Early menopause happens when a woman's periods stop before the age of 45. It can happen naturally, or as a side effect of some treatments.
For most women, the menopause starts between the ages of 45 and 55.
If you're under 45 and have noticed your periods becoming infrequent or stopping altogether, you should speak to your doctor.
Causes of early menopause
The ovaries stop working
Early menopause can happen naturally if a woman's ovaries stop making normal levels of certain hormones, particularly the hormone oestrogen.
This is sometimes called premature ovarian failure, or primary ovarian insufficiency.
The cause of premature ovarian failure is often unknown, but in some women it may be caused by:
- chromosome abnormalities – such as in women with Turner syndrome
- an autoimmune disease – where the immune system starts attacking body tissues
- certain infections, such as tuberculosis, malaria and mumps – but this is very rare
Premature ovarian failure can sometimes run in families. This might be the case if any of your relatives went through the menopause at a very young age (20s or early 30s).
Your risk of having an early menopause will depend on:
- your age – girls who haven't yet reached puberty can tolerate stronger treatment than older women
- the type of treatment you're given – different types of chemotherapy may affect the ovaries differently
- where on your body any radiotherapy is focused – your risk of developing premature menopause is higher if you have radiotherapy treatment around your brain or pelvis
Surgery to remove the ovaries
Surgically removing both ovaries will also bring on premature or early menopause.
For example, the ovaries may need to be removed during a hysterectomy (an operation to remove the womb).
Signs of early menopause
The main symptom of early menopause is periods becoming infrequent or stopping altogether without any other reason (such as pregnancy).
Some women may also get other typical menopausal symptoms, including:
- hot flushes
- night sweats
- vaginal dryness and discomfort during sex
- difficulty sleeping
- low mood or anxiety
- reduced sex drive (libido)
- problems with memory and concentration
Diagnosing early menopause
Your doctor should be able to make a diagnosis of early menopause based on your symptoms, your family history, and blood tests to check your hormone levels.
You may be referred to a specialist.
Early menopause treatments
Your doctor will probably recommend that you take this treatment long term, beyond the "normal" age of natural menopause (around 52 on average), to give you lasting protection.
If you've had certain types of cancer, including some breast cancers, you may not be able to have hormonal treatment.
Your doctor will talk to you about other treatment options and lifestyle changes you can make to help protect your health.
If you're still getting symptoms, your doctor can refer you to a specialist menopause centre.
Read more about treating the symptoms of the menopause.
Going through the menopause early can be very difficult and upsetting.
Permanent early menopause will affect your ability to have children naturally. This can be very distressing to women of all ages.
You may still be able to have children by using IVF and donated eggs from another woman, or using your own eggs if you had some stored. Surrogacy and adoption may also be options for you.
Counselling and support groups may be helpful.