Premature menopause: What should women expect?

Incidents of hot flushes had become regular for Giselle Igiraneza. She also wondered why all of a sudden, she was experiencing frequent mood swings. Research she made pointed to the possibility of menopause, yet she was still in her 30s, and so to her, it couldn’t be happening.

When her monthly period became irregular, however, Igiraneza decided to go for a proper check-up to find out what was really happening to her. The results confirmed her fears, and she was indeed experiencing menopause—in her case, early menopause.

Though not common, it is not unheard of for women under the age of 40 to experience menopause.

Hot flushes are a common sign of menopause.  Net photo

Most women start menopause between 45 and 55, however, due to factors that only scientific reasons can back up, some tend to start this phase much earlier than others.

Menopause defines a stage a woman goes through either just before or after she stops menstruating, marking the end of her reproductive period.

Dr Kenneth Ruzindana explains that the menopausal transition occurs after the reproductive years, and this period is characterised by irregular menstrual cycles and symptoms such as hot flashes.

So in many cases, this usually occurs between the ages of 45 to 55; this is the time when the ovaries stop producing eggs and that’s what causes the menstrual period to end, he says.

Early menopause could cause depression, so seek out new forms of social support or reconnect with old friends. Net photo

Years before a woman stops having her menstrual period, there are changes in her hormone levels and this can lead to some of the symptoms of menopause. In addition to an irregular period, the most common symptoms are hot flushes, night sweats, sleep problems, new onset of depression and many women complain of vaginal dryness.

With natural menopause, the medic explains that it is more of a permanent sensation and it is determined retrospectively after a woman has experienced at least two years of having no monthly period, without any other obvious pathological or physiological issues.

This is called amenorrhea, and it occurs at an average age of about 51 in normal circumstances. It is a reflection of ovarian follicular depletion.

Menopause before the age of 40 is considered abnormal and the condition is referred to as primary ovarian insufficiency, or premature ovarian failure, Dr Ruzindana says.

Is it genetic?

A number of factors are thought to play a role in an individual woman’s age of menopause, says Dr Ruzindana.

That includes genetics, so women with a family history of early menopause are at high risk of undergoing this stage earlier than the average age.

Experts say physical activity can help maintain a healthy lifestyle and keep anxiety down during menopause.  

“There is a lot of evidence that suggests that genetic factors play a role in the normal variation of age at which menopause starts, so a family history of early menopause predisposes a woman to have or undergo an early menopause. Also, ethnicity and race may also affect the average menopausal age,” he explains.

The estrogen receptor gene is a very big determinant of the age of menopause and this has been illustrated in many studies, says Dr Ruzindana. Also, the age of menopause is reduced by two years in women who smoke, he adds.

What should women expect during menopause?

Ruzindana explains that menopause is a normal part of a woman’s life, and does not always need to be treated. However, the changes that happen before and after menopause can be very disruptive, so if the symptoms become bothersome, there is effective treatment available.

A number of reports indicate there is a significant increase of new offset depression in the menopausal transition compared to the pre-menopausal years, he notes.

He also says other occurrences that ensue include vaginal dryness, which comes as a result of estrogen deficiency that leads to thinning of the vaginal epithelium. This results in vaginal atrophy and it causes symptoms of dryness, itching, and often dyspareunia (painful sexual intercourse).

“This condition also reduces blood flow to the vagina so this is the major cause of sexual dysfunction. Menopausal women also complain of memory loss, they experience joint pain and at times breast pain, or what we call menstrual migraines.”

Author Pamela Peeke writes in her article ‘Menopause and Your Changing Body’ that menopause is frequently seen as a negative milestone, a time of loss and is sometimes viewed as a disease or medical condition requiring a cure. With messages like this from the medical establishment and the media, it’s no wonder many healthy women in the midst of this transition develop negative feelings towards their bodies.

What’s an average woman to expect regarding her body as she travels through her perimenopausal years? Peeke notes that an average woman can expect to gain from two to five pounds (almost three kilogrammes) during this period. The main reason women experience this weight gain is the decline of estrogen.

By menopause, most women have a rich and fulfilling life history making them prouder and wiser. However, it’s tough to focus on self-acceptance and emotional wellbeing when your body feels like it has a life of its own and is gaining weight and getting harder to manage. A growing number of women feel less attractive as they reach menopause, she adds.

How to sail through menopause

55-year-old Florence Mulekatete says when she first started experiencing signs of menopause, anxiety set in, for she was terrified of this phase. To her, it signified ageing.

She recalls experiencing hot flushes and her skin becoming really dry. She also remembers battling phases of depression and constant illness.

“It was a hard time for me; it took me some time to really adjust,” she says.

With a conscious effort, Mulekatete says she finally coped and accepted the life she was leading.

“I surrounded myself with friends who helped me go through this stage. They helped me deal with the many questions I had. I also chose to volunteer in a number of projects and this kept me occupied.”

She advises women going through this stage to always surround themselves with family and friends because one needs all the support they can get.

Peeke advises women in menopause to check their nutritional status by eating right. Physical activity on the other hand has been scientifically proven to increase body confidence and a sense of pleasure in life. It is also the key predictor of healthy weight maintenance, she notes.

She commends being active as one of the ways to beat the depression that comes with this stage.

Get a life, find some activities you enjoy and start doing them. If you are lonely, seek out new forms of social support or reconnect with old friends. Make the time to do this. Take walks or hikes in nature. Being in nature is one of the best ways to reclaim the feelings of connectedness to the world. Gardening can also be extremely uplifting for the spirit, Peeke writes.


Stress can come with menopause. This is because of anxiety and the body changes that are taking place, but for one to survive this, they need to learn to deal with it positively. They can surround themselves with friends; one can even choose to see a counsellor.

Rose Kyomugisha, Mother

At this stage, women should do their best to engage in physical activities that can help them maintain a healthy lifestyle, keep them active and most importantly, help them lessen anxiety.

Wilbur Bushara, Medic

Women at this stage tend to fall sick frequently for they tend to be attacked with numerous illnesses. At times seeking medication can help them deal with conditions like blood pressure.

Lovence Mutoni, Pharmacist

Menopausal women should try to stay positive because menopause is a normal phase that every woman has to go through.  They should focus on what really matters in life and engage in activities that uplift their spirits, for example, reaching out to others or joining voluntary organisations.

Robert Mugabe, Therapist