Premature or early menopause refers to menopause that occurs at the age of 40 or younger. It occurs in approximately 1% of women in the United States. Premature menopause can be caused by medical treatments like chemotherapy or radiation or by surgery with the removal of ovaries. It can also be spontaneous or an unknown cause. Other factors that can lead to premature menopause are genetic conditions like Turner Syndrome or Fragile X syndrome; autoimmune disorders like thyroiditis; or a family history of early menopause. Primary ovarian insufficiency (POI), formerly known as premature ovarian failure (POF), can also lead to premature menopause because it is characterized by transient or permanent loss of ovarian function in women younger than 40.
Perimenopause is the transitional period until menopause begins. This transition is when reproductive hormones are fluctuating which can last an average of 2–8 years. Some may even say that they feel “like a teenager again,” because the hormones are on a roller coaster. It can start as early as the late 30s when many peopel notice menstrual irregularities and menopausal symptoms stated above. It is still possible to get pregnant during this phase. If menopause is medically induced, for example, by surgical removal of the ovaries, one would skip this transition period and go straight into menopause.
Menopause is a natural physiologic process, not a disease. It is defined by the final menstrual period and the loss of ovarian function. Post-menopause, your body will experience a permanent decline in production of the hormones estrogen and progesterone. You also produce the male hormone, testosterone, and its level also declines during menopause but at a slower rate compared to estrogen. Menopausal symptoms are the result of the decline of these hormones. Menopause can occur spontaneously any time between the ages of 40 and 58, a small percentage of people will start at 60 but the average age is 52 years old. You can no longer get pregnant spontaneously after menopause starts.
Postmenopause starts the year after menopause and lasts for the rest of a person's life. Menopausal symptoms start to improve or even resolve at this phase. There is a risk of high blood pressure, increase in “bad” cholesterol and osteoporosis (or bone loss). Therefore, it is important to be proactive starting in your perimenopausal phase by eating healthy, exercising regularly (including strength training), and avoid smoking.
The perimenopause into menopause transition is a natural (although it doesn’t feel natural), physiological process that people experience as they age. I encourage you to listen to your body, have an open and honest conversation with your healthcare provider about your symptoms and if any of your symptoms are affecting your overall well-being or quality of life, discuss them with your physician to determine the best treatment plan for you.