How To Handle Early Onset Of The Menopause In Your Twenties

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Aoife P Rafter was 27 when she was diagnosed with cervical cancer in June 2019. Following a radical hysterectomy, her body and mind were hurtled into a perimenopausal and menopausal state. Now 28, and one year post-op, she’s at the height of menopause, navigating daily hot flushes, irregular sleeping patterns and episodes of debilitating anxiety. 

“I knew nothing. Why would I? That’s future Aoife’s problem, not mine,” the Kildare native tells British Vogue. “I learned everything from Instagram, because I didn’t know what other resources to use apart from screaming at the top of my voice ‘What the hell is happening?!’. Nobody talked me through menopause.”

She is not alone. Many women would admit that they were ill-prepared to deal with the onset of the menopause, partly because menstruation and menopause are still shrouded in taboo and stigma of biblical proportions. The problem is further compounded by the lack of accessible information about the female reproductive system, and the fact that women’s health is a historically neglected field when it comes to research and funding. 

How To Survive A Hormone Crisis In Your Twenties

But very few have to deal with such a life-changing process at such a young age: the average age for the onset of menopause in the UK is 51. Premature menopause – when menopause occurs under the age of 40 – affects one per cent of the population, and about five per cent of people will go through the menopause under the age of 45. According to The Daisy Network, one in 10,000 people under the age of 20 will experience menopause. 

The natural menopause occurs when your body runs out of eggs and stops producing oestrogen. As for premature menopause? The cause of 90 per cent of occurrences is unknown; the other 10 per cent accounts for people with autoimmune conditions and women who have had ovaries removed or undergone treatment for cancer. 

Seeking answers as well as a community on social media can be helpful for those grappling with the menopause, though as Dr Anita Mitra – better known to her 108k followers as The Gynae Geek – cautions Vogue readers: “I think there is so much information on social media that it’s easy to fall down a rabbit hole – and that’s absolutely fine – but first and foremost, I think it’s absolutely crucial that you speak to a medically-trained menopause expert.”

Here, a guide to dealing with the menopause – with the caveat that one should always seek advice from a medical professional.

Do your research – and seek out a digital community

A growing number of young people are turning to social media to find sound advice and to shed the feelings of loneliness and isolation often associated with menopause. Dr Anita Mitra’s feed is a good place to start: it dismantles the myths of menopause and all aspects of female health in a relevant and understandable way. “It’s amazing that sometimes one person sharing their story can help so many other people. These problems can be so isolating. I often get people commenting on my posts on instagram saying, ‘Oh, I thought it was just me,’ and that makes me really happy because that person doesn’t feel so alone on their journey,” she tells Vogue.

Her informative Instagram posts, in turn, help her to develop a better understanding of her patients’ experiences. “We need to improve dialogue between doctors and patients. The more we [doctors] start listening to women and listening to what they’re experiencing, [the more] we can actually help them.”

Get a proper diagnosis

As symptoms with menopause are broad-ranging and quite unique to each person (no two menopauses are the same), achieving a diagnosis can be a trying process as people often dismiss their symptoms as being too little or not worthy of seeking medical help. “I think we really need to increase the awareness of other symptoms of menopause, because often women will experience, for example, palpitations, anxiety, changes in their sleep and mood,” Dr Mitra says of the importance of listening to your body. “I think people think they’re going crazy – or [are] thought of as a hysterical, anxious woman, fobbed off with antidepressants, when what they really need is hormones. We need to get better at making people aware of the symptoms.”

The most effective treatment for the menopause at any age is Hormone Replacement Therapy. “It’s all about a rebalance in the hormones,” explains Dr Tania Adib, leading consultant gynaecologist and director of The Menopause Clinic, on the efficacy of hormone replacement. “You’re not ovulating, so you’re oestrogen dominant, and you’re not producing enough progesterone, so you’re getting these incredible mood changes – really low mood – feeling teary, not sleeping and feeling exhausted,” she comments on the typical symptoms experienced during perimenopause and menopause.

Explore natural remedies

For women like Aoife who experience medical-induced menopause, and to whom HRT is not a viable option, natural remedies – such as CBD oil – can prove fruitful. As she explains: “I’ve been playing around with CBD oil to help manage symptoms and it’s helping me to sleep, and when I get a hot flush it removes the feeling of anxiousness and helps to shorten the time. I also have a cooling pad in my pillow and use a silk pillow.”

Take stock of your lifestyle, and implement positive changes

Dr Adib recommends focusing on a good diet, and exercising regularly – exploring both cardiovascular exercise, to keep your heart strong, as well as weight-bearing exercise, to keep your bones healthy and to prevent osteoporosis (which is a severe side effect of reduced oestrogen).

“I recommend a mainly plant-based diet: you can get plant oestrogen through flax, Alfalfa sprouts and soy products. You can take supplements like red clover which is also a weak plant oestrogen and has shown to be safe. A tepid bath or taking shade can help hot flushes. If you’re not sleeping, try valerian and chamomile. There is good evidence also that mindfulness – cognitive-based approaches – are very helpful.”

Be honest with your friends and family about what you are experiencing

“As a society, we have to talk more openly and honestly about menopause at home, work, in popular and high culture, online and in the news media. We have to know what to expect,” writes journalist and author Gabrielle Jackson in her book Pain And Prejudice, which deals with cultures’ attitudes to women, their bodies and female pain. To echo Jackson: “Now seems like a good time to give menopause a makeover.”

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