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A Canadian woman is opening up about going through her first menopause symptoms when she thought she was "too young" — but experts say early symptoms are more common than we think.
This comes after actress Naomi Watts revealed in a recent interview with Marie Claire about first experiencing menopausal symptoms in her mid-30s. When Watts, now 55, was trying to get pregnant at 36, tests revealed she was nearing menopause — something she was not expecting to hear at her age.
"I practically fell off my chair," she told Marie Claire. "I'm being told I'm close to menopause when I'm just feeling ready to get pregnant. How can those things live together at once?. I left the [doctor's] office in pieces and rang my mum and said, 'What the hell? How come you didn't tell me more?'"
"The Impossible" actress' mother spoke to her afterwards about going through menopause at age 45 and experiencing symptoms years prior to that.
Watts' and her mother's experiences may come as a surprise to some, as people generally assume menopause doesn't affect women until they are nearing age 50. But, early menopause is more common than you think.
Studies have shown women feel like they're in the dark or unprepared when it comes to the stages of menopause and their symptoms.
To find out what you should know about this stage of life, Yahoo Canada spoke to experts as well as a Canadian woman who went through early menopause and opened up about her experience.
What is early menopause and premature menopause?
Dr. Shafeena Premji, a board member of the Canadian Menopause Society and a medical advisory board member of the Menopause Foundation of Canada said the average age of women going through menopause is 51, but a normal range is between 45 to 55 years old.
Women experience early menopause if it occurs between the ages of 40 and 45, and premature menopause if it occurs before the age of 40.
"I see it all the time in my practice," said Premji, director of Mahogany Medical Clinic and The Village Medical in Calgary. "It's more common than we think it is."
According to the Canadian Menopause Society, the major causes of premature menopause are unknown. Some cases are autoimmune, with antibodies destroying ovarian egg cells. Less common cases include destruction of ovarian tissues secondary to surgery, radiation and chemotherapy. In rare cases, it can be from genetics or chromosomal abnormalities.
Premji added people who have had a hysterectomy (a surgery involving the removal of the uterus) and have had their ovaries removed can have what is called surgical menopause.
The biggest issue with women who have stopped having their periods at an early age is that their doctor may not recognize it's premature or early menopause, meaning symptoms and treatment go unaddressed. Some women may not even have symptoms other than their period ending, and may not seek treatment right away.
"Women in premature or early menopause require the support of a specialized menopause care specialist or an endocrinologist," Premji said.
Dr. Shannon Trainor, a menopause practitioner at the Westcoast Women's Clinic in Vancouver added menopausal symptoms that happen before age 40 can feel much more severe, pointing to hot flashes and night sweats.
'I thought I was too young'
Samantha McGarry, a 48-year-old living in Ottawa, said she began experiencing night sweats around when she was 40.
"I was feeling very run down and fatigued and I had problems concentrating," said McGarry, adding she had sore joints. "My knees would hurt walking up the stairs and my knuckles were sore and swollen."
She went to her doctor to inquire about perimenopause, the transitional phase before menopause, marked by hormonal fluctuations and irregular periods. Her doctor ran some blood work and told her she was not in perimenopause because her bloodwork came back normal.
I was looking in the mirror and I didn’t recognize my body anymore.Samantha McGarry
McGarry later found out through her own research that perimenopause can't always be recognized through bloodwork, but should be regarded through a patient's symptoms.
By 45, she was still confused as to what was happening to her body. Her menstrual cycle became irregular and then stopped altogether. Even though she exercised regularly, she gained nine kilograms in two years.
"I was feeling lousy," she said. "I was looking in the mirror and I didn't recognize my body anymore."
She added some doctors had been dismissive of her struggles and it was only until she found the right naturopath, endocrinologist and gynecologist that she was able to receive validation and be treated accordingly.
Still, McGarry said she felt a lot of frustration for having to research so much on her own and advocate for herself when it came to her health.
She was not prepared to begin experiencing menopausal symptoms in her early 40s. "I thought I was too young," she added.
There's still stigma around menopause
According to a 2022 national report released by the Menopause Foundation of Canada, nearly 50 per cent of women feel unprepared for menopause and 55 per cent of respondents said they wished they learned about menopause earlier in life.
Most respondents said they were aware of symptoms such as hot flashes, mood swings and night sweats, but less about symptoms like body aches, skin issues and urinary tract infections.
Doctors Premji and Trainor agreed more education around menopause would be helpful for women and health care professionals so that women can receive the right treatment.
How is early menopause treated?
Trainor said treatment options for people experiencing premature or early menopause are viewed through a different lens than those in the typical ages of menopause.
"The goal, of course, is symptom control but also providing psychological support," Trainor said. "The whole aspect of losing your fertility is extremely distressing to women."
Women in this age group will receive hormone replacement therapy as treatment. There is a distinction between this treatment and menopausal hormone therapy for women at the average age of menopause.
The whole aspect of losing your fertility is extremely distressing to women.Dr. Shannon Trainor
Menopausal hormone therapy includes estrogen and progesterone treatments, or estrogen-only treatments.
Premji said the doses they use for these women are doses that are at the lowest effective dose to treat their symptoms. For premature or early menopause, she added women will still receive estrogen and progesterone, but it will be in higher doses and called hormone replacement therapy.
"The reason we're using higher doses than usual for these women is because we're actually replacing what their body should have otherwise been producing," Premji said, adding the doses and regimen can differ.
She said if women in premature or early menopause are not treated with hormone replacement therapy, they are at greater risk of osteoporosis, early onset of cardiovascular disease, cognitive changes such as dementia and premature mortality.