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Dear LADYist: Are You There, God? It's Me, Menopause.

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LADYIST IS SEX ED FOR GROWN WOMEN. OUR SEXPERTS ARE ANSWERING THE QUESTIONS THAT HEALTH CLASS NEVER FULLY EXPLAINED. WHAT DO YOU WANT TO KNOW ABOUT YOUR SEXUAL OR REPRODUCTIVE HEALTH? ASK US HERE.


Recently on LADYist, we examined carnage-level periods and what happens when they come at you like a wrecking ball. This time around, we're going to talk about what happens when your period stops altogether. Forever.

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That's right, we're talking about menopause. So sit back, relax, and cue up some David Bowie.

WHAT THE HELL IS MENOPAUSE, ANYWAY?

In a nutshell, it's when your menstrual cycles stop for good, because your body is no longer producing the levels of estrogen and progesterone needed to mature and protect egg cells every month.

It's a natural stage in the aging process, and it means you're no longer fertile.

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It doesn't necessarily happen all at once. Broadly speaking, there are two ways that doctors define the onset of menopause.

The first is the onset of irregular and less frequent periods. That's usually coupled with some of the classic symptoms of menopause like hot flashes, night sweats, insomnia, vaginal dryness or mood swings over a period of six months.

Alternatively, a doctor will diagnose you with menopause if you stop having your period for 12 consecutive months -- even if you don't have any of those symptoms.

The process typically occurs between the ages of 45 to 55. Although when exactly it will strike is largely determined by genetics (thanks, Mom!), about 90 percent of all women are there by their mid-50s.

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However, this is one of the rare instances in women's health where it's a lot better to be late than early.

Yes, you read that right.

A recent study found that women who reach menopause later in life tend to live longer on average (though the same findings suggest that they are more likely to develop certain types of cancers).

But there are a few ways you can go through the change well before you should, and that's generally a sign that something is very, very wrong.

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BUT...HOW?

Clinically speaking, premature menopause describes the onset of menopause before the age of 40.

Since menopause is all about those hormones, its early arrival is a sign that something is up somewhere between your pituitary gland and your reproductive organs, such as an imbalance or absence of estrogen when there shouldn't be. It's also a sign to call your doctor.

(And by the way, being on birth control doesn't do this. The pill suppresses ovulation, but it gives you enough of an estrogen boost to mask menopause. But being on birth control can make it trickier to figure out if you're going through "the change," because it makes it harder to gauge your natural cycle.)

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The most common reason for early onset menopause is related to surgery. "Surgical menopause" is when you undergo certain procedures on your reproductive organs, particularly the ovaries.

Sometimes, a hysterectomy can put you on the path to early menopause as well -- by about one or two years, according to some estimates.

The same goes for procedures where you're put on hormone blockers, such as those used to treat fibroids or endometriosis. But technically speaking, it's not considered true menopause because it's reversible. Once the hormone blocking stops, your reproductive organs can get back to doing what they do.

However, in rare cases, some women go through actual, non-artificial menopause much earlier than they should.

Dr. Linh Nguyen, an OB-GYN specialist in Orange, said in those instances, the likely culprit is premature ovarian failure, or premature ovarian insufficiency, and it needs to be treated like a disease.

"Because if we don't, then we're allowing [that patient] to age prematurely," she says.

That's not a figure of speech: the hormones in your body regulate a lot of things, including your internal organs. Losing those hormone levels as you age leads to deterioration, so an imbalance can spell trouble.

For instance, women are much more likely to develop heart disease once they reach menopause, compared with their younger counterparts.

"So if you take someone in their 30s who's not supposed to be in menopause," Dr. Nguyen said, "And they go through that change without getting estrogen treatment, you're now increasing their chances of developing those issues earlier."

The decline in estrogen production can also put you at a higher risk for developing osteoporosis, diabetes, high cholesterol, hypertension, and even mental aging.

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There are a whole host of things that can cause this, including chromosomal conditions such as Fragile-X syndrome, Turner syndrome and certain autoimmune disorders

There is also a growing body of research that suggests that certain environmental factors, such as smoking, pollution, pesticides and cancer treatments like chemotherapy can also trigger premature ovarian failure.

SHOULD I WORRY?

The short answer: probably not.

Dr. Nguyen said in her years of practice, less than 1 percent of her younger patients came in with these symptoms. That lines up with the general estimates that premature menopause occurs in less than 5 percent of the total population of women.

Regardless, if you're experiencing some of the symptoms described above and you're under the age of 45...go see your doctor. Your provider can make a definitive diagnosis with some routine lab work, and discuss possible treatment plans, which may or may not include hormone replacement therapy.

And if you need help with what to expect when you make that appointment, or to find a doctor who's right for you, we've got you covered.


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