Don’t know much about biology 🎶
April 21, 2019 11:00 PM   Subscribe

My mom, who is not always a trustworthy source, has claimed that she and her mother reached menopause in their mid-30s. I know this is possible and am inclined to believe her, but she’s also a difficult person who is fond of both family lore and telling manipulative spooky stories to control me. Is there anything I can do to help me proactively forecast my fertility?

My mom loves the classic guilt trip and has been asking me since I was a 23 year old when I’m going to “finally” shack up and have kids. It’s annoying as I do actually want kids, and am concerned about fertility, so her fearmongering does get me upset despite the fact that she’s told me lots of demonstrably untrue things about her own health and family history in the past.

She’s told me that she had endometriosis but having her first baby cured it, and then today that she and my grandmother (her mother) went into menopause at age 36. I have no idea whether the first thing makes sense, but the second one seems to track with things I remember her mentioning when I was growing up. She and my grandmother smoked, which I’ve read is a risk factor for early menopause, and I do not, but it doesn’t sound like that typically makes a huge difference.

I can very easily imagine her going from reading somewhere that early menopause is possible, to shaving a few years off her own age of menopause, to exaggerating the story to extend to my grandmother, and then unscrupulously telling this story in the hopes that it will pressure me into doing whatever. She does this shamelessly with many things and when confronted pulls the “who, me?” defense. But I tend to think that a person remembers pretty well something like when they go through menopause. On the other hand, I also know it can be a slow and unclear process, and I’m not very smart as to at what point your fertility really “ends.”

So in essence, my question is whether I can have any testing or work-ups done to better understand the reality of my reproductive longevity, or if I just have to accept that I’m taking a bigger-than-usual risk by delaying childbearing into my early 30s. (I know there are such things as fertility assessments, but not whether they cover this case, or how accurate they are.)
posted by stoneandstar to Health & Fitness (8 answers total) 2 users marked this as a favorite
Is it possible your mother is really referring to perimenopause?
posted by acidnova at 11:37 PM on April 21, 2019 [3 favorites]

There are conditions that mimic menopause. For example, a lot of women stop menstruating regularly during their fertile years because of hormonal imbalances that affect releasing their eggs each month. This isn't menopause and taking simple medication to stimulate ovulation fixes it and allows you to get pregnant. It's a common experience.
Next time you see your gynecologist ask them to test your hormone levels now and to discuss their implication.
posted by nantucket at 12:17 AM on April 22, 2019 [4 favorites]

In my big city (Chicago) fertility clinics occasional run free or discounted specials for the basic tests that indicate fertility problems. Try and see if there is something near you.

Endometriosis can cause infertility. But lots of stuff impacts fertility honestly, it's hard to tell.

And even within families there can be wide variation.
posted by AlexiaSky at 12:26 AM on April 22, 2019

When I was having problems falling pregnant at 35, my gynecologist gave me the Anti-Müllerian hormone test, which showed I had low ovarian reserve. I had my last period just after I turned 37, so early menopause. They could find no cause and I was told idiopathic premature menopause like I experienced affects about 1% of women. The test is an accurate short term predictor of fertility that you could request from your gyn, even if just for reassurance.
posted by stromatolite at 12:36 AM on April 22, 2019 [2 favorites]

OB/Gyn here, obviously NYOBGYN.

"Menopause" is defined retroactively as 12 months without a period. The median age in the US is 51. However, fertility for everyone declines radically before that. Many people will mention the dropoff as starting around 35, which is true, although the significant decline doesn't occur until around 37 for your average woman. For a woman of 40, not only will conceiving be more challenging, but the miscarriage rate increases (from around 20% at age 35 to 40% by age 40).

As to whether you are an 'average' fertility woman, that is difficult to assess without further discussion. Have you ever had an STI like chlamydia which can scar your fallopian tubes? Have you personally had a history of endometriosis? Do you have regular periods? Do you have a partner with normal sperm count?

You don't mention your age, so it's hard to counsel you on how much time you have to play with, but realistically, the only way to know if you will have fertility issues is to actually try to get pregnant (1yr if you are under 35, 6mo if you are over). You can have some limited fertility testing done prior to that, but we don't have a one-perfect-test which can read the future.

AMH or anti-mullerian hormone is often equated to ovarian reserve, and certainly if yours were low I would counsel you that you should try to achieve pregnancy sooner rather than later. However, it's technically only validated to show whether your ovaries would respond well to stimulation in a cycle with IVF medications.
posted by eglenner at 3:20 AM on April 22, 2019 [16 favorites]

Hey, my mom started hitting menopause when she was 33. However, her mother had her last kid at 35, her grandmother had her last kid at 41, and I am going to turn 35 this year and no signs of menopause yet. So even if your mother is 1) telling the truth, and 2) accurate in her estimate of when she went through menopause, it doesn't mean that you will automatically suffer the same fate.
posted by chainsofreedom at 7:38 AM on April 22, 2019

You can have blood tests done to estimate ovarian reserve. Check with a fertility specialist.
posted by St. Peepsburg at 9:20 AM on April 22, 2019

Hmmm. Hitting menopause in your 30s is rare. Your mom exaggerating and fear mongering is common. I think the odds are that she didn't really hit menopause at 35.
posted by selfmedicating at 9:48 AM on April 22, 2019

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