Early menopause happens when your periods stop before age 45. Menopause before age 40 is called premature menopause or premature ovarian insufficiency (POI).
Early or premature menopause can happen by itself or as a side effect of some treatments.
Non-urgent advice: Contact your GP if
you're under 45 and:
- your periods are less frequent or have stopped
Symptoms of early and premature menopause
The main symptom of early and premature menopause is when you're not pregnant and your period becomes less frequent or stops.
The common symptoms of early and premature menopause are the same as menopause.
They include:
- hot flushes
- night sweats
- difficulty sleeping
- low mood or anxiety
- problems with memory or concentration
- vaginal dryness and pain, itching or discomfort
- reduced interest sex (libido)
- discomfort during sex
- fatigue
- headaches
- heart palpitations (a fast-beating, fluttering or pounding heart)
- recurring urinary tract infections (UTIs)
- lack of energy
- loss of muscle
- weight gain
- joint aches and pains
But you may also have no symptoms.
Premature menopause increases your risk of developing other problems, such as osteoporosis (weak bones) and cardiovascular disease.
Causes of early and premature menopause
Early or premature menopause can happen if your ovaries stop making enough hormones, particularly oestrogen.
In most cases the cause is not known.
Some possible causes may 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
- cancer treatments
- if you have removed your ovaries - this may happen when you have surgery to remove your womb (hysterectomy)
Early or premature menopause can sometimes run in families. This may be the case if a relative went through menopause in their 20s or 30s.
Cancer treatments
Radiotherapy and chemotherapy can cause early or premature menopause. This may be permanent or temporary.
Your risk of having early menopause depends on:
- your age - before puberty you can tolerate stronger treatment than when you're older
- if you had cancer 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
Diagnosing early and premature menopause
Your GP will talk to you about your symptoms and family history.
You'll have blood tests to look your hormone levels.
They may refer you to a:
- GP that specialises in menopause care
- gynaecologist - a doctor that specialises in women's health
- endocrinologist - a doctor that specialises in conditions related to your hormones
Treating early and premature menopause
You'll usually be prescribed medicine to treat early or premature menopause. This medicine helps to replace your missing hormones.
This is usually hormone replacement therapy (HRT). But sometimes it may be the combined contraceptive pill.
You may be advised to stay on this treatment until you are around age 51. This is when natural menopause usually happens. This is to lower your risk of developing problems such as osteoporosis (weak bones) and cardiovascular disease.
You may not be able to have hormonal treatment if you've had certain types of cancer, such as breast cancer. This is because there is a higher risk of the cancer coming back.
Your GP may refer you to a specialist complex menopause clinic.
Early and premature menopause and fertility
Early or premature menopause may affect your ability to have children. This is because you do not release an egg or ovulate every month.
A small number of women may ovulate and become pregnant. If you do not want to become pregnant, continue to use contraception.
If you have early or premature menopause and want to have children, there are options available.
For example:
- egg donation
- surrogacy
- adoption
Your GP can refer you to a fertility specialist to discuss your options.
Getting support for early and menopause
There is support available for women who experience early or premature menopause.
Counselling may help you.
You can also contact a support group and talk to someone who may have had a similar experience as you.
The National Infertility Support and Information Group (NISIG)
Get emotional support if you have menopause symptoms after cancer treatment - cancer.ie
Content supplied by the NHS and adapted for Ireland by the HSE
