Is it or isn’t it?

Susan Deakin dropped her middle schooler off at school one morning and headed for the pharmacy. Staring at the pregnancy tests, she felt nervous. At age 42, she hadn’t been pregnant in more than a decade and thought her days of raising babies were over for good, but not having had a period in eight weeks could only mean one thing. The test was negative, so she bought another a few days later, which was also negative, and a trip to her doctor brought her news she simply was not ready to hear.

“ ‘You may be menopausal.’ That’s what my doctor told me, and I thought he was surely joking,” she says. “I’m young. My period has always been like clockwork and I feel fine.”

“The average [age] in the United States is 51, but it can occur between 40-60,” explains Dr. Shirazian, assistant professor, Department of Obstetrics and Gynecology at the NYU Langone Joan H. Tisch Center for Women’s Health. “Before age 40 it is diagnosed as primary ovarian insufficiency.”

Primary ovarian insufficiency is considered premature menopause, and it may have a specific cause, which can be autoimmune or infection specific. Other possible reasons for premature menopause include having had chemotherapy treatment, having a hysterectomy (which springs a women into instant menopause), smoking, and a history of premature menopause in the family. So at age 42, Susan was technically not experiencing menopause prematurely, even though it was younger than the average age of 51.

There is no one definitive test to diagnose menopause; the official diagnostic criteria states that a woman must have not had a menstrual period in 12 consecutive months. However, it may be a good idea to have certain hormones tested. The Mayo Clinic recommends that women have these tests: follicle-stimulating hormone, estrogen, and thyroid-stimulating hormone. Follicle-stimulating hormone levels increase and estradiol levels decrease as menopause occurs, and an underactive thyroid (hypothyroidism) can cause symptoms similar to those of menopause.

Sonia Rodriguez of Sheepshead Bay, Brooklyn, was 44 when she thought she might be going through menopause because she had not had a period in five months and was not pregnant. “I was convinced my periods were over, and I felt awful, from everything I heard about menopause being so terrible. I had migraines and was extremely fatigued, so I thought that menopause could be starting, but my doctor took a blood test and called a few days later saying I had hypothyroidism, which was probably causing my menstrual irregularities. She gave me medication and my periods came back.”

Signs and symptoms of menopause include irregular periods (very heavy, longer or shorter than usual), vaginal dryness, hot flashes, night sweats, sleep problems, mood changes, and weight gain.

Dr. Shirazian points out that although there is nothing inherently unusual with menopause occurring in early 40s, women should be make sure they are not suffering from “bone loss or bone decline, which tends to occur with a decline in estrogen.” If a woman would like to boost herself through the use of supplements once menopause hits, Dr. Shirazian says “virtually all supplements are good that include calcium and vitamin B. For symptom relief, evening primrose oil works well.”

The vast majority of women report symptoms and up to 70 percent of women experience hot flashes for years, but there are those few who do not. Some women experience no symptoms other than the absence of a monthly period.

“I felt fine throughout,” says Susan, who has not had a period in three years and is considered to have fully reached menopause. “Once I knew I wasn’t pregnant and got over the shock that menopause was probably happening, I was actually relieved. I didn’t have any debilitating symptoms and I honestly don’t miss my period at all!”

If you are having missed periods or symptoms of menopause, don’t make assumptions. The only way to find out exactly what is happening is to see your doctor. Search for doctors that specialize in hormonal testing and menopause.

Danielle Sullivan, a mom of three, has worked as a writer and editor in the parenting world for more than 10 years. Sullivan also writes about pets and parenting for Disney’s Babble.com. Find Sullivan on her blogs, Just Write Mom and Some Puppy To Love.

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