Perimenopausal age: Are menopause symptoms genetic?

Menopause and heredity

While the terms menopause and perimenopause are often used interchangeably, they mean slightly different things. Menopause is defined as the last menstrual period, which can be confirmed after twelve consecutive months without bleeding.r [1]. Perimenopause, on the other hand, is the time leading up to this last menstrual period, when women may experience a range of symptoms. The experience of approaching menopause, varies widely between women. The good news is that there is a growing body of research examining what factors impact when you begin perimenopause and what affects the range of its symptoms. Let’s look closer at what’s been uncovered.

Genetics

The latest research in menopause and perimenopause is investigating links between the age at which you begin perimenopause, the age of menopause, and your genetics. Studies that have examined both twins and families have found between 44% and 65% of variation in when women begin menopause is due to their genes [2]. Another study found that variability of menopausal age between mothers and daughters was around 44% attributable to genetics [3]. The daughters in that study experienced menopause one year earlier than their mothers on average, but researchers acknowledge that more research is necessary with a larger body of participants. Genetics, along with family history, are also being investigated as a way to predict early menopause in some women. A study that focused on early onset menopause, which affects an estimated 10% of women, found that roughly 37.5% of the examined cases had a family history of early menopause [4]. 

While scientists are confident that the age of menopause (AOM) is heavily linked to your genes, the exact variables and their location on different genes continue to be investigated [5]. One analysis identified 17 specific variations on seven genes that are related to hormonal regulation, immune function and DNA repair [6]. Hormones are really key to understanding menopause and perimenopause, especially estrogen, since naturally decreasing levels of estrogen and progesterone are connected to perimenopause and menopause symptoms as well as the stopping of menstruation [1]. 

Genetics has also been linked to the prevalence and intensity of certain menopause symptoms. Vasomotor symptoms (VMS), caused by the tightening and opening of your blood vessels, are some of the most common during menopause: hot flashes, night sweats, heart palpitations, and migraines [1]. The range, severity, and onset of these symptoms are influenced by a number of factors including inherited variations in your genes [7,8]. In particular, scientists have identified a few locations of inherited genetic variation responsible for controlling the rate of production of follicle stimulating hormone, which is associated with reported cases of hot flashes and night sweats [6,8].

Similarly, some research suggests that genetics can also play a role in your experience of psychogenic symptoms like major depressive disorder during perimenopause and menopause [9]. 

Lifestyle

There are two other factors widely connected to age of menopause and common menopause symptoms in current research: 

• Obesity is a major risk factor for symptoms like hot flashes, night sweats, and migraines, particularly during perimenopause and early postmenopause. Researchers are unsure what role body mass index (BMI) plays, but studies have suggested that excess fat in the tissues can worsen the fluctuations in core body temperature that trigger hot flashes [8]. 

• Smoking and exposure to cigarette smoke have been shown to increase the likelihood of reported VMS by over 60%. Some studies have ascribed this to cigarette smoke blocking the effects of estrogen, but scientists insist more research is needed to explain the connection between smoking and VMS. Smoking has also been linked to the early onset of menopause [10].

What other factors impact menopause?

There are different physiological and environmental factors that can impact when menopause begins and the types of menopause symptoms experienced. For example, alcohol consumption, physical inactivity, and emotional stress have all been found to contribute to worse menopause symptoms [1]. Psychological factors like anxiety, stress, and previous mental and emotional trauma, along with health-related factors like sleep disorders and chronic pain, have also been linked to increased risk of depression during menopause [9]. More recent studies have begun examining the experience of menopause as it relates to endometriosis [11].

Perimenopausal experiences may also be hereditary

During perimenopause, your body starts preparing for the natural transition toward menopause. Most women begin to notice some symptoms of perimenopause in their 40s and 50s, but an estimated 1% of the population experiences perimenopause in their 30s [12]. Some may notice symptoms and feel changes in their body right away, while for others, the shift is more gradual. Perimenopause can last months or even years, and every journey looks a little different.

Will I have the same perimenopause symptoms as my mom?

The short answer? Maybe. Like many other aspects of your health, your perimenopause experience is shaped by both genetics and lifestyle. So while you might share some similarities with your mom, sister, or grandmother, it's also possible to have a very different experience of perimenopause [1, 4, 9]. However, just like menopause, scientists have found there is a relationship between perimenopause and family history [7,9]. 

When will I start perimenopause?

We understand you probably have a lot of questions around the timing of your perimenopause journey. Unfortunately, there is no way to predict — either through genetic testing or family history — exactly when you will start perimenopause. Perimenopause typically begins between the ages of 45 and 56, while around 5% of women will experience menopause between the ages of 40 and 45 [1]. Try to remember that perimenopause is different for everyone. Familiarizing yourself with the most common symptoms, like short or irregular periods, can help you physically and emotionally prepare for what to expect during this important transition.

How to improve your menopause experience?

Whether you are worried about potential perimenopause symptoms or are already experiencing them, know that there are a variety of lifestyle adjustments and medical treatments available to improve your quality of life during this important period. To start, eating a healthy and balanced diet, staying active, caring for your mental health can all help ease symptoms [13]. Maintaining your social and emotional support networks is also extremely important. Being able to confide in someone about what is on your mind and how you are feeling can help relieve stress and anxiety, and has been shown to improve the perimenopause and menopause experience [9].

Medically, there are a wide range of interventions available: blood pressure medication to ease hot flashes and night sweats, estrogen treatments for vaginal dryness, testosterone gel for sex drive, as well as hormone replacement therapy (HRT). Cognitive behavioral therapy (CBT) has also been shown to help with mood, anxiety, and sleep problems [13, 14].

When to speak with your doctor

If you have any questions or concerns about perimenopause or menopause, whether you have begun experiencing symptoms or not, you should speak with your doctor. You can discuss together any changes you are experiencing and create a care plan that supports your physical and mental well-being. A healthcare provider can help you understand the role of your family history and talk you through available treatment options.

Make sense of your symptoms with NC° Perimenopause 

While no one can predict exactly when perimenopause will begin, understanding where you are in the journey is now easier than ever. Welcome to NC° Perimenopause, the newest experience in the Natural Cycles app. Use the NC° Perimenopause assessment to determine your stage of perimenopause and track changes in your cycle. Become more knowledgeable about what is going on inside your body during this important time and use this information to shape discussions with your doctor. Understanding your background can help you prepare, but the right tool can shape your journey.

NC° Perimenopause is here to support you with wellness insights and information. It’s not a diagnosis — we always recommend consulting with your own doctor for medical advice.