Early menopause

The menopause usually starts between the age of 45 and 55.

Early menopause happens when your periods stop before the age of 45. It can happen by itself or as a side effect of some treatments.

Talk to your GP if you're under 45 and your periods are infrequent or have stopped.

Symptoms of early menopause

The main symptom of early menopause is infrequent periods or periods stopping altogether, that are not caused by other reasons such as pregnancy.

Other symptoms can include:

Early menopause causes an increased risk of osteoporosis and cardiovascular disease. This is because of low oestrogen hormone levels.

Causes of early menopause

The ovaries stop working

Early menopause can happen if your ovaries stop making enough hormones, particularly oestrogen.

This is sometimes called premature ovarian failure or primary ovarian insufficiency.

The cause is often unknown, but can include:

  • chromosome abnormalities, such as Turner syndrome
  • autoimmune diseases, where the immune system starts attacking body tissues
  • certain infections, such as tuberculosis, malaria and mumps in rare cases

Premature ovarian failure can sometimes run in families. This may be the case if a relative went through the menopause in their 20s or 30s.

Cancer treatments

Radiotherapy and chemotherapy can cause premature ovarian failure. This may be permanent or temporary.

Your risk of having an early menopause depends on:

  • your age – before puberty you can tolerate stronger treatment than when you're older
  • the treatment – different types of chemotherapy have different effects on the ovaries
  • the area treated – the risk is higher if you have radiotherapy around your brain or pelvis

Surgery to remove the ovaries

Removing both ovaries causes premature or early menopause.

If you have a hysterectomy, your surgeon may need to remove your ovaries. A hysterectomy is an operation to remove the womb.

Diagnosing early menopause

Your GP can diagnose early menopause based on your symptoms, family history and blood tests. The blood tests check your hormone levels.

Your GP may refer you to a specialist.

Treating early menopause

Treatment for early menopause is often to replace the missing hormones. This is usually the combined contraceptive pill or hormone replacement therapy (HRT).

Your GP may recommend you take this treatment until at least the age of natural menopause (about 51). This is to reduce your risk of developing osteoporosis and other conditions such as cardiovascular disease.

You may not be able to have hormonal treatment if you've had certain types of cancer, such as breast cancer.

Your GP will tell you about other treatment options and lifestyle changes to help protect your health.

If you still get symptoms, your GP can refer you to a specialist.

Getting support for early menopause

Going through the menopause early can be difficult and upsetting.

Permanent early menopause affects your ability to have children.

You may need fertility treatment using donated eggs. You can use your own eggs if you had some stored.

Surrogacy and adoption may also be options for you.

Counselling and support groups may be helpful:

  • The Daisy Network – a support group for premature ovarian failure
  • Cancer.ie – provides information about menopausal symptoms after cancer treatment

Content supplied by the NHS and adapted for Ireland by the HSE

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This project has received funding from the Government of Ireland’s Sláintecare Integration Fund 2019 under Grant Agreement Number 123.

Page last reviewed: 8 July 2021
Next review due: 8 July 2024

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