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Are You At Risk For Early Menopause?

By: Michael Lam, MD, MPH; Carrie Lam, MD; Jeremy Lam, MD

Some woman experience early menopauseOn the surface, early menopause may not seem like a big issue, but women that go through menopause early—between the ages of 40 to 45—are at a higher risk of certain health problems. Before we get into the health concerns associated with early menopause that every woman should be aware of, it’s equally important to understand what leads to the early onset of menopause in the first place.

Factors that Lead to Early Menopause

Woman have control over a number of factors that may increase or decrease their odds of going through menopause at an earlier age than normal. A history of smoking can increase the chances. Other risk factors include a family history of early menopause as well as chemotherapy or pelvic radiation for cancer, and women who have had their ovaries or uterus removed are also at a higher risk. In addition, HIV and AIDS can increase your chances of early menopause.

These are just a few things you may want to talk to your healthcare provider about to determine whether you are at risk of going through menopause early.

How Do I Know If I am Suffering from Early Menopause?

There are several ways that you can tell if you’re going through menopause. The symptoms are the same regardless of whether you’re going through regular menopause, premature menopause (before the age of 40), or early menopause. Knowing the symptoms is important so you can talk to your healthcare provider to see what can be done. You should be on the lookout for the following symptoms:

  • Hot Flashes – This is when the upper body gets very hot for no reason. Red blotches often accompany hot flashes, followed by cold flashes once the initial hot flash is over. In rare cases, some woman experience cold flashes more frequently than hot flashes. It is a good idea to track your hot and cold flashes since this can help you understand what may be triggering them. If you discover a pattern, then you can potentially reduce the chances of experiencing hot flashes by avoiding certain triggers.
  • Vaginal dryness – Many women experience dryness in their vagina when they’re going through menopause. This can lead to small cuts and tears and may make having sex uncomfortable. If you experience this, creams and moisturizers can help ease some of the discomforts. It can also help to speak with a healthcare professional so you can work together to find the options that work best for you and your individual needs.

Other Issues About Early Menopause to Consider

In addition to the symptoms, there are far more serious issues every woman should be aware of in relation to early menopause. Early onset of menopause can lead to a shortened lifespan, as well as an increased risk of type 2 diabetes. One study examined 3240 women in Europe between 1997–2008 and found that 305 women developed diabetes. The study also discovered higher mortality rates among women with diabetes and early menopause compared to those with normal or late menopause.

These are very serious issues that every woman should be aware of. It’s important to know all the facts and talk to your healthcare provider about them—especially if you’re experiencing symptoms of early menopause.

AFS and Women

The NeuroEndoMetabolic (NEM) Stress Response System helps keep your body in a healthy state. It does this via six interconnected circuits, one of which is the Hormone Circuit. For women, the Hormone Circuit is comprised of the Ovarian-Adrenal-Thyroid (OAT) Axis. The ovaries, adrenal glands, and thyroid gland are closely connected—if any of these components stop functioning, the others must overcompensate for this imbalance.

For women, a balanced Hormone Circuit is extremely important. If the ovaries are not receiving the correct signals, they may stop working the way they should, which can place you at risk of developing Adrenal Fatigue Syndrome (AFS). Unfortunately, many women don’t recognize the signs until it’s too late.

Early menopause and the NEM Hormone CircuitStress can be one of the main culprits of hormonal imbalances during this stage in life. Sometimes early menopause is the stressful situation, or the stressor could be one of many “normal” life events such as losing a job, struggling with your marriage, or losing a loved one. If you are a woman suffering from AFS, your adrenal glands are not functioning as they should and not producing adequate amounts of cortisol. The NEM Stress Response System usually acts as the main control system for stress and triggers actions via the adrenal glands. However, when the adrenals are compromised, your body may be unable to produce the cortisol it needs to prevent potential damage from stress. This occurs gradually in several stages as the condition progresses and symptoms worsen.

One of the major symptoms of AFS associated with female hormone imbalances and early menopause is weight gain, particularly around the waist. Women may also suffer from a lack of sexual drive and infertility. Estrogen dominance is another symptom caused by imbalances in the OAT Axis and is caused by a lack of progesterone, the counterpart of estrogen. Without progesterone, too much estrogen can make a woman’s life miserable. For instance, it can lead to changes in the menstrual cycle, as well as an increased risk of endometrial cancer, and blood clots. Many women experience longer periods, heavier bleeding, severe cramps, and difficulty getting pregnant.

When AFS starts to appear, one of the first stages is linked to the fight-or-flight response. This response is initiated by chemicals produced in the body that cause you to react in one of two ways: stay and face the threat or run away.

During the next stage of AFS, as your body starts to resist the increased demand for cortisol, you will begin to need more and more time to rest and recover at the end of each day. You may wake up in the morning feely more groggy than usual and not refreshed. This will, in turn, prevent you from getting a full night of sleep and as your body will begin to suffer from serious side effects that can greatly affect your overall health and wellbeing.

This increased fatigue can be dealt with in a number of ways to help you function better on a daily basis. One of the biggest ways of helping to regulate the body’s response to stress is through the use of meditation as well as other stress-relieving practices. If the problem is serious enough, medication can be prescribed to aid your body in responding to stress.

The third stage is characterized by exhaustion. At this point, the effects of AFS begin to show in a big way as a result of severely reduced cortisol production. While the symptoms may not occur instantly—it can take several years for the full effects to manifest—you may begin to feel more and more tired all the time and find it hard to perform ordinary day-to-day tasks. The final stage of AFS is utter exhaustion, at which point you may no longer be able to take care of yourself.

Hormones are Very Important—More than Most People Realize

One thing many women are not aware of is that many hormones are interrelated. This means that reduced cortisol production or a total lack of this hormone can cause numerous seemingly unrelated side effects. At some point, your body will no longer be able to operate causing some of the issues discussed earlier, including type 2 diabetes, to develop into something much worse. Early menopause is something that should not be ignored, and as a woman, you should make sure you are fully aware of the symptoms, risks, and options available to you. The more informed you are, the better the outcome will be on the whole.


Understanding what early menopause options you haveEarly menopause and the health problems that accompany it can be quite troublesome for a woman, especially if you are not prepared to start going through this change in your life. This can lead to a lot of additional stress that will eventually take a toll on your body. If you suspect you may be going through this type of change, it’s best to talk to your healthcare provider as soon as the first symptoms begin to appear. They can help you find the right plan of action for you and your individual condition. Early menopause can be a very serious issue. For a lot of women going through menopause can be hard enough so the last thing you want is to go through it early or even prematurely.

© Copyright 2020 Michael Lam, M.D. All Rights Reserved.

Dr. Lam's Key Question

Suddenly experiencing hot flashes, at nighttime or during the day, can be a sign of early menopause in a woman. Vaginal dryness is another symptom that if left unaddressed can lead to relationship difficulties.


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