Sometimes you look back and wonder where all the time went.
Let’s see - in my twenties, the younger, sexier me had been to University and embarked on a career in medical research, and I’d been very active in my leisure time – including hiking and skiing every year in the Alps. I was too invested in my career and hobbies to have children and wanted to put that off until the right time.
In my thirties, I eventually realized it was time to start a family before it was too late. At age 35 I saw a gynecologist who said “at your age, the chances of getting pregnant are very low. You’re probably only producing a viable egg about every 3 months, and you’ll be at higher risk for pregnancy complications as an ‘elderly primagravida’.” Despondent, but undeterred, I set about trying to get pregnant and succeeded within the first month. So much for the gynecologist. At age 36 I gave birth to my son, and at age 38 to my daughter.
But something strange happened when I entered my early forties. After my daughter was born, my periods eventually came back – but very irregularly. I wasn’t too worried at first since I was breastfeeding, but after a year or so it seemed odd that they were still so erratic. I moved to the USA in 2000 and put the still-irregular periods and trouble sleeping down to the stress of an international move with young children. But when I started having more symptoms, including hot flashes and night sweats, and saw my doctor for a checkup, she did an FSH test and said, “guess what – you’re in menopause.” At age 42. When I mentioned this to one of my aunts in the UK she said, “oh yes, that happened to me in my early forties, and your other aunt as well.” Who knew – early menopause runs in families!
What is Early Menopause?
Typically, menopause – characterized by the cessation of periods for a year, and a very high blood FSH level – happens in a woman’s early fifties. “Premature menopause” is a term that refers to premature ovarian failure (POF) affecting around 1% of women under the age of 40, whereas spontaneous early menopause affects 5% of women aged 40-45 . Early menopause can also result from certain medical conditions (e.g., autoimmune diseases, epilepsy, or chromosomal abnormalities), a history of smoking, or certain infections, e.g., mumps, and can be induced as a side effect of chemotherapy or radiation. Removal of both ovaries (bilateral oophorectomy) brings about a “surgical menopause” at whatever age the surgery is done.
Early menopause can also occur when there is a family history of early menopause. Since none of the other medical factors applied to me, that was what happened in my case. A population-based case-control study carried out in 1995  found that 37% of the early menopause (before age 46) cases reported early menopause in a mother, sister, aunt, or grandmother, while only 9% of the controls (who entered menopause after age 46) had such a family history. The cause of spontaneous early menopause when there is a family history is not known.
Health Risks of Early Menopause
Whether spontaneous, induced surgically or by chemotherapy, or as a result of other medical conditions, early menopause comes with health risks of its own . In most cases, these are consequences of the early loss of estrogen production by the ovaries. Estrogen is important for the optimal functioning of the cardiovascular, nervous, and skeletal systems, and of course this is the primary reason why women undergoing menopause seek hormone replacement therapy. We know from all the hoopla surrounding the Women’s Health Initiative, which famously looked mostly at women who started hormone replacement many years after entering menopause, that hormone replacement started a short time after the onset of menopause is recommended to prevent chronic health conditions such as cardiovascular disease and osteoporosis. Results of subsequent trials such as the Kronos Early Estrogen Prevention Study (KEEPS) have demonstrated the efficacy and safety of starting hormone therapy soon after the onset of menopause .
Surgical Menopause and Low Testosterone
Not only did I struggle with insomnia, hot flashes, night sweats, mood changes, and all the other joys of a natural menopause, but I then experienced some pelvic pain and was diagnosed with a growth on one of my ovaries, so I ended up having a bilateral oophorectomy resulting in surgical menopause to boot. Fortunately, the growth turned out to be benign; but the surgery had the unforeseen consequence of sending my testosterone down to undetectable levels.
So not only did I have severe estrogen deficiency, I ended up with testosterone deficiency as well. Let me tell you, this is not fun. Forget the younger, sexy me, menopause or not – without testosterone, there is no libido at all. In women undergoing non-surgical menopause the ovaries do continue to produce testosterone, which can to a large extent “take over” from estrogen in terms of bone support, maintaining vitality, and supporting nervous system and cardiovascular health. But when there are no ovaries, testosterone levels plummet. Low testosterone in women has been linked with low libido and lack of sexual desire, but there is still controversy about the use of testosterone in women . I can only say from experience that the consequences of low testosterone were very real for me.
It is no accident that my plunge into early menopause, and then surgical menopause, eventually led me to ZRT Laboratory. The almost complete absence of both estrogens and androgens from my body, and my dissatisfaction with the synthetic hormones prescribed after my oophorectomy, sent me on a quest to find out as much as I could about natural hormone replacement. It’s not always easy to find a health care practitioner who really understands what you are going through in terms of hormone health, and can identify the right testing to home in on the most suitable hormone replacement therapy. I saw several doctors before finding the best fit for me, and I always went in armed with my own research and understanding so that I could feel confident in proper hormone restoration without unnecessary side effects.
Thank goodness I met Dr. Zava and ZRT Laboratory along my journey and was able to find the best testing around and the practitioner who could properly interpret it and prescribe appropriately! If this blog rings all too true for you, find out how ZRT can help you with your menopause symptoms today.
Now in my early sixties, I may not be young any more but with proper hormone replacement the zest for life is definitely back – with my children now in their early twenties and getting on with their own lives, I’m back to hiking regularly and I’m going skiing again this winter for the first time in 20 years!
- Blog: Banishing the 7 Dwarves of Menopause
- Blog: Mood and Menopause - Going Through "The Change"
- Webinar: Hormone Replacement Therapy Dosing For Optimal Clinical Response
 Shuster LT, et al. Premature menopause or early menopause: long-term health consequences. Maturitas. 2010;65:161-6.
 Cramer DW, et al. Family history as a predictor of early menopause. Fertil Steril. 1995;64:740-5.
 Miller VM, et al. The Kronos Early Estrogen Prevention Study (KEEPS): what have we learned? Menopause. 2019 Apr 1.
 Davey DA. Androgens in women before and after the menopause and post bilateral oophorectomy: clinical effects and indications for testosterone therapy. Womens Health (Lond). 2012;8:437-46.