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Early menopause (premature menopause)

• What is early menopause?
• How to know if you have early menopause
• Effects of early menopause
• More information on early menopause (premature menopause)

What is early menopause?

When menopause happens before age 40, it is considered early. Early menopause can be caused by certain medical treatments, or it can just happen on its own.

Medical treatments that may cause early menopause include:

• Chemotherapy or pelvic radiation treatments for cancer. These treatments can damage the ovaries and cause your periods to stop. Effects like having trouble getting pregnant can happen right away or several months later. The chances of going into menopause depend on the type and amount of chemotherapy that was used. Also, the younger a woman is, the lower the chances that she will experience menopause.
• Surgery to remove the ovaries. Surgical removal of both ovaries, also called a bilateral oophorectomy (OH-uh-fuh-REK-tuh-mee), causes menopause right away. A woman’s periods will stop after this surgery, and her hormones drop quickly. She may immediately have strong menopausal symptoms, like hot flashes and diminished sexual desire.
• Surgery to remove the uterus. Some women who have a hysterectomy (his-tur-EK-tuh-mee), which removes the uterus, are able to keep their ovaries. They will not enter menopause right away because their ovaries will continue to make hormones. But, because their uterus is removed, they no longer have their periods and cannot get pregnant. They might have hot flashes because the surgery can sometimes affect the blood supply to the ovaries. Later on, they might have natural menopause a year or two earlier than expected.

Sometimes menopause happens early on its own. Some possible causes include:

• Chromosome defects. Problems in the chromosomes can cause premature menopause. For example, women with Turner's syndrome are born without all or part of one X chromosome. The ovaries don't form normally, and early menopause results.
• Genetics. Women with a family history of early menopause are more likely to have early menopause themselves.
• Autoimmune diseases. The body's immune system, which normally fights off diseases, may mistakenly attack the ovaries and prevent them from making hormones. Thyroid disease and rheumatoid arthritis are two diseases that can cause this to happen.

When menopause comes early on its own, it sometimes has been called “premature menopause” or “premature ovarian failure.” But a better term is “primary ovarian insufficiency,” which describes the decreased activity in the ovaries. In some cases, women have ovaries that still make hormones from time to time, and their menstrual periods return. Some women can even become pregnant after the diagnosis.

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How to know if you have early menopause

Usually, menopause is confirmed when a woman hasn't had her period for 12 months in a row. To help determine if you may be reaching menopause, your doctor will ask if you've had signs like hot flashes, irregular periods, sleep problems, and vaginal dryness. But these signs are not enough to determine that you are reaching menopause.

Blood tests that can measure estrogen and related hormones, like follicle-stimulating hormone (FSH), can help determine if you have reached early menopause. You may choose to get tested if you want to know whether you can still get pregnant. Your hormone levels change daily, though, so you may need to have a test more than once to know for sure.

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Effects of early menopause

Women who enter menopause early can have symptoms similar to those of regular menopause. These can include hot flashes, mood changes, vaginal dryness, and decreased sex drive. For some women with early menopause, these symptoms are quite severe. In addition, women who go through menopause early may have a higher risk of certain health problems, such as heart disease and osteoporosis. Talk to your doctor about treatments like menopausal hormone therapy that can help with symptoms. Discuss ways to protect your health.

Women who want to have children and go through early menopause may feel extremely upset. If you want to be a parent, talk to your doctor about other options, like donor egg programs or adoption. Your doctor may suggest that you see an infertility specialist. You also can talk to your doctor or a therapist about painful feelings from the loss of fertility and other effects of reaching menopause early.

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More information on early menopause (premature menopause)

Read more from womenshealth.gov

• Menopause and Menopause Treatments Fact Sheet — This fact sheet answers frequently asked questions about menopause topics, including menopausal hormone therapy (MHT), coping with symptoms, and preventing diseases like osteoporosis and heart disease.
  http://www.womenshealth.gov/publications/our-publications/fact-sheet/menopause-treatment.cfm

Explore other publications and websites

• Do I Have Premature Ovarian Failure? — This article discusses premature ovarian failure (POF), its symptoms, and its patterns. Hormones, genes, the immune system, and other factors may all play a role in POF.
  http://www.nichd.nih.gov/publications/pubs/pof/
• Early Menopause Guidebook (Copyright © The North American Menopause Society) — This booklet explains premature menopause and its causes. It lists the symptoms and treatments associated with menopause and gives information on postmenopausal health concerns.
  http://www.menopause.org/edumaterials/earlyguidebook/emgtoc.aspx
• Health Care Maintenance for Women Undergoing Risk-Reducing Ovarian Surgery — This publication explains health concerns for women who are considering risk-reducing ovarian surgery that causes early menopause.
  http://ovariancancer.gog199.cancer.gov/PrematureMenopause_082404.pdf
• Medical Procedures That Cause Menopause (Copyright © The Cleveland Clinic Foundation) — This fact sheet explains surgical menopause and what procedures might cause it.
  http://www.clevelandclinic.org/health/health-info/docs/3200/3288.asp?index=10335
• Premature Ovarian Failure: Premature Menopause (Copyright © American Pregnancy Association) — This article describes how ovulation happens, how premature ovarian failure affects fertility, and what treatment options there are.
  http://www.americanpregnancy.org/womenshealth/pof.htm

Connect with other organizations

• Hormone Foundation, The
  http://www.hormone.org/
• International Premature Ovarian Failure Association
  http://www.pofsupport.org/
• The North American Menopause Society (NAMS)
  http://www.menopause.org

Content last updated September 29, 2010.

Resources last updated September 29, 2010.

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