Premature menopause is on the rise and doctors tell you why

‘Bechaari, kuwari’ – unmarried or childfree women have heard it all. If they choose not to have children, they’re scolded for missing out on a major life experience. What people don’t realise is, owning a uterus is like parenting a teenager. Both are moody and throw tantrums. One slight hiccup in hormonal levels, and they go into a tailspin. There are destructive phases that cause much pain. And if womanhood wasn’t hard enough already, there’s a fresh curveball we need to dodge. Doctors have noticed a troubling increase in the cases of early or premature menopause.

According to Dr Rajashri Tayshete Bhasale, Dr Surabhi Siddhartha, and Dr Anjali Kumar, an unfortunate number of women are hitting the pre-menopause stage or perimenopause in their thirties. Siddhartha, a consultant obstetrician and gynaecologist at Motherhood Hospital, Kharghar, says, “We had a case in Navi Mumbai where a 30-year-old woman was trying to get pregnant. She came for pre-conception counselling with her husband. After scans, tests and checking her genetic history, we realised she was going into premature menopause.” Kumar, a Gurugram-based gynaecologist and obstetrician, endoscopic surgeon and founder of Maitri, told us another tale of a young woman who came in with an irregular period, thinking she was pregnant, “but it was actually premature menopause.”

So, why are more and more younger women experiencing this bumpy, hormonal ride to a destination that is unpredictable, uncomfortable and… sweaty? The answers lie in a tangled web of factors in and out of our control. Here, experts help us figure out why premature menopause is on the rise and what women can do to slow down that runaway train.

Note: The caffeine-fueled battle cries every morning as we stare down deadlines aren’t helping.

Understanding premature menopause?

Despite the incredible impact of menopause on women’s health, there are few studies looking into premature menopause. One study, by the Journal of Obstetrics and Gynaecology Research, states that 2.1% of 302,557 women, aged 25–39 years, in India had experienced natural premature menopause. The percentage may seem small, but to put it in perspective, our population is currently 1.4 billion (approx.) people, and this study uses data from a survey conducted during 2015-2016.

Bhasale, a consultant gynaecologist, laparoscopic surgeon and obstetrician at Wockhardt Hospitals in Mumbai, explains that menopause is the permanent cessation of menses, a natural part of ageing. She adds that the average age of menopause in India is between 48 to 50. “Menopause occurring at 40 to 45 years is called early menopause, and menopause occurring before 40 is known as premature ovarian insufficiency.”

Delving into this hormonal whodunnit, there are multiple expected and unexpected suspects. Like a lot of ailments, genetics play a big role. If women in your family have experienced premature menopause, the likelihood of it happening to you is already increased – add poor lifestyle choices into the mix, and the alarm bells start ringing for experts. Dr Kumar cites high pollution, ever-increasing stress levels and the depleting quality of ingredients in our meals as some other reasons behind women hitting menopause earlier.

Stress can be the ultimate party pooper in our quest for a smooth menopause transition. Pushing our cortisol levels to the max, stress disrupts the delicate balance of hormones and the menstrual cycle.

Dr Siddhartha says lack of exercise and sun exposure also speed up our menopause timelines. “Body mass index can also factor into early menopause since oestrogen is stored in fat tissue. Women who are thin have fewer oestrogen stores which get depleted sooner. Premature menopause can also be a symptom of an autoimmune disease, such as thyroid disease or rheumatoid arthritis.”

Tobacco consumption (in all forms) can not only hasten arrival but also intensify the symptoms of menopause. An analysis of 17 studies found that former smokers had a 15% higher risk of early menopause, and current smokers had double the risk when compared to those who never smoked.

What we can do?

Siddhartha says that sometimes, unfortunately, early menopause is beyond our control. But finding the right set of doctors who can help you navigate your reproductive journey is worth the effort. Routine check-ups are important, say Siddhartha and Bhasale, to monitor vaginal health, screen for abnormalities and address any concerns, such as vaginal dryness or irritation that come up as a result of premature menopause.

Bhasale also recommends incorporating foods rich in calcium, such as dairy products, leafy greens, seeds and nuts, like almonds and sesame seeds, and vitamin D3, like fatty fish and mushrooms. Make sure there are veggies on your plate for every meal, and avoid things like coffee and very spicy foods, which can aggravate menopause symptoms. “A diet rich in phytoestrogen like soya bean, flaxseed and tofu; maintaining moderate, healthy body weight and exercise are some ways you can curb your symptoms,” adds Bhasale.

For those planning to have children, early menopause can be distressing, with a significant reduction in fertility. Conceiving naturally can become challenging, but with advancing fertility treatments and assisted reproductive technologies like in-vitro fertilisation (IVF), egg freezing and the use of donor eggs, conceiving a child isn’t an impossibility. The path to adoption is as emotionally challenging as it is rewarding, and we have a helpful guide you can read here.

Entering menopause can feel like stepping onto a railway station during peak hours, but it’s a matter of figuring out the timings and train lines that work best for you. There will be days when you get jostled around, but with each day comes more confidence.