"You’re too young
This is a common response to younger women with symptoms of premature ovarian insufficiency, premature menopause, early menopause and surgical menopause
The average age for reaching menopause in the UK is 51
but it’s estimated that 12% of women will go through spontaneous early menopause between age 40 and 45.
Four in 100 women will experience premature menopause - when periods stop before the age of 40. And one in 100 women under 40 will experience premature ovarian insufficiency (POI), where ovaries are no longer functioning properly. In the vast majority of cases, there is no known cause. POI is different from early menopause or premature menopause, in that women may still have periods and may still be able to get pregnant.
On the flip side, some girls with POI will never reach puberty
With three similar terms to describe three different ways women can be impacted by perimenopausal and menopausal symptoms at an earlier age than usual, you could be forgiven for being confused. Especially since many doctors haven’t been taught much about these conditions. But there’s more.
Surgical menopause and medical menopause
There’s another way that women can end up dealing with menopause symptoms earlier in life, and that’s surgical menopause. When the ovaries are removed, with or without the uterus, menopause happens immediately. This is irreversible.
If the surgery happens before the age of 40, then this may be called POI. If a woman’s uterus is removed – but the ovaries are left in place – then menopausal symptoms can also occur, though they may lessen over time. Unless it’s near the time when she’d naturally go through menopause.
Women may also be given medication to shut down ovarian function, sometimes before surgery to treat cancer, endometriosis or other menstrual problems.
This is medical menopause. Once the medication is stopped, the ovaries can start to work again. The younger a woman is, the more likely it is that the ovaries will begin functioning as before.
Talking to your doctor about premature ovarian insufficiency, early or premature menopause, or surgical menopause
We know that doctors are often in the dark about perimenopause and menopausal symptoms - it just hasn’t been a big enough part of their training. Well with POI, early and premature menopause, GPs often have even less awareness. Surprisingly, this can even be the case when it comes to surgical menopause in a younger patient.
Being your own advocate - and why it’s so important
If you do suspect you’re “too young but still menopausal” then you may have a fight on your hands to get the treatment you need. But please don’t let this deter you. Diagnosis is important. Not only so you can seek treatment or introduce lifestyle changes to help reduce your symptoms.
Diagnosis is usually made through a combination of blood tests and looking at your medical history - usually when your periods stop for at least three months. A doctor will look at hormone levels for FSH (follicle-stimulating hormone), which will be high. They’ll need to take two tests, four to six weeks apart.
What about surgical menopause?
Before surgery, you should be involved in a discussion about the impact of surgery on your health. Ideally with an explanation of what’s likely to happen, the symptoms you may experience, and potential treatment options such as HRT. Sadly, this discussion is often missed.
HRT in premature menopause, early menopause, POI or surgical menopause
If there are no contraindications – no reasons why HRT may be harmful to you – then taking HRT can be of real benefit. It essentially replaces the hormones that you would usually be making naturally. One thing to consider is that you may need a higher dose than someone who reaches peri or menopause at a later age. So it’s important to find a medical practitioner who understands the complexity.
If you’ve had a surgical menopause, you might not be able to take HRT, since some cancers – such as breast cancer – can be oestrogen dependent. Alternatives include selective serotonin reuptake inhibitors (SSRIs) that can help with some of the symptoms, including hot flushes.
Oestrogen is the main hormone required, but if you still have a uterus you’ll need progesterone too. Testosterone can also be considered. Regardless of whether HRT is an option for you, there are plenty of other ways to positively impact your symptoms. More on that in a moment.
Grief and feelings of isolation are normal
A menopause diagnosis in your teens, twenties or thirties is very different from going through this transition in midlife, when friends will be going through the same experience, and family members may tell you about their own transition.
Both you and the people around you are less likely to realise that all of your symptoms add up to perimenopause or menopause. If this is what you’re going through, it’s perfectly normal to go through a grieving process and even to feel quite isolated.
Women in this situation might experience:
Starting fertility treatment and then discovering they’re actually post-menopausal,
Wondering how on earth to have this conversation with their partner,
Suffering challenging symptoms for years before figuring out they’re in menopause,
Taking HRT when their friends are more worried about contraception,
Grief, denial or disbelief.
It’s important to understand that you are not to blame for early menopause, premature menopause, POI or surgical menopause. When you’re going through menopausal symptoms, showing yourself the kindness and compassion you would show a friend is vital. If you’re only just finding out that your body is going through a transition – because it wasn’t what you were expecting at this age – diagnosis can be a shock.
But it can also feel positive. Because you’re finally able to understand what’s up, and what your body needs for you to start feeling like yourself again. Conflicting emotions are to be expected, but getting a diagnosis is known to have a significant impact on psychological wellbeing and quality of life.
Your next steps for dealing with your menopause symptoms
If you haven’t already, it’s a good idea to talk to your GP. But you might’ve already been down that road and not yet got the help you need. You certainly wouldn’t be alone if that’s the case. It’s one of the reasons I trained as a BANT Registered Health Coach and Functional Medicine certified Nutritionist - I started along that path to educate myself as I went through my own menopausal challenges. And it gave me the tools, the experience and the qualifications to help other women too.
My symptoms won’t be exactly the same as yours, but I do have some idea of how you feel, and how difficult it can be to see a way through. I know when I started looking into the diet and lifestyle changes I could make, it all felt impossible. I resisted, because who wants to give up all of life’s pleasures?! But, of course, when you make gradual changes – and start with the things that’ll have the biggest impact – you start to feel more like you again. Your energy starts to return, and you can feel your confidence in yourself and your body increase. At that point, the changes you’ve made start to stick, and the effort all feels worth it.
Making changes to support your body through peri & menopause
There are a number of changes you can make to deal with your immediate symptoms as well as support your long-term health. These could include:
Eating a balanced diet,
Balancing blood sugar levels,
Ensuring you have a healthy gut microbiome,
Looking at the impact of caffeine and alcohol,
Getting more exercise,
Making sure you get a good night’s sleep,
Managing stress levels,
Balancing your hormones,
Ensuring optimum vitamin D and other vitamins and minerals,
Managing your weight.
That might sound like a lot, which is why it can help to work with someone who can put you on the right path for you. It’s important to take your time and follow a step-by-step process so you don’t feel like you’re making an overwhelming number of changes in one go. This is exactly what I do for the women I work with.
Book your taster session today
If you’d like to find out more about how I work with women, book your free taster session using using the button below.
I know it can be difficult to know who to turn to when you’re dealing with brain fog and all the rest of it. So after our taster session, if I don’t think I’m the best person to help you, I’ll point you in the direction of another professional. And if (a) We hit it off and (b) I know I can help you, then we’ll talk about the best path forward.
No pressure at all - I’ll just explain the different options to you and then it’s up to you what you do next. If we don’t end up working together, you’ll still go away from your taster session with advice on what you could try to potentially help improve your symptoms. As well as those suggestions I’ll give you, often the biggest thing people take away from these sessions is being listened to by someone who really “gets it”.