Why menopause can happen earlier than planned
Most women place menopause far back in their minds, somewhere in their fifties. But for many, this chapter actually begins earlier: around 5% of women enter early menopause between the ages of 40 and 45. Around 1% even experience a premature menopause before the age of 40. Under 30, it is rare, but not impossible, at around 0.1%.
In medical terms, we speak of an early menopause when the last menstruation cycle occurs before the age of 45, explains Dr Dascha Berek, a specialist in gynaecology and obstetrics. If this happens before the age of 40, it is called premature ovarian failure. It affects around one percent of women under 40 and is much rarer in women under 30. Nevertheless, according to Dr Berek, it raises many questions.
Symptoms of an early menopause
The problem is that an early menopause is rarely recognised immediately by doctors; instead, the symptoms are often classified differently or not taken seriously at all. What makes it even more difficult is that the symptoms do not match the image of the menopause that people have in their heads. In younger women in particular, hormonal changes often do not manifest themselves in the classic way, but rather through cycle irregularities, shortened or prolonged cycles, sleep disorders or inner restlessness. All of this is "often initially attributed to stress, psychological strain or lifestyle", says Berek. Depressive moods, concentration problems, loss of libido or unusual exhaustion also fall into this pattern. However, the symptom most commonly associated with menopause, hot flushes, is often completely absent in the beginning. It is precisely this that leads to hormonal changes remaining unrecognized for a long time. "Many people notice the change in their own well-being very clearly, but don't associate it with menopause," says the doctor.
When you should take a closer look
There are warning signs that you should definitely take a closer look: "Repeatedly elevated FSH levels, a significant drop in AMH or persistent cycle disorders should be taken seriously," she says. The same applies to missing your period for several months. According to Dr Berek, even PMS can be a sign of approaching menopause. "The earlier hormonal changes are recognized, the better symptoms can be alleviated and long-term health consequences mitigated."
Can early menopause be prevented?
Many women wonder whether an early menopause can be stopped or at least delayed. Dr Berek is realistic about this: "Honesty is crucial here. The natural decline in ovarian function cannot be reversed." Instead of trying to stop the process, it is much more about accompanying it well. Medical care can reduce the consequences of hormonal changes and alleviate symptoms in a targeted manner. For many women, individually tailored hormone replacement therapy can not only alleviate symptoms, but also protect against osteoporosis, cardiovascular disease and cognitive changes, says Dr Berek and is often expressly recommended for very young patients in particular.
Where the fear of hormones comes from
The fact that hormones were viewed critically for a long time is due to the fact that "hormone therapy was attributed a disproportionately high risk over many years due to incorrect interpretation of studies". In reality, however, there were often positive effects on general health and life risks. "Nevertheless, it always remains a case-by-case decision as to whether therapy is an option." Even when there is a high level of suffering, Dr Berek repeatedly experiences resistance and reluctance when it comes to hormones: "We gynaecologists often have to fight against deep-seated fears and rejection."
How is a diagnosis made?
Before treatment can begin, a proper diagnosis must be made. According to Dr Berek, this is as follows: a careful medical history is always taken at the beginning: cycle history, family history, autoimmune diseases or previous medical treatments play an important role. A structured hormone status is crucial, ideally at the start of the cycle, including FSH, LH, estradiol, AMH and thyroid values. Abnormal values should be checked, supplemented by a gynaecological ultrasound to assess the ovaries. "The aim is not a hasty diagnosis, but clarity and certainty".
Why women should definitely trust their own perception
Dr Berek advises women in their early 30s or 40s who notice the first changes: "Take your own perception seriously." Changes in your cycle or emotional experience are not a sign of weakness, but indications from your body. "Get everything checked out medically, ask questions and don't be afraid to get a second opinion. An early hormonal change does not mean a loss of femininity or quality of life. With good medical support, it can lead to a new, stable balance".