By Corrie Pikul
Only about 1 percent of women in the U.S. go through menopause before 40. Here's what else those symptoms that are scaring the bejesus out of you could mean.
The Freakout: You wake up damp and clammy and think: night sweats!
What else it might be: The jalapeños you had at dinner—no joke. Night sweats have so many causes, they’re practically unavoidable. In addition to spicy food (and, yes, menopause), they're commonly due to nightmares, thermostat-creep and superfluous layers of flannel or down, as well as the extra drinks you may have had after dinner (alcohol causes your blood vessels to dilate, triggering the glands to release perspiration even throughout the night). Antidepressants are another often-overlooked culprit: Night sweats affect 8 to 22 percent of people taking them.
What to do: Recognize the difference between "sweaty" and "drenched." While both can be annoying enough to wake you up, it's the flash flood out of nowhere that you should tell your doctor about. It could be a sign that your body is dealing with hormones, a viral or bacterial infection, a thyroid imbalance, a disease (like lymphoma, especially if you also have fevers and unexplained weight loss), or a reaction to medication.
The Freakout: You're having trouble falling asleep or you've been waking up in the middle of the night, consumed with fears of aging.
What else it might be: If you're under 40, your insomnia is more likely to be due to PMS than menopause. The fluctuations in estrogen and progesterone that happen in the second phase of the menstrual cycle (around ovulation as well as right before your next period) can make it harder for women to fall and stay asleep. Those who are already prone to premenstrual cramps, mood swings or irritability will be especially likely to have trouble.
What to do: Keeping a sleep diary can help you see if your sleepless nights tend to fall during a specific time of the month. (If you haven't been getting your period, read on...)
The Freakout: Your period due date came and went...along with your faith in your youth and fertility.
What else it might be: One missed period could be due to stress, certain types of medication, exercising too much, extreme weight fluctuations or, of course, pregnancy. If you've had sex in the past month (and aren't using reliable birth control), it's worth picking up a pregnancy test at the pharmacy—the kits are basically the same as the ones used at the doctor's office. Yes, this advice sounds obvious, but many female patients seem weirdly resistant to the idea that they might be pregnant—even if they would like to be, says Lauren Streicher, MD, an associate clinical professor of obstetrics and gynecology at Northwestern University’s medical school. Streicher recently saw a patient whose mother had gone through early menopause; the patient thought her missed period meant she was, too...but it turned out she was at the end of her first trimester.
What to do: If your period is still MIA next month, make an appointment with your health care practitioner. (One of the official signs of menopause is when you haven't had any periods for a year, but you still want to address this sooner rather than later).
The Freakout: You got your period, then two weeks later got it again...and started to worry that your tampon-buying days were numbered.
What else it might be: Are your periods usually as predictable as a Japanese train schedule? And you're not on the pill (or any other hormonal contraception), right? Then an irregular cycle could be just a hormonal hiccup...or it could be a shout that something more serious is going on. "Periods are important vital signs," says Jan Shifren, MD, an associate professor of obstetrics, gynecology and reproductive biology at Harvard Medical School. When they become irregular, it's often a sign that something is off. Double-periods can be due to polyps or fibroids in the uterus or abnormal thickening of the uterine lining. Also, we don't want to alarm you (as we mentioned, anxiety can disrupt your cycle), but erratic periods, especially when combined with hot flashes, can be a sign of premature ovarian insufficiency—different from premature menopause, in that you still have follicles, but they're not working properly.
What to do: It's worth talking to your gynecologist and getting your hormone levels evaluated—especially your FSH levels, says Shifren, which will give you a better idea of your fertility.
The Freakout: You sometimes feel like your blood is boiling. There's no way other people aren't noticing your burning red face and neck—and thinking, as you are, "Hot flash!"
What else it might be: Hot flashes affect about 85 percent of women during the years immediately before and after menopause, so it's understandable that you might assume that's what's going on. But they can also be triggered by anxiety and stress. And they can be related: Your worries about aging and infertility, if intense enough, could be giving you a panic attack. Less common causes of hot flashes are hormone imbalances, thyroid disorders and infections. Some people also report getting hot flashes after eating MSG (have you eaten any chicken lo mein lately?).
What to do: Take a deep breath...and call your doctor, who can not only do a checkup and a hormone test, but can also counsel you on stress management.