Menopause Is Different If You’ve Never Had Children — and It’s Important to Know How This Affects You

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Your menstrual period can vary with age, hormones, family history, and health conditions. Some factors that affect your period also influence the age when menopause starts. Or the kinds of symptoms you have during menopause and perimenopause. And one of these factors is your pregnancy history.

Hormone changes during pregnancy affect all parts of a woman's body. And for some people, it can impact the age when menopause begins - and the symptoms they experience with it.

Does pregnancy affect menopause?

Pregnancy may affect the age at which you go through menopause.

For most women around the world, menopause happens between the ages of 45 and 55. In the U.S., the average age for menopause is 51. How old you are when your periods end depends on factors like:

• Your genes

• Whether you've taken oral contraceptives or hormone therapy

• If you smoke or have smoked in the past

• Social factors like income level and education

• Nutrition

• Pregnancy and breastfeeding

If a woman stops having periods before the age of 45, it's called early menopause. If she stops before the age of 40, it's called premature menopause. Pregnancy and breastfeeding seem to lower the risk of early and premature menopause.

The reason this happens is related to the number of eggs in your ovaries, which is a fixed number that you are born with. During pregnancy, ovulation stops and so the ovaries don't release eggs. Nursing may also put a pause on ovulation for some women. So women who have spent more time pregnant or nursing may ovulate later into life. And that could lead to menopause happening at a later age.

Do you go through menopause early if you've never been pregnant?

If you've never been pregnant, it doesn't mean you'll definitely experience early menopause. But the risk is higher.

Overall, about 5% of women in the U.S. go through menopause before the age of 45. Around 1% of women experience menopause before the age of 40.

One study looked at more than 50,000 women in different countries who had gone through menopause. They compared the age when menopause started for women who had never given birth with those who had two or more children. They found that:

• Women who hadn't given birth had more than twice the risk of starting menopause before the age of 40.

• If those women also had their first period before the age of 12, there was a fivefold risk of premature menopause.

• The chance of starting menopause between the ages of 40 and 44 was also higher.

There are many reasons why women don't have biological children. It may be a matter of choice. Or circumstance. Or a health condition that results in infertility. But each reason may result in different factors that influence the age when a woman begins menopause.

Some of these include:

• Oral contraceptive use:Birth control pills may delay the age when menopause begins. Especially if taken for many years. At the very least, oral contraceptives don't appear to increase the risk of early menopause.

• Tubal ligation: Having a tubal ligation might increase the risk of early menopause. That's because after the procedure, a little less blood is supplied to the ovaries.

• A history of infertility: Infertility, regardless of what causes it, may be a risk factor for early menopause. But the research hasn't figured out exactly why this is the case.

• Pregnancy loss:Miscarriage and stillbirth are also associated with early menopause.

• Endometriosis: People with endometriosis can have trouble getting pregnant. In one large study, women with endometriosis had a higher risk of early menopause. Especially if they never used oral contraceptives or had not given birth.

• Polycystic ovarian syndrome (PCOS): The hormone imbalance of PCOS can also affect fertility. But unlike endometriosis, women with PCOS may begin menopause at a later age.

Are menopause symptoms worse if you've never been pregnant?

Hormones, pregnancy, and health conditions can all impact the age when menopause begins. But those factors may also affect the type and severity of perimenopausal and menopausal symptoms.

During midlife and menopause, women who have experienced infertility may have a higher risk of:

• Depressed mood

• Feeling irritable

• Trouble sleeping

• Vaginal dryness

• Less interest in sex

Some studies suggest that women who have not been pregnant or have not had children are less likely to have hot flashes and vaginal dryness. But other studies found that they were more likely to experience menopausal symptoms.

It's likely that many aspects of physical and mental health come into play when it comes to menopause symptoms. For some women who have never been pregnant, certain symptoms may be worse. But that won't be true for everyone.

What can help with menopause if you've never been pregnant?

Most experts recommend treatment with hormone replacement therapy (HRT) for women who begin menopause before the age of 45. And to continue treatment at least until the age that menopause starts for most women. The goal is to help prevent some of the long-term health conditions that can occur with early menopause.

Menopause before the age of 45 is also a risk factor for:

• Cardiovascular diseases like heart attack and stroke

• Osteoporosis and osteopenia (fragile bones)

• Depression and anxiety

• Dementia symptoms, like trouble thinking and remembering

So HRT may help to lower the risk of things like cardiovascular disease and osteoporosis.

If you've never been pregnant, here are some additional options to consider:

• Nutrition: Certain foods, in particular oily fish and legumes, may help to delay the age you begin menopause. On the other hand, processed foods made with refined wheat and rice may increase the risk of early menopause.

• Not smoking: On average, people who smoke go through menopause 1-2 years earlier than those who don't. Quitting also lowers the risk of health conditions like heart disease that can happen with early menopause.

• Exercise: Regular physical activity can help to balance hormones. And along with a nutritious diet and not smoking, exercise improves the health of your heart, bones, and brain.

• Healthy sleep habits: Menopause can affect your sleep. But not getting enough quality sleep can also make some menopause symptoms worse. Develop a regular sleep routine to get the best rest you can.

• Mind-body practices: Try yoga, mindfulness-based stress reduction, or cognitive behavioral therapy (CBT). All of these may help ease menopause symptoms.

• Vitamins and supplements: Evidence varies for how well different vitamins and supplements work for symptoms like hot flashes. But talk with a healthcare professional before starting over-the-counter (OTC) medications, herbal remedies, or supplements.

• Hormonal treatments:Oral contraceptives may help to prevent early menopause. They can also help regulate menstrual periods and treat symptoms during perimenopause.

• Mental well-being: Tend to your mental health. This is helpful advice for all women who are approaching or experiencing menopause. But it may be especially important for those who have gone through infertility treatments or experienced pregnancy loss

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