and autoimmune diseases is key to these conditions.

Primary Ovarian Insufficiency (POI)

Primary Ovarian Insufficiency (POI) is a condition where the ovaries lose function before 40. Unlike premature menopause, POI is not always permanent.

Women with POI may still have irregular periods and occasional ovulation but they have menopause-like symptoms and significantly reduced fertility(9).

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Causes and Risk Factors for Early and Premature Menopause

What Causes Early and Premature Menopause?

What causes early menopause? “There’s no crystal ball that can predict exactly when you’ll begin perimenopause or reach menopause, but there are factors that can influence the timing of these stages,” says Dr. Claire Haver. Several factors contribute to early and premature menopause including genetic predispositions, autoimmune disorders, and medical treatments like chemotherapy or radiation for cancer(6). The exact cause is often unknown, but understanding the triggers can help manage the risks(8).

Genetic and Family History

Genetics play a big role in when menopause starts. “Numerous studies have demonstrated that the primary influence in your age of menopause is family history,” says Dr. Claire Haver. Women whose mothers or sisters experienced early or premature menopause are more likely to have the same(4,8). Certain genetic mutations are even linked to premature ovarian failure(8).

Autoimmune Diseases and Health Conditions

Autoimmune diseases where the immune system attacks the body’s own tissues can cause early menopause. Conditions like thyroid disease, rheumatoid arthritis, and lupus are linked to POI and early menopause(6).

Surgery and Cancer Treatments

Surgery and cancer treatments like oophorectomy (removal of the ovaries) or treatments like chemotherapy and radiation can induce early menopause. These interventions damage the ovaries and cause a rapid drop in hormone levels and menopause(9).

Dr. Claire Haver emphasises that surgical removal of the ovaries before menopause should be a last resort option. “Surgically induced menopause is a big deal. It brings about sudden and dramatic changes in your hormones and can have severe consequences.” Not only can symptoms be much more severe than the gradual onset of perimenopause, but the risk of heart disease, stroke, cognitive impairment, mood disorder, and osteoporosis all increase significantly(4,8).

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Signs of Early Menopause

Symptoms of Early and Premature Menopause

Early menopause symptoms are the same as typical menopause. These include hot flushes, night sweats, vaginal dryness, mood swings, and irregular periods.

While symptoms overlap, early and premature menopause have a more sudden and severe onset due to the rapid drop in hormone levels. This can make managing symptoms more difficult than the gradual transition of natural menopause(11).

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Health and Well-Being Impact of Early Menopause

Long-Term Risks

Early menopause increases the risk of long-term health issues like osteoporosis, cardiovascular diseases, and cognitive decline. Women who menopause earlier than average may need to take preventive measures sooner to protect their health(12).

Emotional and Psychological Impact

The emotional and psychological impact of early menopause can be massive. Women may feel loss, anxiety, and depression especially if early menopause affects fertility. Support from healthcare providers, counselling, and connecting with others who are going through the same situation is key.

Can I Still Get Pregnant After Early or Premature Menopause?

Fertility is affected by early and premature menopause but not always lost. Some women can still get pregnant naturally but it’s rare. Assisted reproductive technologies like IVF using donor eggs are options for women who want to get pregnant after early menopause(11).

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How is Early Menopause Treated?

Take Control of Your Health

Early menopause is treated the same way as natural menopause. Whatever symptoms you are experiencing, you don’t have to suffer through them. Educate yourself and talk to your healthcare provider about your symptoms, family and medical history, and preferences. Whether you want to manage your symptoms through natural solutions, lifestyle changes, or menopausal hormone therapy (MHT, also known as hormone replacement therapy), you have options.

Try Treatment Options

MHT is a good treatment for many menopausal symptoms including hot flushes and bone density loss. But it’s not for everyone, especially those with certain health risks or personal preference against hormone use. Talk to your healthcare provider about the benefits and risks of MHT to help you decide.

Natural Solutions with Biolae

If prescription solutions like MHT are not your cup of tea, try Biolae’s natural solutions. Our products are formulated with ingredients that have been clinically tested to alleviate common menopausal symptoms like hot flushes, night sweats, sleep disruptions, mood imbalances, and brain fog. These natural alternatives are another option for women who want relief during this big life transition. With Biolae, you can take control of your symptoms in a way that suits your preferences and health goals.

Raising the standard for natural menopause care.

Meno Essential + is a practitioner-formulated blend of clinically tested, natural ingredients that treat menopause symptoms at the source.

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