Early or Premature Menopause: Causes, Symptoms, Treatments

Last updated 11.28.2023 | by Sabrina Johnson | 11 Minutes Read

This article has been reviewed and fact checked by Dr. Karen Pike, a senior physician administrator and board-certified emergency room doctor actively working in northern California. Read more at our medical disclaimer page.


The terms early and premature menopause aren’t synonymous. They are two different aspects. From the name itself, it could be understood that when one goes through menopause way before the estimated time, that is referred to as early and premature menopause. If we look at the data, 5% of females go through menopause early, between 40 and 44. Contrastingly, 1% and 0.1% of females experience premature menopause below 40 and 30, respectively. 

A friend’s daughter went into menopause at 25 after going through chemotherapy for breast cancer. Not all chemos lead to permanent stoppage in your menses. Sometimes, it is temporary, and the menses resume in two years on average. 

Of late, some of my readers have requested that I enlighten them on early and premature menopause that happens before time. Keeping their needs in mind, I researched and gave my input on the topic. Do you know someone who has gone through menopause prematurely or early? Do you wish to learn more about the same? This article of mine will be of help to you. 

I have included the definitions of early and premature menopause and even mentioned the causes and symptoms of the same. Read on to learn more.

What is Early and Premature Menopause? Do They Mean the Same Thing?

As I have already mentioned, early and premature menopause aren’t interchangeable. They are two distinct entities.

Taking a cue from what I said above, a woman goes into early menopause if she experiences it between 40 and 44 years of age. Menopause happening below 40 is referred to as premature menopause. I have made a tabular presentation of the facts I mentioned to give you a better idea. 

Type of MenopauseAge (in years)Percentage of women affected
Early40-44Around 5%
PrematureBelow 401% (0.1% in those below 30)

So before you panic too much, from the data, you can see that premature and early menopause is a rare occurrence. Not everyone experiences it.

Is Premature Menopause the Same as Premature Ovarian Failure?

Many confuse between premature menopause and premature ovarian failure. Though used interchangeably, they aren’t the same thing. In premature or early menopause, the ovaries stop releasing eggs, and your reproductive years end. Your periods stop entirely, and there isn’t any chance of getting pregnant.

This isn’t the case in premature ovarian failure, also called primary ovarian insufficiency (POI). The periods could stop abruptly or over a while after occurring irregularly. But there are chances of the period to come back again. In such cases, the menstrual cycle might be irregular and occasional. A woman can still become pregnant since her ovulation hasn’t stopped.

What Are the Causes of Early and Premature Menopause?

Causes of Early and Premature Menopause

In most cases, a woman can go into early or premature menopause due to a medical emergency. That’s not the only reason, though. There are other causes also. You will be surprised to know that one could sometimes experience menopause early or prematurely without a reason. It holds good for 50% of premature or early menopause cases.

1. Cancer Treatment

Some cancer treatments may bring in early menopause. Certain kinds of chemo may cause damage to the ovaries, lessening their capacity to produce eggs. Under such circumstances, menopause could start immediately or a few months after the procedure (chemo). Not every chemo puts you at risk of early menopause – it depends on the type and the amount of the chemo drug that has been given. The same goes for radiation. If you receive rays around your pelvic area, your ovaries might get damaged.

Medical menopause could sometimes be temporary and resume in 8 months – 2 years after the treatment stops. However, in some cases, it could also be a permanent occurrence, especially if the ovaries have been removed through surgery.

2. Primary Ovarian Insufficiency (Premature Ovarian Failure)

POI, or primary ovarian insufficiency, can lead to early or premature Menopause. It mostly happens in women below 40. The ovaries stop functioning in a manner that they actually should. This could lead to menopause as an aftereffect. However, the outcome of POI may not always be menopause. The periods could stop and start again, and women still have a chance of getting pregnant.

3. Surgical Treatment

Sometimes, women may experience surgical menopause if both their ovaries have been removed after surgery. In this context, I would like to mention about hysterectomy.

Let me explain what it is before getting into the details for those who aren’t aware of it. It’s a surgery where the uterus is removed. It could even involve the removal of the cervix, fallopian tubes, and ovaries, which isn’t always the case. 

So, if one has undergone a total hysterectomy involving the removal of the ovaries, then one would experience menopause after the surgery.

However, suppose both the ovaries or either one have been spared. In that case, a woman won’t experience menopause right away. Yet, she is still likely to have it earlier than the time she would have had it hadn’t she gone for a hysterectomy.

4. Family History

If you’ve had a history of premature ovarian failure, it could be carried on to the following generations. It could be that you, your mother, or any relatives in your family had menopause in their 20s or 30s, then your daughter could be at risk of the same.

5. Early Periods

According to a study, women having their first periods at 11 years of age or earlier than that were at an increased risk of premature or early Menopause. The study assessed that women whose menstrual cycle commenced at or before 11 years of age were at a 30% and 80% risk of early and premature menopause, respectively.

6. Chromosomal Abnormalities

Turner Syndrome is a chromosomal abnormality affecting females, 1 of 2500 females. Women with this syndrome have short stature, and the symptoms get highlighted by the time they turn 5. Their ovaries become dysfunctional either from birth or in their childhood. For some, the ovaries could function until their teens or till the time they are young adults. Then it stops working, leading to premature menopause.

Fragile X Syndrome, a genetic disorder more common in males, can also be seen in females. The affected females are at an increased risk of low fertility and early Menopause.

7. Autoimmune Diseases

Autoimmune diseases such as thyroid, connective tissue disease, and rheumatoid arthritis can affect estrogen levels increasing the risk of early menopause.

8. Smoking

Smoking is considered to be another reason for early menopause. Those who smoke are at an increased risk of early Menopause by a year on average than those who don’t smoke. Several studies have also established a direct relationship between early Menopause and active smoking.

How Do You Know That You Are in Your Early or Premature Menopause? 9 Probable Symptoms

Know 9 Probable Symptoms of Early or Premature Menopause

The signs of early and premature menopause are the same as those of women during perimenopause. The low estrogen levels result in many bodily changes, resulting in hot flashes, night sweats, mood swings, and other discomforts women face just before Menopause.

1. Hot Flashes

Hot flashes are one of the most familiar symptoms of menopause, and you’ll feel that if you have early menopause as well. That warmth across your neck, face, and chest is annoying. Your face may look flushed, while the skin looks red and blotchy. You could hold the low estrogen levels responsible for these sudden hot flashes.

2. Vaginal Dryness

Estrogen is responsible for lubricating the vagina and maintaining its elasticity and thickness. When there’s a reduction in the levels of this hormone, the walls get dried up, appear inflamed, and even become thin. This leads to pain and discomfort.

3. Night Sweats

Estrogen and progesterone play a significant role in regulating your body temperature. When levels fluctuate and reduce before and during menopause, your brain finds it difficult to maintain your body temperature. The outcome is a hot flash followed by night sweats since your body is trying hard to cool down. Around 75% of women experience night sweats and hot flashes in menopause.

4. Troubled Sleeping

Hot flashes and night sweats make you feel miserable and are responsible for the insufficient sleep you experience in menopause. The National Sleep Foundation mentions that about 61% of women have trouble sleeping during menopause.

Sleep difficulty was something that bothered me to the core when I was transitioning into menopause. It wasn’t early or premature, yet going night after night with scanty sleep is troublesome. If your periods have stopped quite earlier than they should, then your stress and trauma could be even more, taking an increased toll on your sleep. 

5. Frequent Urge to Urinate

Estrogen helps strengthen tissues of the urinary tract and helps to control bladder function. During menopause, estrogen levels decrease, increasing your urge to urinate more often due to bladder incontinence.

6. Soft Breasts

The fluctuating and changing hormone levels cause fluid to accumulate in your breasts, making them appear tender and swollen. The breasts may even shrink in size or look too big, all due to the fluctuating hormones.

7. Skin Changes

Estrogen contributes to the increased supply of collagen. Low estrogen means low collagen. Thus, the skin loses its elasticity and appears dry, wrinkled, and itchy. As per studies, around 30% of the collagen is lost in the initial 5 years after the onset of Menopause. Then the loss is slow and gradual, 2% each year, and continues for the following 20 years or even more if you have had early Menopause. Loss of collagen will therefore rob the skin of its firmness, giving it a shaggy look.

8. Thinning of Hair

Hormonal imbalances are responsible for shrinking hair follicles, causing hair to become thin and fall rapidly. You’ll see more of your hair on your brush, sink, and floor. That means you are going through hair loss.

9. Irregular Periods

Irregular periods are a key marker indicating that you’ll be in menopause soon. Your flow becomes inconsistent, varying from extremely high to very low. Your cycle varies, sometimes long and sometimes lasting for a short span.

You may even have irregular periods, or there may be spotting in between your cycle. However, if you have had surgery where the ovaries have been removed, then you will slip into menopause right away, without prior warning from your body.

How is Premature or Early Menopause Diagnosed?

When you have symptoms like mood swings, hot flashes, or night flashes quite often, and you aren’t 45, you must talk to a medical practitioner at the earliest. The doctor may ask you several questions like

  • How regular are your menstrual cycles?
  • What symptoms are you going through?
  • What medications do you take?
  • If you have any underlying conditions?
  • When did you have your first period?
  • Is there any family history of early menopause?

He will even go for bloodwork to check your hormone levels, mainly FSH (Follicle-Stimulating Hormone). When you are nearing menopause, the FHS levels are high. A physical examination will also be needed. No periods for twelve months mostly confirm that menopause has started.

Treatment for Early Menopause

The treatment of premature and early menopause varies from one woman to the other, depending on the reason behind the Menopause.

Most doctors recommend HRT (Hormone Replacement Therapy) to compensate for the missing hormones. In this way, you will be at less risk of health problems that you could suffer from because of premature or early Menopause. HRT is advised until the woman turns 51, the average age for Menopause. However, HRT isn’t a safe option for breast cancer patients. Moreover, you should know the boons and banes of hormone therapy before going for it.

Besides these, you will even need symptomatic treatment to deal with the associated symptoms of Menopause, like hot flashes, depression, sleep problems, etc.

FAQs

Q. Can early or premature menopause be reversed?

No, there isn’t a way in which you can reverse Menopause and get your ovaries to function again. But, the symptoms can be managed with a doctor’s advice. It would be best if you even led a quality life to stay healthy.

Q. Can you get pregnant if you have premature or early menopause?

If you have gone without periods for a year, that means you aren’t ovulating anymore. So there aren’t any chances of getting pregnant. If you want to start a family, then a fertility expert’s opinion will help. You could go for IVF (In vitro fertilization) or even opt for adoption.
If premature Menopause is due to POI (primary ovarian insufficiency), then there are chances that your periods could come back even after it has stopped abruptly.

Q. Can stress be one of the triggers for early menopause?

Menopause brings in stress. But stress cannot be deemed the main reason behind early or premature menopause. Yet if your anxiety levels are high, you need to seek a doctor’s advice for tips to manage stress.

Conclusion

Menopause itself comes with a lot of emotional and psychological changes. When you get it early or prematurely before the stipulated age, the ordeal could be even more. Early menopause means that you’ll have to go without estrogen for a longer time. This could put you at risk of heart problems, osteoporosis, neurological diseases, and so on. Therefore taking care of your physical and mental health is of utmost importance.

References:

  1. ncbi.nlm.nih.gov
  2. medlineplus.gov
  3. medlineplus.gov
  4. medlineplus.gov
  5. clevelandclinic.org

Author

  • Sabrina Johnson

    Meet Sabrina Johnson, a compassionate author and a seasoned expert in Obstetrics and Gynecology. She is a driving force behind Simply Menopause, where her extensive medical knowledge and empathetic nature come together to empower women in their menopausal journey. Sabrina offers culturally sensitive guidance and support through her approachable writing, making her a trusted friend on the path to menopause wellness.