Perimenopause Symptoms May Affect More Than Half of Women as Young as Age 30
Although many women experience symptoms of perimenopause between ages 30 and 35, the majority do not seek medical attention for up to 2 decades, a new study reveals.
Among women aged 30 to 35 years, more than half report already experiencing moderate and even severe symptoms associated with menopause, according to findings of a large US survey. And yet, they study found, the majority of them do not seek medical attention for up to 2 decades later.1
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The new study, a collaboration between researchers at the University of Virginia department of psychiatry and neurobehavioral sciences and Flo Health, Inc, analyzed symptoms self-reported by 4432 American women aged 30 years and older responding to a survey conducted online and in the Flo app. Among women 30 to 35, 55.4% reported symptoms that met the criteria for “moderate” or “severe” on the validated and widely used Menopause Rating Scale (MRS). The proportion increased to 64.3% among women aged 36 to 40. The mean age at which respondents reported seeking treatment for menopause-associated symptoms, however, was 56 years or older.1 Many women who enter perimenopause early assume they are too young to be experiencing the symptoms, a mistaken belief that leads many to “suffer in silence,” according to a statement from UVA.2
The findings were published online in the journal npj Women’s Health.1
“We had a significant number of women who are typically thought to be too young for perimenopause tell us that they have high levels of perimenopause-related symptoms,” Liudmila Zhaunova, PhD, study co-author and director of science at Flo, said in the statement. “It’s important that we keep doing research to understand better what is happening with these women so that they can get the care they need.”2
The physical and emotional symptoms that accompany the period of transition leading to menopause are understudied, according to the study authors, and importantly are often dismissed by physicians. Understanding the prevalence of the symptoms and their impact on women’s quality of life and raising awareness among physicians and the public at large are the objectives behind studies like this one, co-author Jennifer Payne, MD, an expert in reproductive psychiatry at UVA Health and the University of Virginia School of Medicine, said in the statement.2
Payne and colleagues found that psychological symptoms (eg, anxiety, depression, irritability) are often prevalent long before physical symptoms manifest. They reported that the mood-related symptoms peaked between the ages of 41 and 45, then declined to the lowest level by age 56 and remained low.1
Among physical symptoms, including bladder issues and vaginal dryness, as well as sexual problems, prevalence increased to the highest among women aged 51 and older. These types of problems were reported least frequently by women aged 30 to 35 years, according to the study results. Classic menopausal symptoms such as hot flashes and sweating also were reported least among the youngest group of respondents while the researchers found the peak ages between 51 and 55 years.1
Payne et al found, “not surprisingly,” that rates of consulting a health care professional about symptoms rose with age, increasing from 4.3% in the 30–35-year-olds to 51.5% in the 56 years and older group. Approximately one-third (30.2%) of survey respondents who had consulted a clinician about perimenopause were aged 30–45 years.1 Importantly, while the group aged 51 to 55 years had the highest rates of medically confirmed perimenopause, more than one-quarter of those aged 30 to 35 and 40% of the group aged 36 to 40 years had been told they were perimenopausal.1
These finding point to a significant proportion of women who may reach the criteria for perimenopause despite being younger than the average age of onset for the transition period of 47.5 years.3 The authors cite literature that supports a variable individual course for perimenopause with a wide range of duration and severity.
“This study is important because it plots a trajectory of perimenopausal symptoms that tells us what symptoms we can expect when and alerts us to the fact that women are experiencing perimenopausal symptoms earlier than we expected,” Payne said.1
"Further research is needed to understand the temporal patterns of perimenopause symptoms across age groups and to understand whether our findings of significant symptoms in individuals younger than 45 years and psychological symptoms being more common in early perimenopause can be replicated," the authors concluded.
