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Dr. Jerilynn C. Prior, Scientific Director, Centre for Menstrual Cycle and Ovulation Research

Ask Jerilynn |

Early Menopause

Q: 
I am 39 and having hot flushes and night sweats. I've skipped my period for the last 18 months. Does that mean I am in menopause? Help! I'm too young—what can I do?

A: 

Thank you for your question. It is a very difficult thing to have perimenopause and menopause when you are as young as you are. First of all, it's hard to figure out why you don't feel well. Doctors take a long time to realize what's going on. And menopause is viewed very negatively in our society. Women who have put off having children they always wanted feel betrayed when menopause comes too early.

Because you have skipped periods for over a year you do meet the diagnosis of menopause. Because you are less than 40 that makes your menopause too early ("early menopause"). However, menopause is a normal part of our hormonal lives for all women. Yours just came about 12 years too soon.

Women with early menopause were cut short on their normal life cycle exposure to estrogen and progesterone. Therefore I think that you need balanced, bio-identical estrogen and progesterone therapy until you reach age 52. (See Ovarian Hormone Therapy for Women with Early Menopause.)

I'd suggest that you start keeping the Daily Perimenopause Diary and do a record for a week. Then ask your family doctor for full dose daily progesterone (Prometrium 300 mg at bedtime) to get your hot flushes under control. Then next gradually add low dose bio-identical estradiol as a gel or patch. (Estradiol is normal and important for early menopause except for women with breast cancer or severe blood clots for whom it is not a good idea. The Women's Health Initiative negative results don't apply to women with early menopause.)

You should have a bone density test because one of the risks of early menopause is osteoporosis (that estrogen, progesterone and healthy life will improve). I'd suggest you look at the ABCs of Midlife Bone Health if your bone density is normal and at ABCs of Osteoporosis Treatment if your bone density is low.

You've successfully survived perimenopause (which was very rough for me) and graduated into menopause a bit too early. That doesn't change who you are or your value as a woman and a person. There will be some time of change but eventually you'll feel well, and probably better than you have for at least five years!

Hope this is helpful to you.

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