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Premature Menopause
If you reach menopause before the age of 40, you have what is considered premature menopause, or early menopause. Premature menopause can happen naturally or as a result of surgery or other medical interventions. Women who reach menopause early generally have the same symptoms as those who enter menopause in their forties and fifties.
Natural Early Menopause
Natural premature menopause is rare: only about 1% of American women enter menopause at an early age. For most of these women, it occurs around ages 27–30. Premature menopause can be caused by the following:
- Genetics: Women with a family history of premature menopause are more likely to experience premature menopause themselves.
- Chromosome defects: Some women with chromosome defects, such as Turner’s syndrome, are born with defects that can affect the ovaries and result in early menopause.
- Autoimmune diseases: Some women with autoimmune diseases, such as thyroid disease and rheumatoid arthritis, have immune systems that mistakenly attack parts of their reproductive systems, thereby preventing ovaries from producing hormones and leading to premature menopause.
Induced Menopause
Premature menopause due to outside circumstances, such as surgery, is known as induced menopause. Induced menopause is more common than early menopause that occurs naturally. Causes of induced menopause include:
- Hysterectomy (surgical removal of the uterus)
- Oophorectomy (surgical removal of one or both ovaries)
- Chemotherapy
- Radiation
Though chemotherapy and radiation don’t necessarily result in early menopause, surgery that removes both ovaries always does. If only one of your ovaries is removed in an
oophorectomy, you can continue to produce estrogen and ovulate. If you have a hysterectomy but your ovaries remain intact, you might also continue to ovulate. However, you’ll reach menopause earlier than you might have otherwise.
Premature Ovarian Failure
When the ovaries prematurely stop producing eggs before the age of 40, the condition is called premature ovarian failure. Premature ovarian failure can lead to premature menopause. Unlike the other causes of premature menopause, however, premature ovarian failure isn’t always permanent and can often be reversed.
Diagnosis of Premature Menopause
In many cases, doctors can diagnose premature menopause by speaking to you about your symptoms. In some cases, however, these signs and symptoms aren’t enough to confirm diagnosis, and a blood test might be administered to check hormone levels. High levels of follicle-
stimulating hormone (FSH) signal menopause.
Symptoms of Premature Menopause
Though most women who have premature menopause experience normal perimenopause symptoms (see “Symptoms of Perimenopause” in What Is Perimenopause?), they may experience certain symptoms more severely. For instance, women who have had both ovaries removed often experience severe hot flashes, as hormone production drops suddenly rather than gradually. This drastic change can be a shock to the system, resulting in stronger symptoms.
Treatment During Premature Menopause
If you experience early menopause, whether natural or induced, your doctor will likely encourage you to take hormone therapy (HT). At a young age, your body depends on estrogen for overall health. Without it, you face a greater risk of developing osteoporosis and heart disease as you grow older. Doctors generally prescribe HT until the age of 51. The hormone doses that you’re given will likely be higher if you’re experiencing premature menopause, since the goal is to replace the estrogen that would normally be in your system.
Infertility Issues
If you enter menopause at an early age, the adjustment can take an emotional toll. Losing
your fertility earlier than expected can be a devastating experience. If you’re facing induced
menopause, you do have a number of ways to keep your fertility options open—for
example, you might freeze your eggs prior to impending surgery or cancer treatments. If you choose this route, you can later have your eggs implanted in your own uterus if it remains intact; alternatively, you can seek a surrogate. Another possibility is to use donor eggs if you lose your ovaries but retain your uterus. For more information on these options, see the Quamut guide to Infertility.
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