“I'm 45, why do I have all these symptoms now (hot flashes, insomnia, dryness, swollen belly)? Is it menopause?”

Here's how Prof. Graziottin answers this question from her patients:

Your body is telling you the truth: your ovaries are losing their last oocytes, say the reproductive female cells, and are losing their follicles, say the cells that nourish the oocytes and produce estradiol, estrogens, and progesterone.

These symptoms tell you that the three major consequences are impending:

• First, loss of menses = menopause
• Second, loss of fertility (unless oocytes preservation, with cryo-conservation, has been carried out in the earlier fertile years).
• And third, loss of health: because these symptoms (hot flashes, insomnia, swollen belly, pain in your joints…) are a real “cry for help”. Your body is asking for help because it wants to have back the hormones lost with ovarian exhaustion. For example, the belly is getting “swollen” because the loss of sexual hormones causes a major dysbiosis in the gut, with reduced biodiversity and an increasing number of gas-producing bacteria.

In parallel, it causes vulvar and vaginal dysbiosis, with the loss of our friend Lactobacilli, increased biodiversity in the vaginal microbiota and microbiome and an increasing number of bacteria like the Gardnerella Vaginalis causing bad smell. Also, this increases the vulnerability to contaminants from the bowel like Escherichia coli

Remember: women are never too young to get menopausal. Therefore, listen carefully to those symptoms even in adolescent girls! A woman can be young and very beautiful, and yet have a very early premature ovarian insufficiency, for a number of reasons (genetic first, autoimmune if she has celiac disease or other autoimmune diseases, after removal of an endometriotic cyst in the ovary or mono-lateral ovariectomy for endometriosis or chemo or radiotherapy.

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