Menopause is when your periods permanently stop. It usually happens between age 45 and 50, and menopause between the ages of 40 and 45 is called early menopause. If menopause occurs before the age of 40, this is called premature menopause.
Around 5% of women begin menopause early, while 1% experience premature menopause. There are several possible causes, but it can also happen for no clear reason. While going through menopause is a natural part of life, it can feel like an especially big change if it happens at an earlier age.
What are the signs of early menopause?
The main sign of early menopause is your periods becoming less frequent or stopping altogether. You may also experience symptoms like:
- Hot flushes
- Night sweats
- Difficulty sleeping
- Vaginal dryness, irritation or urinary problems
- Low libido
- Low mood
- Difficulty concentrating or remembering things
What causes early menopause?
Early menopause can be triggered by natural or medical causes, including:
Primary ovarian insufficiency
Primary ovarian insufficiency (POI) is when the ovaries stop working before age 40. It happens in about 1% to 2% of women under 40 and much fewer women under 30 (around 0.1%).
It used to be called primary ovarian failure, but that name was found to be inaccurate. The ovaries don’t always stop working completely, and some people with POI still have periods from time to time, so pregnancy is still possible in some cases.
Around 90% of the time, the cause of POI isn’t clear. Some potential triggers may include:
- Genetic disorders like Turner syndrome
- An autoimmune disease
- Certain infections
POI is diagnosed by testing your levels of hormones, including follicle stimulating hormone (FSH). This will need to be checked twice so that the diagnosis can be confirmed.
Surgery to remove the ovaries
Having surgery to remove your ovaries before your periods stop, such as in addition to the uterus during a hysterectomy, causes early menopause. Removing the ovaries means you’ll lose the hormones they produce, including oestrogen and progesterone.
Cancer treatments like chemotherapy and radiation can trigger early menopause. Sometimes this is temporary, but if you’re close to the natural age of menopause, it may be permanent. A doctor will be able to tell you what may happen in your situation and what options you have.
What does early menopause mean for my health?
Menopause causes your levels of oestrogen and other hormones to drop off. This can affect things like your mood and cognition. After menopause, women are also at a higher risk of health issues like cardiovascular disease and osteoporosis.
To help your bones stay healthy, make sure you’re getting enough vitamin D and calcium in your diet.
There are also treatments you can take to relieve your symptoms and lower your risk of other health problems.
How is early menopause treated?
The main treatment for early menopause is taking medicine to replace the hormones you’re missing. This could be by taking hormone replacement therapy (HRT) or the contraceptive pill.
A doctor might recommend that you take treatment until at least the average age of menopause, which is around 51. This is to help relieve your symptoms and lower your risk of developing certain health conditions.
You might not be able to take any kind of hormonal treatment if you’ve had certain types of cancer, like some breast cancers.
Can you have children after early menopause?
Early menopause can affect your ability to get pregnant. Any impact on your fertility can be upsetting, even if you weren’t planning to have children.
If you have POI, you may still be able to get pregnant with IVF using donor eggs or your own eggs if you’ve frozen them. Around 5% to 10% of women with POI get pregnant naturally.
What support is there for early menopause?
It can be challenging to go through menopause at any age. Early menopause may also come as a shock. Nearly three-quarters of women experience some sort of mental health impact during menopause. Treat yourself with extra compassion and self-care during this time. Opening up to others around you can also be really helpful.
When should I speak to a doctor?
If you’re under 45 and your periods have been getting less frequent or stopping altogether, speak to a doctor.
This article was medically reviewed by Dr Bryony Henderson, Lead GP at Livi.