'Menopause is not a one-day thing,' says gynaecologist Dr Nidhi Jha, founder and director at Care&Cure Clinic, New Delhi. 'It's a gradual process that begins years before your last period and it's deeply influenced by how you live your 20s.'
Do you believe menopause is something only your mother or aunt should worry about? That you can stay up till 2 am, skip meals, live on coffee and it won't matter because you're still 'too young' to think about hormones?
That weight training, regular check-ups or sleep schedule is something to worry about in your 30s?
"That is one of the biggest mistakes young women make," says Dr Nidhi Jha.
Menopause might feel like a faraway chapter but your 20s quietly write its first pages. The body you have today, the way you sleep, eat, move and handle stress is setting the tone for your 40s and 50s. The hormonal imbalances you ignore now could shape how early (or how painfully) you experience menopause later.
Dr Jha, who graduated from the Calcutta National Medical College and has over 15 years of experience in women's health, believes that understanding your body early is key to avoiding anxiety, fatigue, bone loss and mood swings later in life.
On the eve of World Menopause Day, she tells Rediff's Rishika Shah why every 20-something woman needs to start thinking about her hormone health now and how small changes today can ensure a smoother and stronger tomorrow.
Many young women think menopause is a 'later' topic, something their moms should worry about. Why should women in their 20s start understanding it now?
See, menopause is not a one-day thing.
There is a fertile period, then perimenopause and finally menopause.
The average age of menopause in India is around 47 but the changes start almost 10 years earlier. The symptoms you'll face at that time depend on how healthy your hormones are today.
Your 20s are when lifestyle habits like diet, sleep, exercise and stress begin shaping your hormonal rhythm. If you maintain a good routine now, your body will handle menopause smoothly later.
Biologically, how early do our hormones start laying the foundation for what menopause will look like later? Is it really true that what we do in our 20s affects our 40s?
Yes, absolutely.
The body's hormone balance starts forming in your 20s. Habits like staying up late, sleeping irregularly or crash dieting interfere with your circadian rhythm and melatonin production.
When these continue for years, your ovaries and egg quality start ageing faster. So yes, what you do in your 20s very much shows up in your 40s.
Can you explain how lifestyle habits like diet, sleep, stress and exercise influence hormonal health and the time or severity of menopause later in life?
If you eat well, sleep on time and work out regularly, your hormones stay balanced.
But if you live on caffeine, eat erratically and never rest, your stress hormones go up. Cortisol increases, insulin drops and this disturbs ovulation and menstrual cycles.
These imbalances don't just cause PCOS or thyroid problems, they also make your menopause transition rougher later.
A lot of 20-somethings today skip meals, sleep late and live off caffeine. What long term impact can these habits have on reproductive or hormonal health?
Sleep is one of the most important things for hormone health. It's not only about the number of hours, but also the quality of sleep.
When you sleep late, your circadian rhythm gets disturbed. Melatonin drops and cortisol rises. In the long term, this affects your ovarian health and egg quality.
If you're supposed to hit menopause at 50, you may start experiencing changes in your early 40s because of these habits.
Many women go on restrictive diets or push themselves with extreme fitness routines. Can those choices affect fertility or increase the risk of early menopause?
Yes.
When you follow an extreme diet or over-exercise, your body goes into stress mode.
It can lead to a condition called hypothalamic amenorrhea, where your periods stop because the body is conserving energy.
It's common among athletes or those who lose weight too fast. The good news is that it's reversible once you return to a balanced routine.
Are there any specific habits or foods that can delay early menopause or make the transition smoother later?
Yes, weight-bearing exercises are very important.
During menopause, hormones like insulin and testosterone -- which help in maintaining muscle mass -- reduce.
If you don't build muscle in your 20s or 30s, you'll lose it faster later. That's why women who lift weights early look stronger and more energetic in their 40s and 50s.
Along with this, maintain a balanced diet that includes calcium, vitamin D and iron. Avoid sudden weight gain or loss.
Stress has become part of everyday life from work to relationships to social media. How much does chronic stress in your 20s mess with our hormones and future menopause health?
Stress can affect anything.
When you are stressed, your cortisol increases and, over time, it can affect your ovarian health. Chronic stress may not directly cause menopause to begin early but it disrupts your journey towards it.
People who are stressed often don't eat or sleep properly. Some start smoking or drinking more. All these things add up and create bigger hormonal imbalances.
Can poor habits in your 20s like smoking, drinking or lack of sleep actually lead to premature menopause?
They definitely increase the risk.
Smoking and chronic sleep deprivation disturb oestrogen levels while excess alcohol affects liver function and hormone metabolism.
Over time, this can make menopause arrive earlier or make symptoms worse.
Irregular periods, PCOS or thyroid issues are common among young women now. Can these conditions make menopause come earlier or hit harder later?
PCOS doesn't make menopause come early, in fact, it delays it slightly.
The average age of menopause in India is 47, give or take five years. With PCOS, it can stretch a little further.
But PCOS comes with its own issues -- irregular periods, infertility, obesity and a higher risk of heart disease.
Thyroid disorders too cause irregular cycles but they don't cause early menopause. Both are easily managed with medication and lifestyle changes.
Birth control pills are also common for most 20-somethings. Does long term use have any connection to menopause timing or symptoms later on?
No, not at all.
The pills we use now are low-dose and very safe. They don’t affect the age of menopause.
In fact, if prescribed by a qualified gynaecologist, they can even help ease perimenopausal symptoms later.
The only thing is, when you're on the pill, you might not notice natural hormonal changes because your body's getting synthetic hormones regularly.
What are some early warning signs that a woman's hormone health might be off-track even in her 20s?
The early signs are quite simple:
Sudden weight gain or loss, sleepless nights without a reason, fatigue, mood changes or irregular and scanty periods.
If you have PCOS, thyroid or high blood sugar, you should be even more alert. These are all signs that your hormones need attention.
How important are regular gynaecological check-ups or hormone tests for young women who otherwise feel 'healthy'?
Very important.
Even if you feel fine, you should visit your gynaecologist once a year or at least once in two years.
A gynaecologist doesn't just check reproductive health; we look at your overall well-being.
Important tests include CBC (to check anaemia), thyroid profile, blood sugar, lipid profile, liver function and vitamin B12 levels.
After 23, every woman should get a pap smear and HPV test. And yes, please take the HPV vaccine as it also protects you from cervical cancer.
How can young women start protecting their hormonal health right now? Any simple tips for their daily routine?
Sleep early, eat balanced meals and exercise regularly.
Avoid smoking, limit alcohol and caffeine and maintain a healthy weight.
If you have children, monitor childhood obesity early.
And make sure you get regular check-ups and take supplements if your doctor advises it. Small habits make a big difference.
Finally, what's one thing you wish every 20-something woman knew about her body that could change how she experiences menopause decades later?
That your lifestyle today decides your future health.
Eat well, move daily, sleep properly and take care of your mental health.
Avoid smoking and unsafe sex. The age of sexual activity is decreasing and the percentage of sexually transmitted diseases are rising so always use protection and know your partner.
Menopause is not a disease. It's a natural transition. If you take care of your body now, it will take care of you later.