Women's reproductive health changes throughout their lives, and understanding how it evolves can help them make more informed decisions with greater confidence. This is one of the key messages shared by Dr Sonia Albero, a gynaecologist specialising in assisted reproduction at IVF-Life Alicante, in her first book, La menopausia empieza antes de los 37 (Menopause Begins Before 37).
The book aims to help women understand the hormonal changes that occur with age and provide them with the knowledge and tools to navigate a stage of life that is still surrounded by questions and taboos. The title itself is intended to highlight why women should start learning about these changes long before menopause begins. It does not mean that menopause necessarily starts at the age of 37, but rather that many of the processes associated with ovarian and hormonal ageing begin well before menstruation stops permanently.
Traditionally, much of the information available about women's health has focused on menstruation, contraception, pregnancy and motherhood. However, there is a period in between that receives far less attention: the years during which ovarian function gradually changes and the body begins moving towards the menopausal transition.
Dr Albero believes it is essential to address this gap in knowledge. Understanding the hormonal changes that may occur as women get older can help them recognise certain symptoms and better understand what is happening in their bodies before menopause itself. From a medical perspective, menopause is diagnosed after 12 consecutive months without a menstrual period. The climacteric, however, refers to a broader period surrounding menopause and may involve a range of physical, hormonal and emotional changes.
One of the key connections between this topic and reproductive medicine is that fertility and menopause do not follow exactly the same timeline. A woman may still have regular menstrual cycles and be several years away from menopause, while her reproductive potential has already started to decline.
As women get older, particularly from the age of 35 onwards, both ovarian reserve and egg quality gradually decrease. This is why female fertility begins to decline long before menstruation stops. This is particularly relevant in a society where women are increasingly postponing motherhood for personal, professional, financial or family reasons.
In her book, Dr Albero explores the difference between personal life plans and biological timelines, emphasising that having access to fertility information early enough allows women to make more informed and considered reproductive decisions.
For women who wish to postpone motherhood, one option worth considering is fertility preservation through egg vitrification. This technique allows eggs to be collected and frozen for future use, preserving the characteristics associated with the woman's age at the time of freezing.
However, freezing eggs does not guarantee a future pregnancy. The outcome depends on several factors, including the woman's age when the eggs were frozen, the number of eggs retrieved and their reproductive potential. This is why specialist fertility advice is particularly important. Understanding both the possibilities and limitations of fertility preservation techniques enables women to make realistic decisions based on their individual circumstances.
This reflects one of the messages Dr Albero conveys in her book when discussing the pressure that can accompany reproductive decisions. As she explains, “Having more information should empower women to make their own choices, not make them feel guilty.”
Another central message of La menopausia empieza antes de los 37 is the importance of not assuming that certain symptoms must simply be accepted because they are common. During the years of hormonal transition, women may experience a wide range of symptoms, which can vary considerably from person to person. Hot flushes are probably the most widely recognised, but they are far from the only ones.
Sleep disturbances, fatigue, mood changes, difficulty concentrating and discomfort during sexual intercourse can also occur during this stage of life. When these symptoms affect quality of life, seeking medical advice is important. Every woman's needs are different. In some cases, lifestyle changes may help improve wellbeing, while in others, individually tailored medical treatments may be appropriate.
Dr Sonia Albero's professional career has been closely linked to women's health. After studying Medicine at Miguel Hernández University and specialising in Obstetrics and Gynaecology in San Juan de Alicante, she focused part of her career on reproductive medicine before undertaking further training in hormonal health and integrative medicine.
This combination of expertise has shaped her approach to women's health as a continuous process rather than a series of separate stages. During the reproductive years, healthcare may focus on fertility, contraception or pregnancy. Later in life, new needs emerge as a result of hormonal changes, the climacteric and menopause.
Her book reflects this broader perspective on women's health, drawing on the clinical experience she has gained throughout her career.
Ultimately, Dr Sonia Albero's book encourages women to start conversations about menopause, fertility and hormonal ageing earlier in life. The aim is not to create unnecessary concern, but to ensure that women have the information they need before facing important decisions about their health and reproductive future.
The book explores biological and hormonal changes alongside other essential aspects of wellbeing, including nutrition, physical activity, sexuality, sleep, stress and emotional health. As Dr Albero explains, “Understanding how our bodies change gives us the tools to navigate each stage of life and make decisions that better reflect our individual needs.”
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DATA CONTROLLER: IVF SPAIN ALICANTE S.L.U (hereinafter IVF-Life)
CIF: B-54973227
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