Sue:
Early menopause or premature ovarian failure holds a number of very important psychological, emotional, and health concerns. Of these three areas can you tell us the toughest aspect of each of them?

Kathy:
I think the toughest aspect psychologically is that feeling of "I'm no longer a real woman." Learning that you've lost your ability to have a child at an early age -- an age when so many of your friends are starting or adding to their families -- is a very difficult thing to cope with. It's a very wrenching concept to adjust to, and it really shakes your vision of yourself as a woman. It may sound overstated, but we often equate being female with reproductive ability. So when you have to face the fact that you're no longer able to have a child, you often feel like you're not feminine anymore, not a woman. Add to that the fact that your body is changing -- you may notice weight gain, lines and wrinkles, skin dryness; your libido is often in the basement, and your moods are on a roller coaster..... You feel older, unsexy, undesirable, different...

You're so much more than your ovaries...
But the one thing I've learned in researching premature menopause and in living through it is that you can get past that. You're so much more than your ovaries. You're a woman, a young woman regardless of your ability to reproduce! It does take some time, though, to get to the point where you can feel that way. Premature menopause -- whether it's natural or surgical -- is such a wrenching change. But with time and understanding, you can regain your belief in yourself.

As for health concerns, the major ones would be the increased risk of osteoporosis and heart disease.
The culprit in both cases is low estrogen levels. Unlike women who enter menopause at the average age of 51, we face many more years with diminished estrogen, so we face higher risks of the problems resulting from low estrogen.

Osteoporosis
Our risk for osteoporosis is very high -- more so than those of women who go through menopause at the average age of 51-52. In fact, according to a study of women with premature ovarian failure conducted at the National Institute of Child Health and Human Development (NICHD), two thirds of the women had enough bone loss that they might be at risk for a hip fracture, and over seventy seven out of the 89 women they studied had osteopenia, below-normal bone density and the precursor to osteoporosis. And this bone loss occurred rapidly -- often within the first 18 months of being diagnosed. To make matters more worrisome, we reach peak bone mass typically around the age of 35. So if you go through premature menopause -- naturally or surgically -- before age 35, it may mean that your bones never attained their optimum strength.

I know all too well how high the risk is.
I'd always done the right things for bone health -- ate a lot of calcium-rich foods, exercised regularly, and so on. Yet when I finally went in for a bone density test, I found out that I already had osteopenia in my hip and forearm. It was definitely a shock -- and a major reminder that I've got to be extremely aware of being as bone-healthy as possible!

Risk of heart disease....
As for heart disease, according to recent research, women who go through menopause before the age of 35 have a two to three fold increased risk of heart disease. Women who've had their ovaries removed before the age of 35 have a sevenfold risk. If you're older than 35 but still younger than 40, your risk is only a bit lower -- about twice the chance of heart disease. Again, the increased risk of heart disease is something I experienced. Before I went on HRT, with no change whatsoever in my diet or exercise program, I saw my cholesterol levels shoot up from 126 to over 200 and my blood pressure go up as well -- all apparently as a result of low estrogen levels. It was yet another reminder that it's vital for me to be vigilant about my health now.

These are startling risks to deal with at a young age, to be sure -- and one of the key reasons it's so important for those of us in premature menopause to take charge of our bodies and our health -- including looking into hormone replacement therapy, eating well, taking vitamin and mineral supplements, and exercising. And, of course, it's yet another reason why it's so important to find out as quickly as possible if, indeed, you are in premature menopause. With the proper care, we can minimize these increased risks. That's the most important thing to realize of all.

Sue:
How can a woman differentiate between early menopause and perimenopause?

See the answer
Premature vs. Early Menopause

Natural vs. Synthetic Hormones
In Stephanie Bender's best seller, The Power of Perimenopause, she covers all aspects of perimenopause and menopause. She spends a great deal of time talking about how to use hormones to balance out the ups and downs of perimenopause and menopause.  Ms. Bender talks about the differences between synthetic and natural hormone preparations, you'll be surprised to learn what she has to say.

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