Premature or early menopause, or premature ovarian insufficiency (POI), is defined as being menopause that happens before the age of 40. Early menopause is estimated to affect 1% of women under the age of 40 years and 0.1% of women under the age of 30 years.
What is early or premature menopause?
Early menopause happens when ovaries stop making hormones and periods stop at a younger age than usual. This can happen naturally or for a medical reason, such as when both ovaries are removed in a hysterectomy.
Early menopause can have the same causes. The only difference is the age at which it happens. Menopause that happens before age 45 is called early menopause. Menopause that happens before age 40 is called premature menopause.
Women who have gone through early menopause cannot get pregnant.
What causes early menopause?
Early menopause can happen on its own for no clear reason, or it can happen because of certain surgeries, medicines, or health conditions.
Family history
Women with a family history of early menopause are more likely to experience it themselves.
Smoking
Women who smoke may reach menopause as much as two years before non-smokers. They may also get more severe early menopause symptoms.
Chemotherapy or pelvic radiation treatments for cancer
These treatments can damage your ovaries and cause your periods to stop forever or just for a while. You also may have trouble getting pregnant or not be able to get pregnant again.
Not all women who have chemotherapy or radiation will go through menopause. The younger a woman is at the time of chemotherapy or radiation, the less likely she is to go through menopause.
Surgery to remove the ovaries
Surgical removal of both ovaries, called a bilateral oophorectomy may cause menopausal symptoms right away. Your periods will stop after this surgery, and your hormone levels will drop quickly. You may have strong menopause symptoms, like hot flashes and issues with your sexual wellbeing.
Surgery to remove the uterus
Some women who have a hysterectomy, which removes the uterus, can keep their ovaries. If this happens, you will no longer have periods, and you cannot get pregnant. But you will probably not go through menopause right away because your ovaries will continue to make hormones. Later on, you might have natural menopause a year or two earlier than expected.
Certain health conditions
Autoimmune diseases, such as thyroid disease and rheumatoid arthritis
Although rare, the body’s immune system, which normally fights off diseases, may mistakenly attack the ovaries and keep them from making hormones.
HIV and AIDS
Women with HIV, whose infection is not well controlled with medicine, may experience early menopause. Women with HIV may also have more severe hot flashes than women without HIV.
Missing chromosomes
Women born with missing chromosomes, or problems with chromosomes, can go through menopause early. For example, women with the condition called Turner’s syndrome are born without all or part of one X chromosome, so their ovaries do not form normally at birth and their menstrual cycles, including the time around menopause, may not be normal.
Chronic fatigue syndrome
Women with myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) have extreme tiredness, weakness, muscle and joint pain, memory loss, headache, unrefreshing sleep, and other symptoms. Research has found that women with ME/CFS are more likely to have early or premature menopause
What are the signs of early menopause?
You know you have gone through menopause when you have not had your period for 12 months in a row. If you think you may be reaching menopause early, talk to your doctor.
Your doctor will talk to you about the signs of early menopause such as hot flashes, irregular periods, sleep problems, and vaginal dryness.
Your doctor or nurse may give you a blood test to identify early menopause. These tests measure oestrogen and related hormones, like follicle-stimulating hormone (FSH).
You may choose to get tested if you want to know whether you can still get pregnant. Your doctor will test your hormone levels in the first few days of your menstrual cycle (when bleeding begins).
What are the effects of early menopause?
Women who go through early menopause may have symptoms or health problems similar to those of regular menopause. But some women with early menopause may also have:
Higher risk of serious health problems
Serious health issues, such as heart disease and osteoporosis, may be more likely since women will live longer without the health benefits of higher oestrogen levels.
Talk to your doctor or nurse about steps to lower your risk for these health problems.
Severe early menopause symptoms
Talk to your doctor about treatments to help with menopause symptoms if they affect your daily life.
Sadness or depression
You may feel sad at the early loss of fertility or the change in your body. Talk to your doctor if you have symptoms of depression, including less energy or a lack of interest in things you once enjoyed that lasts longer than a few weeks. Your doctor can recommend specialists who can help you deal with your feelings.
Your doctor can also discuss options, such as adoption or donor egg programs, if you want to have children.
Supporting your health at Benenden Hospital
It’s important not to suffer in silence during the menopause. We’re experts at treating women’s health concerns and offer a range of private gynaecology services, in a comfortable, discreet and reassuring environment in the heart of the Wealden countryside.
Contact our Private Patient team in confidence today via Livechat, by completing our online form or by calling 01580 363158.
Published on 23 June 2022