The symptoms were intense and unexpected. There was the time I was attending a conference and suddenly became so hot I had to immediately find the nearest bathroom so I could run cold water over my wrists and dry off my sweaty neck and breastbone. And the day I was having lunch with one of my professors and started burning up so much I couldn’t concentrate. My face felt crazy flushed, and I wanted to put my hands to my cheeks as if to stabilize myself.
If I had been, say, 48—rather than 28—I might have recognized these episodes for what they were: hot flashes. But I was way too young to be going through menopause. Wasn’t I?
Early Signs
In 2013, I felt like the world was mine. I was an extremely motivated PhD candidate at a major Canadian university. My research contributions were new and significant to my field; I was winning a number of awards; and receiving recognition for my work. My husband and I were newly married and we had a clear vision for our life.
Menopause—or even perimenopause, as it turned out to be—was not on my radar. But I was no stranger to odd symptoms and to the little voice inside me that said, “Hey, this warrants attention!” By age 28, I had been begging doctors for approximately 12 years to help me get to the bottom of my intense stomach pain. Because I was often anemic, experiencing brain fog, or strange nerve symptoms, I thought the hot flashes could be another manifestation of whatever it was that was causing my abdominal issues. They were unlike anything I had ever experienced before in terms of the heat and the speed with which they would arise, radiating from my chest up to my buzzing ears. It was as if someone were cranking up the dial on my internal thermostat and there was no way out because it was inside of me.
Hot flashes weren’t my first sign of early-onset menopause. The very first was rage. Granted, I sometimes had a temper in my teens, usually because of anxiety, and triggered by the same buttons I didn’t like pushed. But the rage that made me consult my doctor was different from other fits of temper. It seemed uncontrollable and out of proportion.
During a family supper at my parents’ house, for instance, I totally lost it when my sister made the small gesture of moving a strand of hair away from my glasses. I felt triggered by her being up in my face, but my reaction was deplorable. I couldn’t reel myself in. It was so bad that I called my doctor the next day and explicitly asked whether I might have a hormonal imbalance and if my estrogen levels should be checked.
Unusual Symptoms
I also started having nightmares that made me feel as if I’d spent the whole night in severe conflict with loved ones. After the first or second occurrence, I said to my husband: “Something is wrong. I have so much anger coming out in my sleep.” But when I told my physician I was easily angered and having rageful dreams, he chuckled and asked, “You’re usually angry?” as though we were having a fun conversation.
We know in our gut when something can’t be dismissed because it’s different from our usual baseline. And it can be deeply infuriating when something that feels alarming to us gets scoffed at when we bring it to others’ attention, whether it’s family, friends, or medical professionals.
I pressed my physician to send me for testing because I knew the anger and the pain I was experiencing warranted some kind of investigation, even if I was an outlier in medical textbooks. He referred me to a gynecologist who was receptive to my concerns and did a battery of hormonal tests.
It turned out my follicle-stimulating hormone (FSH) levels were unusually high and my estrogen and progesterone levels were unusually low, both of which suggested menopause or perimenopause. We repeated the tests to ensure they didn’t give us an inaccurate snapshot at a particular point in time; the results were consistent.
The OB/GYN referred me to a fertility clinic for further investigation. There, a specialist explained I was experiencing premature ovarian failure, or ovarian insufficiency. My egg reserve was unusually low for my age, and I was told that I should freeze my eggs as a precaution.
Finally, at age 31, I was diagnosed with endometriosis—16 years after the onset of symptoms—which helped explain why I was going through menopause so early. (Research suggests that women with endometriosis are more likely to experience early-onset menopause.)
After my first surgery for endometriosis, I was given an injection treatment which induced chemical menopause for several months. Unlike many endometriosis sufferers, I experienced natural perimenopause symptoms before the induced, or chemical, symptoms that come with hormone suppression therapy. Spoiler alert: I hated them both!
Self-Care Solutions
Once I knew what was going on, I made several lifestyle changes to manage my endometriosis and menopausal symptoms. For starters, I became self-employed so that I can work from home and choose my own schedule. I swim daily, which helps recalibrate my mood. And I try to limit foods that are high in histamines—such as tuna, spinach, wine, and cheese—because they exacerbate my hot flashes.
Kasparian and her husband are exploring egg donorship and surrogacy to start a family soon.
Not surprisingly, going through menopause so early affected my relationship with my husband and my own body image. It slammed the breaks on our intimacy because of the changes my body was going through, and how painful sex had become, thanks to vaginal dryness. Pelvic floor rehabilitation and vaginal dilator therapy has helped me retrain muscles and relax tension to counteract some of the effects of hormonal changes.
Early menopause has also complicated our discussions about building a family. We are now in the process of making that happen through egg donorship and surrogacy.
Sharing the Message
I always associated menopause with people in their 50s. All I knew of hot flashes, until I started experiencing them myself, were the superficial “amusing” facts we get in pop culture. I never imagined they could be so deeply disruptive.
Here’s what I would tell other women facing the same situation: You are not alone, even if you’re an outlier who doesn’t fall within the norm. Be aware of your body and mind; honor when something feels off and advocate for yourself. You deserve answers.
Kristina Kasparian, PhD, is a neuro-linguist, consultant, writer, and entrepreneur. She’s also a health activist advocating for more inclusive and more effective standards of care for conditions like endometriosis.