Premature menopause in 20s and 30s: What’s causing it?

“We have pain on a cycle for years and years and years…and then, just when you feel you’re making peace with it all, what happens? The menopause comes...”
In the renowned TV series Fleabag, the character Belinda gives this liberating take on menopause, revealing how it makes ‘your entire pelvic floor crumble’ and you ‘get hot.’ On whatever social media platform this scene is shared, it’s always followed by insightful comments like ‘Menopause is puberty’s older sister with crazy hormone shifts,’ and ‘Being a woman is a trauma.’

While menopause was considered a problem of women in their 50s in the past, as their fertility declined or they experienced menopause, it is no longer so. The number of women having menopause in their 20s and 30s has reportedly soared, according to doctors, possibly due to changes in their lifestyle and food habits. In an interview to a prominent national publication, Dr Beena Mutkesh, director of Motherhood Fertility and IVF Clinic, said that women now lack enough ovum required for fertilization and it can affect their reproductive abilities and lead to fertility.

Lack of enough eggs or ova could apparently make natural conception impossible and even affect the efficacy of IVF treatment. Anti–Mullerian Hormone (AMH) blood test and Antral Follicle Count ultrasound test are done to measure the number of eggs. Low AMH levels indicate declining fertility in women. Infertility often begins silently and does not show any apparent symptoms. Although some women have regular menstrual cycles, their fertility may be low, she says.

What causes the condition?
The doctor lists the following reasons as the causes for premature menopause and hormonal imbalance:
1) Severe stress
2) Sleeplessness
3) Unhealthy diet
4) Smoking
5) Proximity to a toxic environment

6) Regular use of contraceptives
7) Sitting for a longer duration
8) Overconsumption of caffeine
9) Vaping
10) Depending often on ultra-processed packaged food

11) Regular usage of cosmetic products
12) Certain chemicals in plastics and cosmetics that affect the endocrine system

How to ensure effective treatment?
Dr Beena recommends the following for treating the condition effectively.
1) Lifestyle changes
2) Early detection tests
Those who have a family history of premature menopause, polycystic ovarian syndrome and irregular menstrual cycles should do the necessary tests in their late 20s to determine their fertility.