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Dear Doctor - Part Two

Dr. Sarah De La Torre

How early can menopause start? I'm only 34 but have every one of the symptoms – could I be going through menopause already?

Experiencing menopausal symptoms at the age of 34 is relatively uncommon, but it is not impossible. Perimenopause and menopause are typically experienced by women in their mid-late 40s or early 50s, and the average age of menopause is 51. However, it is possible for menopause to start earlier, and this is referred to as early menopause or premature ovarian insufficiency (POI), which is defined as menopause occurring before the age of 40. There are various factors that can contribute to early menopause, including genetics, certain medical conditions, autoimmune disorders, chemotherapy or radiation therapy, surgical removal of the ovaries, and lifestyle factors such as smoking. If you are experiencing symptoms of menopause at an early age, it is important to consult with a healthcare professional to determine the underlying cause and explore potential treatment options.

Will I still go through menopause if I had a hysterectomy?

A hysterectomy is the removal of the uterus. The lower part of the uterus is the cervix, and most often, the whole uterus including the cervix is removed. If the entire uterus and cervix is removed, then a woman will no longer experience menstrual bleeding. If her ovaries are also removed, then she will be in “surgical menopause". If her ovaries are not removed, then she will not go through menopause from a hormonal perspective until her ovaries naturally stop producing estrogen. Menopause is not immediate after a hysterectomy unless the ovaries are also removed.

If the ovaries are removed during the hysterectomy (oophorectomy), menopause will occur immediately or shortly after the surgery, regardless of your age. This is referred to as surgical menopause or induced menopause. Removal of the ovaries leads to a sudden drop in estrogen and progesterone levels, resulting in menopausal symptoms.

My sex drive is completely gone. Will it ever come back or is this just life now?

A decrease in sex drive or libido is a common symptom reported by many women during menopause. Each person's experience with menopause is unique, and while some women may experience a decrease in libido, others may find that their sex drive improves over time.

Hormonal changes, specifically a decline in estrogen levels, can contribute to changes in sexual desire and arousal. Additionally, other factors such as fatigue, mood changes, vaginal dryness, and psychological factors like stress or relationship issues can also affect libido during menopause.

The good news is that there are various strategies, treatments and products available that can help address decreased libido during menopause. It's important to discuss your concerns with a healthcare professional who can provide personalized advice and explore potential solutions based on your specific situation. Don’t be shy – they have heard it all. This may include hormone replacement therapy (HRT) to rebalance hormone levels, vaginal lubricants or moisturizers to alleviate dryness, as well as red light devices which improve vaginal tone, lubrication, sensation, strength, and above all, confidence.

My mom went through menopause late and had a difficult time with symptoms. Will my experience be similar?

While there can be some familial patterns in the timing and experience of menopause, it is not guaranteed that your experience will be the same as your mom’s. Menopause experiences can vary significantly from person to person, even within the same family.

Several factors can influence the menopause experience, including genetics, lifestyle, overall health and individual differences in hormone levels and sensitivity.

It's important to remember that menopause is a highly individualized process, and what one person experiences may not be the same for another.

While your mom’s experience may give you some insight into what to expect, it does not necessarily mean that you will have the same difficulties or symptoms. It's best to approach menopause with an open mind, be prepared for potential changes, and seek support from healthcare professionals who can guide you through this transition.

Find a doctor or professional you are comfortable having these conversations with so you can get the support and information you deserve and need to navigate this next phase of life.


Dr. Sarah de la Torre received her medical degree from the University of New Mexico and completed her OBGYN residency at the University of Washington. She has worked in private practice for over 19 years and has been a medical consultant for over 10 years. Dr. Sarah is an entrepreneurial Femtech thought leader and is double board-certified in Obstetrics and Gynecology, as well as Lifestyle Medicine, and is also a Certified Functional Medicine Practitioner.


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