Menopause is one of those things most younger women don't spend a lot of time thinking about, assuming they'll just go through it when they're “older.” Currently, data suggests the average woman begins her menopausal transition between 45 and 55, per the National Institute on Aging. So, it's easy to push off thinking about that life phase if you're not in your forties yet. But surprising new research suggests that more than half of women in their early- to mid-30s are actually already experiencing perimenopause symptoms—and some are pretty severe.
Unfortunately, the research also found that most women wait years before they see a doctor about symptoms or concerns, which leaves them suffering in silence. The findings are worth paying attention to, given just how many women may be impacted.
Here’s what the study found, plus what doctors suggest you do if you think you might be starting to experience menopause symptoms at a younger age.
Meet the experts: Lauren Streicher, MD, a clinical professor of obstetrics and gynecology at Northwestern University Feinberg School of Medicine; Jessica Shepherd, MD, author of Generation M: Living Well in Perimenopause and Menopause; Christine Greves, MD, is an ob-gyn at the Winnie Palmer Hospital for Women and Babies in Orlando, Florida; Adam Cunningham, PhD, lead study author and lead research scientist at Flo Health
What did the study find?
The study, which was published in the journal NJP Women’s Health, analyzed symptoms reported by more than 4,400 women aged 30 and up online and in the Flo app, which helps women track ovulation and menstrual cycles. The researchers found that 55.4 percent of women in the 30 to 35-year-old group said they were experiencing symptoms that could be classified as “moderate” or “severe” on the Menopause Rating Scale (MRS), a questionnaire that measures the severity of menopause symptoms.
That jumped to 64.3 percent of women in the 36 to 40-year-old camp. But the researchers also discovered that most women don’t talk to a doctor about menopause symptoms until they’re 56 or older.
The women in the study reported that they experienced mental health symptoms like anxiety, depression, and irritability before they had physical symptoms of menopause. These peaked in women between the ages of 41 and 45, and then dropped in women who were 56 and up. Physical issues like sexual problems, bladder issues, and vaginal issues peaked in women who were 51 and older, while “classic” menopause symptoms like hot flashes and sweating were most common in women between the ages of 51 and 55.
Ultimately, the researchers concluded that “a significant number of individuals aged 30–45 years experience perimenopause-related symptoms.”
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What are perimenopause symptoms?
Perimenopause, or the years leading up to menopause, typically happens in your 30s and 40s, according to the American College of Obstetricians and Gynecologists (ACOG). During this time, the amount of estrogen produced by the ovaries starts to fluctuate and your periods can become longer or shorter than usual.
“When we think of symptoms of perimenopause, one red flag is if someone is menstruating regularly and suddenly they start skipping periods,” says Lauren Streicher, MD, a clinical professor of obstetrics and gynecology at Northwestern University Feinberg School of Medicine. But women in perimenopause may also have hot flashes, brain fog, and mood shifts, she adds.
“The difference between perimenopause and menopause is that when someone is menopausal, she’ll no longer produce estrogen and the symptoms are persistent,” Dr. Streicher says. “In perimenopause, the hormones are bouncing around, and symptoms may come and go.”
The study specifically looked at these symptoms from the Menopause Rating Scale:
Hot flashes and sweating
Heart discomfort or palpitations
Sleep problems
Depressive mood
Irritability
Anxiety
Physical and mental exhaustion
Sexual problems
Bladder problems
Vaginal dryness
Joint and muscle pains
“Those are very real and can be very disruptive in life,” says Christine Greves, MD, an ob-gyn at the Winnie Palmer Hospital for Women and Babies in Orlando, Florida.
Is it normal to experience perimenopause symptoms between 30 to 45?
Dr. Streicher says while you can go through perimenopause in your 30s, it’s not common. “That doesn’t mean it can’t occur," she adds.
If you are experiencing symptoms in your 30s, it can also “be very normal as the fluctuations in hormones begin in the mid-30s and can be generally understood to last between five to 10 years,” says Jessica Shepherd, MD, author of Generation M: Living Well in Perimenopause and Menopause.
When do women normally hit perimenopause and menopause?
The average age of menopause in the U.S. is 51, according to ACOG. “But that number can be somewhat misleading, because it’s just an average,” says Adam Cunningham, PhD, lead study author and lead research scientist at Flo Health. “Most women actually go through menopause between the ages of 45 and 56.” Because perimenopause can last for five to 10 years before that, Cunningham says that it's “not unrealistic to expect that some women will experience perimenopause symptoms in their 30s.”
However, most women will go through perimenopause in their mid- to late- 40s, Dr. Streicher says.
How do I know if I’m in perimenopause?
This can be tricky. Having any of the symptoms listed above can be a sign that you’re in perimenopause—but it's not a given that you’re actually in this life stage. “There are many reasons why someone might experience these symptoms outside of perimenopause,” Dr. Streicher says, listing off thyroid issues as one good example. “It’s not as if you can say, ‘Okay, I’m going to tick off these symptoms and therefore I have perimenopause,’” she adds.
If you suspect you’re in perimenopause and your symptoms are bothering you, Dr. Greves says it’s time to talk to a doctor.
What can I do about perimenopause symptoms?
A lot depends on what your symptoms are and your personal goals, Dr. Streicher says. If fertility is a concern, she says it’s important to connect with a specialist about next steps, which may include freezing your eggs. But if you’re not interested in having children or having any more children, Dr. Streicher says a low-dose hormonal birth control pill may be helpful.
Dr. Shepherd stresses that you have a lot of options. “There are many treatments for perimenopause including hormones, complimentary alternative treatments, nutrition, and exercise,” she says. “Understanding all the nuances with the symptoms are helpful to decide which treatments are best for each individual.”
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Korin Miller is a freelance writer specializing in general wellness, sexual health and relationships, and lifestyle trends, with work appearing in Men’s Health, Women’s Health, Self, Glamour, and more. She has a master’s degree from American University, lives by the beach, and hopes to own a teacup pig and taco truck one day.