In your 30s, it feels irrelevant to imagine the end of your fertility, especially if you’re very much focused on being fertile, either trying to have a baby or looking after them. And it’s not a fun prospect; the menopause, from the perspective of a 35-year-old, feels like the beginning of old age.
Women in their 30s tend to know very little about the menopause, says Dr Shahzadi Harper of The Harper Clinic, London. But knowledge is power. Menopause is going to happen to you, and you can prepare for it, she says.
“I want you to think about your future health and to look after your health now, to make the next stage of your life as positive as it can be,” says Dr Harper.
Dr Harper reveals the five things she would like you to know, right now, so you can get ready for your future.
The menopause might happen sooner than you think
Five per cent of women will have a naturally early menopause, that is their periods will stop completely when they are under the age of 45. And one in 100 women have it before the age of 40, when it’s called premature ovarian insufficiency. Other possible reasons for an early menopause might be surgery to remove the ovaries or chemotherapy. And smokers reach menopause just over two years earlier than those who don’t.
Even if you don’t have an early menopause, symptoms can start earlier than you might have thought too, as they begin in perimenopause, the four to 10 years leading up to the menopause. If your menopause is at the average age, 51, your symptoms could start aged 41.
At this time – and later on too – women often put any changes down to other reasons: maybe they are busy with children or looking after parents, their partner, their career. And hormones don’t decline in a straight line, they tend to fluctuate, so the change can feel very gradual.
You might think of the main menopause symptom as being hot flushes but often, the very first symptoms of the perimenopause are feeling tired and/or joint pains. You may notice your cycle perhaps getting a bit shorter and/or your periods doing the same. Then, in your early 40s, the main symptoms women tell me they notice are mainly fatigue and changes in their skin and hair, perhaps feeling anxious when they never used to, or starting to put on weight around the middle.
Think about your weight
There are a lot of factors that lead to mid life weight gain. Not all of them are down to the menopause, but some are. So it’s good to be aware that you may not be able to eat as you did in your 20s.
From our 40s onwards, women tend to put on half to 1kg of weight per year. It’s often around the middle, which is related to the decline of oestrogen. Declining testosterone can lead to a drop in metabolism and muscle mass, as well as energy and libido, too. But weight gain can also be related to the hormone insulin not working as well. Or there may be a drop in thyroid function, which also affects metabolism.
Be aware of breast cancer
Although we hear a lot about younger women who have breast cancer, when women reach the menopause the risk rises significantly. Eight out of 10 cases of breast cancer are in women over the age of 50.
It’s good to be aware of the other breast cancer risk factors so you can reduce them while you’re younger. If you haven’t already, stop smoking. Drinking any amount of alcohol increases your risk; the more you drink, the greater the risk. Weight is also important as breast cancer is linked to being overweight or obese. And inactivity is a risk factor too; aim for at least 150 minutes of moderate activity a week, according to Cancer Research UK.
Breast cancer isn’t the only reason to stay a healthy weight, to exercise, to drink sensibly; these will have an impact on your later life health in other ways, for example on your cardiovascular system.
Look after your pelvic floor
After the menopause, because of the change in oestrogen levels, women are much more likely to suffer from urinary incontinence as well as vaginal dryness and atrophy. So it’s worth getting your pelvic floor in shape as early as possible. This is especially relevant for anyone who’s been pregnant, as you may know. I suggest that my patients look after their pelvic floor by doing pelvic floor exercises pre and post pregnancy, and keep doing them.
Be prepared – but don’t be scared
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Ideally, I’d like everyone to be aware of the menopause as a natural process, just like pregnancy. If I had my way, it would be taught in school so boys know about it., and for everyone to know that there are treatments available as well as support so it feels much less scary and more manageable. I’d like it talked about in the workplace too, as part of employers developing a menopause policy that makes life a little easier for women at this time.
As for my final advice: The earlier in your life you tackle the lifestyle factors above – smoking, drinking, exercise, eating well – the better prepared you’ll be when the menopause does happen. If you are in good shape and get good advice, the menopause needn’t be terrible, although it may still be challenging at times. That’s why it’s worth focusing time and energy on your health, right now.
For more advice on menopause and wellbeing, visit Dr Harper at The Harper Clinic in London.