A woman’s reproductive years come to an end with the menopause, a normal biological process that usually occurs around age 51.

Early or premature menopause, on the other hand, occurs in some women much sooner, in their 30s or even 20s.

While perimenopause, the period of transition before menopause, can begin in the early 40s, early menopause is defined as the commencement of menopause before the age of 40. According to the Mayo Clinic, an online health library, early menopause affects around 1% of women under 40 and 5% of women under 45, while being quite uncommon.

Early menopause can be caused by a variety of reasons, including lifestyle choices, genetics, autoimmune disorders, and pharmacological interventions like chemotherapy. Given that early menopause can entail special dangers, including an increased risk of osteoporosis, cardiovascular disease, and mental health conditions like depression, it is crucial for women’s health to recognise the warning indications of early menopause.

This article explores five early menopausal warning signals to assist women in identifying the symptoms and swiftly seeking medical advice:

Missed or irregular periods

An irregular menstrual cycle is the earliest and most obvious indication of early menopause.

As the ovaries eventually stop producing hormones, menstruation for women nearing natural menopause can become unpredictable. However, in women going through early menopause, this tendency could begin considerably sooner.

Missed or irregular periods are frequently the initial indication of a hormonal imbalance, according to leading gynaecologist Dr. Amanda Kolawole. According to her, a woman under 40 should see a gynaecologist if she begins to have irregular periods for three months or longer.

Bleeding often lasts two to seven days, while a menstrual cycle typically lasts 21 to 35 days. Women going through early menopause may notice greater or lighter bleeding, skip a few cycles, or have longer periods. Even while irregular periods are common, women under 40 should not disregard chronic irregularities since they may indicate the beginning of early menopause, according to Kolawole.

Scientific Insight: According to a research that was published in The Journal of Clinical Endocrinology & Metabolism, these irregular menstrual cycles are caused by changes in the hormones progesterone and oestrogen.

The regularity and consistency of menstruation can be an early indicator of ovarian decline if these hormone levels significantly fall.

Night sweats and hot flashes

Hot flashes are a typical menopausal symptom, according to medical professionals, but if they occur before the age of forty, it may be an early sign of menopause. Hot flashes can last anywhere from a few seconds to several minutes and are characterised by abrupt, strong feelings of heat, mainly in the upper torso. Similar episodes that take place during sleep and frequently cause discomfort and disturbed sleep are known as night sweats.

According to Dr. Tim Banes-Wale, a Nigerian endocrinologist living in Europe who specialises in women’s hormonal health, oestrogen is essential for controlling body temperature, which is why hot flashes and nocturnal sweats happen.

“A sharp decline in oestrogen levels impacts the hypothalamus, which regulates body temperature, resulting in feelings of intense heat,” he continued.

Additionally, Banes-Wale pointed out that hot flashes can have a major negative influence on a woman’s quality of life, especially if they happen frequently or interfere with sleep.

Emotional shifts and mood swings

Hormones like progesterone and oestrogen affect mood, mental health, and cognitive function in addition to controlling the menstrual cycle.

According to psychologist and women’s health researcher Tanko Sule, women experiencing early menopause frequently report feeling more irritable, melancholy, or nervous.

According to Sule, the synthesis of serotonin, a neurotransmitter linked to mood regulation, is influenced by oestrogen in particular.

Early menopausal women frequently endure emotional anguish as a result of both the unanticipated changes in their life’s course and hormonal irregularities, he added.

Many women have a sense of loss, particularly if they had intended to become parents, and this can make anxiety and despair worse.

While mood swings, anger, and anxiety are typical throughout the perimenopause, early menopause may cause these symptoms to be more severe or last longer. According to research published in the journal Psychosomatic Medicine, women going through an early menopause are more likely to experience sadness than those going through a natural menopause. It’s critical to identify and deal with these emotional shifts since mental health assistance may be very helpful in navigating the transformation.

Dryness and pain in the vagina

Vaginal dryness is a less well-known but no less significant early menopausal symptom that can cause pain during sexual activity, discomfort, and even recurring UTIs.

Oestrogen helps to maintain lubrication and suppleness in vaginal tissues, which are extremely sensitive to it. The vaginal lining gets thinner, drier, and more irritable as oestrogen levels fall.

“Women in early menopause may notice increased vaginal dryness or experience pain during sex, which is directly linked to the reduced oestrogen levels,” says Dr. Amanda Langton, a gynaecologist in Boston, U.S. Because many women are reluctant to talk about it, it’s a frequent but underreported symptom.

Nearly half of all women going through menopause have vaginal dryness, with those going through early menopause being especially vulnerable, according to a research published in Menopause, the journal of the North American Menopause Society. Oestrogen lotions or over-the-counter lubricants may help reduce vaginal dryness, according to another Lagos-based physician, Dr. Suleiman Alade. However, for individualised care, speaking with a healthcare professional is advised. “Early intervention can lower the risk of recurrent infections, enhance comfort, and help maintain sexual health,” he stated.

Reduced libido and fertility

An abrupt drop in fertility might be upsetting for women who are fertile. Due to the loss of ovarian follicles, which are essential for ovulation, early menopause frequently results in decreased fertility, according to Dr. Alade.

“Dominant ovarian reserve, a condition that indicates a decline in the quantity and quality of eggs, may be diagnosed in women or they may notice that it becomes more difficult to conceive,” he said.

“Many women seeking fertility treatments are unaware that their struggles may be due to early menopause,” said Dr Destiny Ekinyi-Ochete, CEO of EEK reproductive Centre in Abuja and a fertility specialist.

Because hormone imbalances affect sexual desire, which may further undermine closeness in relationships, reduced libido is also frequent. Reduced sexual desire and satisfaction may result from a decline in oestrogen and testosterone, two hormones that affect libido.

Reduced libido and fertility in younger women can be a surprise and emotional hardship. Especially if they had intended to have children later in life, they can feel pressured to make reproductive decisions quickly.

Research Finding: According to studies published in the journal Human Reproduction, ovarian reserve rapidly declines in the early stages of menopause, which has important ramifications for sexual health and fertility. Women can make better decisions if this issue is addressed early on, whether they are thinking about lifestyle changes or alternatives for fertility preservation.

Recognising the effects and looking for assistance

Early menopause presents mental and physical difficulties that affect a woman’s fertility, general health, and quality of life. Even though the symptoms could resemble those of a natural menopause, the experience is frequently more sudden and unanticipated. Because early menopause raises the risk of diseases including depression, heart disease, and osteoporosis, it is imperative that women get medical attention if they experience any of these symptoms.

According to Sule, it is imperative that anybody under 40 who observes any of the aforementioned symptoms speak with a healthcare professional.

“A gynaecologist or endocrinologist can help you navigate treatment options, such as hormone replacement therapy, lifestyle changes, or fertility advice,” he added, adding that blood tests can measure hormone levels.

The key is early awareness.

A woman’s physical, mental, and reproductive health may be impacted by the difficult condition known as early menopause. Women can seek medical advice and take action to properly manage their health by identifying and comprehending the warning indicators. In order to reduce health risks and provide women the assistance they require to get through this time of life, early diagnosis and intervention are essential.