Menopause is a natural milestone in every woman’s life. It happens when your body stops ovulating and ceases to menstruate for 12 consecutive months. For many women, menopause occurs between the ages of 45 and 55. In the UK, women typically reach the menopause at 51 (1).
However, around 1 in 100 women experience the menopause before the age of 40 (2). This early onset is medically known as premature menopause or premature ovarian insufficiency. Menopause between 41 and 45 years is called early menopause (3).
What is premature menopause?
Premature menopause occurs when your monthly period ceases well before the age of ‘normal’ menopause — when you’re still in your teens, 20s, or 30s.
Premature menopause happens when your ovaries stop producing eggs years before they should. Because of this, your ovaries are unable to effectively produce the hormones that serve critically important roles for your health and wellbeing — namely, oestrogen and progesterone.
What causes premature menopause?
There are many possible explanations for premature menopause. In some instances, medical treatments, such as chemotherapy or radiation therapy, or the surgical removal of the ovaries, can induce premature menopause (4).
Sometimes, there’s no apparent reason why a woman’s ovaries stop working. Primary ovarian insufficiency — where a woman’s ovaries spontaneously stop ovulating and producing eggs — may bring about premature menopause (5).
Beyond this, genetics, lifestyle factors, and other health conditions can play a role in the development of premature menopause.
Genetics
Defects in the female sex chromosome (the X chromosome) or other genes impacting the function of sex hormones can lead to premature menopause.6 A common cause is Turner syndrome, in which one of the X chromosomes is missing. Rare genetic conditions, like Fragile X syndrome, can also trigger premature menopause.
Autoimmune diseases
Autoimmune conditions occur when the body’s immune system attacks its tissues. Sometimes, if the ovaries are damaged, it can result in premature menopause. Only 5% of women with premature ovarian insufficiency experience the condition due to an autoimmune disease (7).
Lifestyle choices
Your lifestyle choices may also play a role in the development of premature menopause. Smoking, in particular, is known to have anti-oestrogen effects that may contribute to early menopause.
In a meta-analysis, researchers reported that long-term or regular smokers are more likely to start menopause one to two years earlier than those who don’t smoke (8).
Since fat tissue stores oestrogen, empirical data suggests being underweight — that is, having a body mass index (BMI) below 18.5 — may also factor into premature menopause (9).
Signs and symptoms of early menopause
The symptoms of premature menopause are much like those of a typical menopause, including (10):
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Mood swings
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Intimate dryness
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Low libido
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Weight gain
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Aches and pains
How is premature menopause diagnosed?
If you suspect that you may be experiencing premature menopause, you may want to see your GP. Premature menopause often begins with irregular periods. You may experience heavy bleeding, notice spotting, have periods that last longer than a week, or notice a longer amount of time between periods.
At this point, your doctor may run tests to rule our pregnancy or other causes of menstrual irregularities. From there, your doctor can diagnose early menopause based on your symptoms, family history, and blood and hormone levels.
For instance, your doctor will often measure levels of follicle-stimulating hormone (FSH) in the blood to ascertain if you’re approaching menopause (11). This test will also determine the function of your ovaries. FSH causes the ovaries to produce oestrogen, so circulating levels of this hormone spike when oestrogen dips. FSH levels greater than 40 mIU/ml signal the menopause.
Medical interventions for premature menopause
There are no known treatments to prevent or reverse premature menopause. Nevertheless, there are specific medical interventions available to help manage the challenging symptoms.
Your GP may prescribe Hormone Replacement Therapy (HRT) or the combined contraceptive pill to accommodate for your missing hormones. You usually need to take these medications long-term — beyond the traditional age of natural menopause — to provide lasting protection.
How to cope with early menopause
Experiencing premature menopause in your 20s and 30s can be emotionally devastating. At such a young age, you may have to contend with fears about ageing, long-term relationships, self-esteem and medication.
In particular, premature menopause can force you to confront your fertility. Going through this hormonal transition so early can impact your ability to conceive naturally, which can be deeply upsetting. It is, however, still possible to have children through IVF using the donated eggs, or your own if you have them frozen. You may also want to consider surrogacy or adoption.
Lastly, many women find psychological counselling and support groups a helpful way to come to terms with premature menopause. Talking through your feelings and fears can help you come to terms with your premature menopause, and many women find comfort in finding a community of women who have a shared experience.
To find out more information about how to manage menopause symptoms, as well as resources explaining the science behind the menopause, check the articles on our Menopause hub.
References:
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nhs.uk. 2020. Menopause. Available online: https://www.nhs.uk/conditions/menopause/
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nhs.uk. 2020. Menopause. Available online: https://www.nhs.uk/conditions/menopause/
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nhs.uk. 2020. Menopause. Available online: https://www.nhs.uk/conditions/early-menopause/
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Daisy Network. 2020. What Is POI Daisy Network. Available online: https://www.daisynetwork.org/about-poi/what-is-poi/
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Daisy Network. 2020. What Is POI Daisy Network. Available online: https://www.daisynetwork.org/about-poi/what-is-poi/
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Stolk L. et al., Meta-analyses identify 13 loci associated with age at menopause and highlight DNA repair and immune pathways. Nature genetics. 2012;44(3):260-268.
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Szegda K. et al., Adult adiposity and risk of early menopause. Human Reproduction. 2017;32(12):2522-2531.
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(10) Daisy Network. 2020. Signs And Symptoms Of Premature Ovarian Insufficiency. Available online: https://www.daisynetwork.org/about-poi/signs-and-symptoms/
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(10) Daisy Network. 2020. Signs And Symptoms Of Premature Ovarian Insufficiency. Available online: https://www.daisynetwork.org/about-poi/signs-and-symptoms/
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Disclaimer: The information presented by Nature's Best is for informational purposes only. It is based on scientific studies (human, animal, or in vitro), clinical experience, or traditional usage as cited in each article. The results reported may not necessarily occur in all individuals. Self-treatment is not recommended for life-threatening conditions that require medical treatment under a doctor's care. For many of the conditions discussed, treatment with prescription or over the counter medication is also available. Consult your doctor, practitioner, and/or pharmacist for any health problem and before using any supplements or before making any changes in prescribed medications.
Olivia
Olivia Salter has always been an avid health nut. After graduating from the University of Bristol, she began working for a nutritional consultancy where she discovered her passion for all things wellness-related. There, she executed much of the company’s content marketing strategy and found her niche in health writing, publishing articles in Women’s Health, Mind Body Green, Thrive and Psychologies.
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