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What is premature menopause? — Menopause is the time when a person naturally stops having monthly periods. The ovaries stop releasing eggs and stop making the hormones estrogen and progesterone. Menopause usually occurs between the ages of 45 and 55. But in some people, it happens earlier.
Doctors use the term "early menopause" in people who go through menopause between the ages of 40 and 45 years. For people younger than 40, doctors use the term "premature menopause." Premature menopause can happen for different reasons. For example, certain types of cancer treatment can cause the ovaries to stop working normally and periods to stop. If the ovaries are removed with surgery, this will also cause periods to stop. But sometimes, a person stops having periods before age 40 for no clear reason. This type of premature menopause is called "primary ovarian insufficiency."
Some people who are going through premature menopause keep having periods every once in a while. They might even be able to get pregnant during this time. But eventually the ovaries stop working, monthly periods stop, and it is no longer possible to get pregnant naturally.
What causes premature menopause? — Premature menopause happens when something causes the ovaries to stop working well. Normally, the ovaries release an egg about once a month. This is called "ovulation," and it makes pregnancy possible (figure 1).
In people with premature menopause, the ovaries start running out of eggs. As a result, they might:
●Release eggs less often than normal
●Stop releasing eggs completely
Why did my ovaries stop working? — Most of the time, doctors don't know what causes premature menopause. In some people, causes include:
●Problems with their genes
●Cancer treatments
●Certain autoimmune diseases, in which the body's infection-fighting system attacks healthy organs (such as the ovaries)
What are the symptoms of premature menopause? — The first thing most people notice is missed periods, or periods that are lighter than normal. Other symptoms can include:
●Hot flashes, which feel like a wave of heat that starts in your chest and face and then moves through your body
●Extreme sweating at night
●Trouble sleeping
●Changes in your mood, such as feeling very irritable
●Dryness in your vagina
●Pain during sex
What other symptoms should I watch for? — Certain symptoms can be clues about what is causing your condition. Make sure to tell your doctor about any symptoms you have. This will help them figure out what is going on, and what treatment you might need.
Should I see a doctor or nurse? — See your doctor or nurse if you are younger than 40 and your periods have been irregular for at least 3 months.
Are there tests I should have? — Your doctor or nurse will decide which tests you should have based on your age, other symptoms, and individual situation. Common tests include:
●A pregnancy test
●Blood tests – The most common blood tests measure hormone levels. They can show why your periods are irregular. There are also other blood tests that can help doctors figure out why you have premature menopause.
●Genetic tests – If your hormone tests show that you do have premature menopause, you will probably have other blood tests that can show if something is wrong with your chromosomes. (Chromosomes are structures in cells that contain thousands of genes.) The main test to look at chromosomes is called a "karyotype."
How is premature menopause treated? — The most important part of treatment is getting support. Finding out that you have premature menopause is upsetting. You might feel anxiety, sadness, or grief. Tell your doctor if you are feeling this way. There are also doctors, nurses, and therapists who are experts in this area. It might help to find a support group so you can talk to other people who are dealing with similar things.
Depending on what is causing your condition, your doctor can also suggest specific treatment. The most common way to treat premature menopause is with hormones, most importantly estrogen. These replace what the ovaries are not making anymore. Hormones will reduce your symptoms, especially hot flashes and night sweats. They will also help protect your bones and maybe your heart. Experts recommend that people with premature menopause take hormones until at least age 50.
What if I want to get pregnant? — There might still be hope. About 5 to 10 percent of people with premature menopause are able to have a baby on their own. If this does not happen, it might be possible to get pregnant with new technologies. These methods use eggs that come from another person. If you want to try to get pregnant, your doctor can talk to you about your options.
Patient education: Absent or irregular periods (The Basics)
Patient education: Female infertility (The Basics)
Patient education: Primary ovarian insufficiency (Beyond the Basics)
