Menopause typically starts around age 50, but for some women it can happen in the early 40s or even sooner.
Early menopause and Premature Ovarian Insufficiency can have a big negative impact on your emotional, physical, and reproductive health.
Regional One Health’s unique Menopause Care Clinic can provide the expertise you need to manage your symptoms and protect your long-term health.
Menopause usually starts in your early 50s – but for about 1 in 10 women, it can happen in the early 40s or even sooner.
“It can be devastating,” said Pallavi Khanna, MD, OB/GYN, FACOG, a Certified Menopause Practitioner at Regional One Health. “When menopause happens too soon, it impacts your quality of life. It affects your physical, emotional, reproductive, social health – you name it.”
A multidisciplinary, expert team like the one at Regional One Health can help.
Dr. Khanna recently hosted a Lunch & Learn to talk about early menopause. Swapna Thota, MD, a hematologist and medical oncologist with Regional One Health Cancer Care, joined her to discuss how patients can access the care and support they need.
What is early menopause?
Menopause is defined as going a year without a menstrual cycle. It occurs when ovarian function declines, causing the body to stop ovulation. This leads to a drop in estrogen.
When that happens between age 40 and 45, it is considered early menopause. If it happens before age 40, a patient may be diagnosed with Premature Ovarian Insufficiency (POI).
Doctors use blood tests and an analysis of symptoms to diagnose these conditions. Along with irregular or no periods, women may suffer from hot flashes, vaginal dryness, weight gain, and other symptoms commonly associated with menopause.
“The severity of the symptoms depends on when and how quickly it happens,” Dr. Khanna said. “The quickest is when you have surgery – those patients have it the worst.”
What are the risk factors?
“When menopause happens too soon, it impacts your quality of life. It affects your physical, emotional, reproductive, social health – you name it,” says Dr. Pallavi Khanna, a Certified Menopause Practitioner.
Dr. Khanna said the main lifestyle risks are smoking and being overweight.
For many patients, early menopause is related to genetics, an autoimmune or metabolic illness, infections, or toxins.
Some surgeries and treatments for cancer and other conditions can also be a cause.
“People are being diagnosed with cancer younger, and treatments like chemotherapy can cause ovarian deficiency,” said Dr. Thota. “We do have newer treatments like immunotherapy, but chemotherapy is still a cornerstone of treatment for many types of cancer.”
A hysterectomy for ovarian, uterine, or cervical cancer – or for non-cancer conditions like uterine fibroids – would also cause a patient to enter menopause.
What about the impact on fertility?
Dr. Khanna and Dr. Thota encourage patients to talk to their provider about their family planning goals. If you have a family history of early menopause or POI, genetic testing could be a valuable resource. Knowing your genetic risk can help with family planning decisions and lets you consider options like freezing your eggs.
The same is true if you’re undergoing treatment for cancer.
“Patients might want to consider options for fertility preservation,” Dr. Thota said. “It’s a conversation oncologists should have with their patients.”
While Dr. Thota said it is important to start cancer treatment promptly, there is typically a window of time specific to each cancer where patients can continue planning treatment for cancer that allows for fertility preservation. This would give them time to seek fertility-protective measures.
If a patient needs to undergo cancer treatment that can lead to early menopause, they can explore their options. “Patients might want to consider options for fertility preservation,” medical oncologist Dr. Swapna Thota said. “It’s a conversation oncologists should have with their patients.”
What are the long-term health consequences?
Infertility isn’t the only serious consequence of early menopause.
Dr. Khanna said patients are at higher risk of cardiovascular issues like high blood pressure, stroke, arterial fibrillation, and heart failure. “Estrogen helps the blood flow more easily. In its absence, the arteries can become narrower,” she explained.
There are also metabolic consequences, like weight gain and a higher risk of diabetes. “When your ovaries stop making estrogen, your body tries to compensate. Fat also makes estrogen, so your body adds fat,” Dr. Khanna explained.
Early menopause can impact bone density and muscle mass, increase your risk of anxiety and depression, cause cognitive issues like brain fog and forgetfulness, and more.
“Every organ system is affected,” Dr. Khanna said. “Overall life expectancy decreases when menopause happens very early.”
What can I do if I’m diagnosed?
Dr. Khanna and Dr. Thota said it’s important to seek care from the experts you need for your specific needs and goals.
As a certified menopause practitioner, Dr. Khanna has specialized training to help patients manage both their symptoms and risk of serious conditions.
That includes discussing Hormone Therapy. Patients who are interested in HT should always work with a provider, and those who take the medication need regular monitoring for heart health and bone density.
Regional One Health’s Menopause Care Clinic offers access to an additional level of expertise and experience for addressing symptoms and long-term health implications.
“Your underlying conditions and general health impact whether hormone therapy is right for you,” Dr. Khanna said. “We make a shared decision that addresses your individual risk factors and how the medication can benefit you.”
Blood clots, breast or endometrial cancer, unexplained vaginal bleeding, and severe liver or heart disease can all be contraindications for HT.
Dr. Khanna also connects patients with additional specialists based on their needs. That includes fertility specialists, genetic counselors who can help family members learn about their risk, mental health professionals for depression and anxiety, and more.
Learn more!
Dr. Khanna and Dr. Thota encourage women who experience early menopause or POI to advocate for themselves and seek care tailored to their specific needs.
If cancer plays a role, Dr. Thota noted there are growing resources to support the needs of survivors. “We take a multispecialty approach to find the best option for patients,” she said. “Cancer doesn’t have to steal your quality of life. We can bridge the gap for women who are facing early menopause.”
Dr. Khanna said patients should never feel like they “just have to live with” concerns during menopause. “Specialized menopause care is available – and it isn’t just for hot flashes and vaginal dryness,” she said. “We take care of you from head to toe.”