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Premature menopause

Menopause is a naturally occurring stage in women life which means the cessation of menstrual periods – it is a time of the end of women’s reproductive function and reproductive years. Medically menopause is defined as the absence of menstrual periods for 12 consecutive months. Usually menopause happens between the ages of 45 and 55. During menopause, a women’s reproductive system changes, resulting in a discontinuation of estrogen production, the menstrual cycle, and egg maturation. What about premature menopause?

Sometimes women could have premature menopause – around the age of 40. There are many reasons why some women get menopause early, it can be due to genetics, medical procedures or an illness.

Premature menopause causes

There are different reasons why early menopause can happen. Main premature menopause causes can be divided into two main groups – medical and/or genetic.

Woman in premature menopause

Women could have earlier menopause because of some medical procedures or surgeries or women could have specific diseases which run in the family. There is a high chance that a woman who has undergone chemotherapy or other radiation procedures can have premature menopause. If the person has a family member with hypothyroidism, lupus or Graves’ disease then there is a high chance that she will have premature menopause.

It is already proved that menstrual cycles are genetically and hormonally determined. What does it mean practically? It means in most cases and in many families the type of menstrual cycle, the duration of the menstruation, the fertility, the age of beginning of the period and the age of menopause are very similar in all female generations starting from grand-grandmother to grand-mother to mother and to grand- daughters. Women with a family history of premature menopause are more likely to have early menopause themselves.

Chromosome defects
Scientists discovered that problems in the chromosomes can cause early menopause. For example, women with Turner’s syndrome are born without all or part of one X chromosome. The ovaries don’t function normally and it could end up with premature menopause.

Autoimmune diseases
Autoimmune diseases arise from an overactive immune response of the body against substances and tissues normally present in the body. In other words, the body actually attacks its own cells (Wikipedia). In some very specific cases body produce so called “antibodies” again own ovaries – body’s immune system, which normally fights off diseases, could mistakenly “attack” the ovaries and prevent them from making hormones. Thyroid disease and rheumatoid arthritis are two diseases that can cause this to happen.

Actually menstrual cycles are disturbed because the autoimmune diseases dramatically reduce the production of female hormones and as a consequence periods stopped unexpectedly resulting in premature menopause.

Hysterectomy is the surgical removal of the uterus. Hysterectomy could be total or partial. In some cases women who have a hysterectomy are able to keep their ovaries. They will not enter menopause right away because their ovaries will continue to make hormones. But, because their uterus is removed, they no longer have their periods and cannot get pregnant. They might have hot flashes because the surgery can sometimes affect the blood supply to the ovaries. Later on, they might have natural menopause a year or two earlier than expected.

Ovariectomy (so called “Oophorectomy”) is the surgical removal of an ovary or ovaries.
Surgical removal of both ovaries called “bilateral oophorectomy” causes premature menopause right away (just after operation). After this suregery women will experience amenorrhea (absence of periods) because of rapid hormonal drop.
Most women after bilateral ovariectomy have strong menopausal symptoms including hot flashes with night sweats, mood swings, reduced libido, etc.


Some types of cancer require chemotherapy or pelvic radiation treatments. These treatments can damage the ovarian tissues and cause menstrual disturbances up to amenorrhea (absence of periods). The chances of going into menopause after chemotherapy and after radiation treatments depend on the type and duration of these therapy required and used. In general younger women have more chances for full recovery and less chances for premature menopause.

Premature Ovarian Failure
The term premature ovarian failure describes a stop in the normal functioning of the ovaries in a woman younger than age 40. Some people also use the term primary ovarian insufficiency to describe this condition. It is also known as hypergonadotropic hypogonadism.

Health care providers used to call this condition premature menopause, but premature ovarian failure is actually much different than menopause:

  • In menopause, a woman will likely never have another menstrual period again; women with premature ovarian failure are much more likely to get periods, even if they come irregularly.
  • A woman in menopause has virtually no chance of getting pregnant; a woman with premature ovarian failure has a greatly reduced chance of getting pregnant, but pregnancy is still possible.

Premature menopause symptoms

Symptoms of premature menopause are very similar to normal menopause because it is the same menopause phase that is occurring just several years earlier.

Premature menopause symptoms include missed periods, irregular periods, periods that are lighter or heavier than usual, hot flashes, mood changes, vaginal dryness and decreased sex drive. Sometimes premature menopause symptoms can be quite severe. In addition, women who go through premature menopause may have a higher risk of certain health problems, such as heart disease and osteoporosis.

Premature menopause diagnosis

  • In all cases of menstrual disturbances before 40, professional expertise and opinion is needed.
  • You can speak about premature menopause if your periods stopped before 40 for 12 consecutive months.
  • Important indicators for premature menopause would be very typical symptoms including hot flashes and night sweats, absence of periods for minimum 12 months, sleep problems, vaginal dryness and reduced libido.
  • Very important indicators for premature menopause are hormonal tests. Blood tests that can measure estrogen and related hormones, like Follicle Stimulating Hormone (FSH), can help determine if you have reached early menopause.
  • When estradiol levels of a woman is at a low level, this means that the ovaries are suffering and/or failing and not releasing estrogen hormones anymore. If the estradiol levels hit below 36 then the woman is undergoing menopause already. Another way to check premature menopause is FSH test – when estrogen production is low, FSH levels will increase. When your FSH levels rise above 30 or 40 mIU/mL, it usually indicates that you are undergoing premature menopause.
Premature menopause cannot be treated because it is a natural occurrence in a woman’s body. Unfortunately, it is not reversible too.

Premature menopause risks

  • As during early menopause women have low estrogen levels, it is becoming a risk factor for ovarian and colon cancer.
  • Periodontal gum disease, some tooth loss and cataract formation in the eyes are also expected risks during premature menopause.
  • Women undergoing pre-mature menopause are very prone to osteoporosis.
  • Women who have menopause during their late 30s and early 40s are usually infertile.
  • Women in pre-mature menopause are on higher risk of heart diseases and stroke.

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