It’s winter. But the thought of putting on another layer is enough to make you sweat.
You’ve had another really productive day. So why can’t you sleep again?
For as long as you remember, you’ve always been a well put together sort-of person. But now your mood is all over the place.
These are just some of the symptoms of menopause. It’s a wide topic of continued focus among those in the medical community. For some, symptoms are mild to moderate and manageable. For others, symptoms can be more serious and have a debilitating impact on everyday life.
The menopause usually begins between the ages of 45 and 55. The average age to experience it in the UK is 51.
It’s defined as the cessation of menstruation. Having had no periods or spotting for up to 12 months. This happens because of changes to natural hormone balances with age. The ovaries slow down and stop producing as much oestrogen over time. The body reaches a point where it can no longer produce eggs.
However, the menopause doesn’t always come as and when you’d expect.
Sometimes, it arrives early.
We’re talking specifically about early menopause and the perimenopause. What are they? What’s the difference? And what can you do about them?
There is an important distinction to make about any menopause that occurs before the average age range of 45-55.
Typically – the younger a woman is, the less likely she is to experience menopause.
But for some, it can strike at any time. Some people are even affected as teenagers or into their twenties, though this is a small proportion of people who experience premature menopause.
As many as one in 1000 women are post-menopausal before the age of 30. 
The big question is: Why? Why do some women experience the menopause early or prematurely? Some of the reasons are not fully understood. But it is thought one or more of the following may play a role.
Certain medical treatments can kickstart perimenopausal symptoms (we’ll talk a bit more about the perimenopause in the next section).
Treatments for breast cancer, chemotherapy or radiotherapy can all bring about early or premature menopause.
The removal of certain organs in a surgery can also send the body into menopause. Surgery to remove the ovaries, for example, if someone is at risk of developing ovarian cancer.
Research by Menopause, the journal of The North American Menopause Society (NAMS) showed there could be a link between fatigue syndromes and early menopause. Symptoms of chronic fatigue or related syndromes can include weakness, pain in the joints or muscles, headaches or even loss of memory.
People with less than 46 individual chromosomes, or people who have problems with their chromosomes, are more likely to experience early or premature menopause.
HIV which is not controlled by medication may lead to premature or early menopause. It’s not been studied enough to form a complete medical consensus. But the evidence is growing. Furthermore, according to charity aidsmap: ‘HIV or the immune system’s response to it may also have an impact on the ovaries and the production of hormones that affect the experience of menopause.’
Other autoimmune diseases can bring about early menopause too. In some cases, the immune system may ‘attack’ certain organs, like the ovaries, as part of a defensive immune response. This can impact hormone production, which can impact when and how menopause happens.
There is thought to be a link between early and premature menopause and your family history.
One study found that 37.5% of people suffering from early menopause reported at least one case of family history where menopause occured before the age of 46. By ‘family history’, this includes mother, sister, aunt or grandmother.
That’s more than one third of early menopause sufferers reporting of a family history link.
The perimenopause means ‘around menopause.’ It refers to the transition period leading up to menopause.
It all starts when hormone levels begin to fluctuate. The body is struggling to produce them as regularly as it once did. Sometimes they rise, sometimes they fall. The more sharply, the more adverse symptoms may be.
This includes all the old familiars. Hot flushes, headaches, changes to the mood, night sweats.
These are common and well-publicised. Most people could probably name at least one symptom of the perimenopause.
But there is a long list of perimenopause symptoms, many of which are less well-known and understood. Some are quite serious, some are less so. Some are experienced by a lot of women, some are very rare.
Even women who have never suffered with mental health problems in the past can begin to experience things like depression and anxiety, seemingly out of nowhere, as they begin the perimenopause.
Women who previously suffered from premenstrual syndrome (PMS) can be more adversely affected during the perimenopause. Many women feel extremely vulnerable, both mentally and physically, when they begin to experience the perimenopause.
It’s really important that you make time to talk to your doctor about the perimenopause if you think you’ve started to experience it. Even if you develop certain symptoms and you’re unsure, it’s better to check it over with a medical professional.
The symptoms that kickstart the entire process, the perimenopause, can last for up to four years on average. Every one in 10 women will experience the symptoms of menopause for up to 12 years.
Knowing whether you’re suffering with perimenopause or something else can be really difficult. Sometimes, medical professionals need to monitor you closely over a period of time before they’re comfortable making a firm diagnosis.
The menopause isn’t always straightforward and sometimes it can come early. Having a basic understanding of early menopause, and the perimenopause which will precede it, doesn’t hurt.
Millions of women experience the menopause every year. Regardless of the age this happens – some level of perimenopausal symptoms is to be expected.
Just reading up on the perimenopause and having a basic understanding of what it might look and feel like can be of benefit. Be open with your friends and family – the menopause is nothing to be ashamed of.
Though it can be distressing if it comes early, particularly if prematurely. So never hesitate to come forward and talk to a health professional about your symptoms and concerns.
 ‘Menopause’, NHS, accessed: 31st March, 2021, https://www.nhs.uk/conditions/menopause/
 ‘Premature an early menopause’, Better Health Channel, accessed: 31st March, 2021,https://www.betterhealth.vic.gov.au/health/ConditionsAndTreatments/premature-and-early-menopause
 ‘Menopause Journal’, North American Menopause Society, accessed: 31st March, 2021
 Rosalie Hayes, ‘Menopause and HIV; NAM Aidsmap, January 2021, accessed 31st March, 2021, https://www.aidsmap.com/about-hiv/menopause-and-hiv
 Cramer DW, Xu H, Harlow BL. Family history as a predictor of early menopause. Fertil Steril. 1995 Oct;64(4):740-5. doi: 10.1016/s0015-0282(16)57849-2. PMID: 7672145, https://pubmed.ncbi.nlm.nih.gov/7672145/#:~:text=Risk%20for%20early%20menopause%20associated,%25%20CI%202.5%20to%2031.2