Premature and Early Menopause

Premature menopause and early menopause are when a woman goes through menopause at an earlier age than expected. Menopause is the point in your life where your menstrual periods stop. Once you’ve gone 12 straight months without a period, you’ve gone through menopause. Natural menopause typically happens around age 51.

The difference between premature menopause and early menopause is when it happens:

• Premature menopause is when menopause happens before age 40. It happens in about 1 in 100 women.
• Early menopause is when menopause happens before age 45. It happens in 1 in 20 women.

Premature menopause isn’t the same as primary ovarian insufficiency (POI). POI is when your periods stop suddenly, either early or prematurely. With POI, there’s a chance your period will come back. With premature or early menopause, menstruation permanently ends.

What’s the earliest age to start menopause?

Menopause can happen in your 20s, 30s or 40s. Premature menopause is menopause that occurs any time before age 40. It’s rare for menopause to happen before age 30.

Can you start menopause at 35?

Yes. Fertility often begins to decline around age 35. A decline in your fertility isn’t the same as menopause, though.

What are the signs of early menopause?

One of the first signs is changes in your period. Your menstrual cycle may become shorter or longer, or you may bleed (or spot) between periods. Your bleeding may be lighter or heavier than usual.

Other early menopause symptoms include:

• Hot flashes and night sweats
• Vaginal dryness and discomfort during sex
• Frequent urge to pee
• Frequent urinary tract infections (UTIs)
• Difficulty sleeping
• Mood changes
• Dry skin, dry eyes or dry mouth
• Changes in your sex drive (libido)
• Difficulty concentrating or being more forgetful
• Weight gain or weight loss

Early and premature menopause causes

Anything that damages your ovaries or stops your body from making estrogen can cause early menopause. Sometimes, there’s no direct cause of early or premature menopause. This is the case in up to half of women who experience early or premature menopause.

Having the following conditions or factors can lead to early menopause:

• Chemotherapy or radiation to treat cancer
• Surgery to remove your ovaries or uterus
• Chromosomal abnormalities, like Fragile X or Turner’s syndrome
• Autoimmune diseases, like rheumatoid arthritis, Crohn’s disease or thyroid disease
• HIV or AIDS
• Infections, like mumps

Risk factors

Your risk may be higher if you:

• Have a biological mother or sister who went through early menopause
• Smoke cigarettes
• Get your first period before age 11

Most causes of early menopause are beyond your control. Smoking cigarettes is the only lifestyle factor that may cause early menopause. In most cases, you can’t prevent other causes of menopause, like health conditions, family history or cancer treatment.

Complications of this condition

People who go through menopause early often have stronger symptoms. These symptoms can affect sex and intimacy.

Early menopause also means spending more years without estrogen. Estrogen plays an important role in bone and heart health. Loss of estrogen can increase your risk for:

• Osteoporosis
• Heart disease
• Depression
• Various neurological diseases, like dementia and Parkinson’s disease

How do doctors test for early menopause?

If you have symptoms of menopause before 45, your healthcare provider may recommend testing and ask questions to make a diagnosis. They’ll ask you about your symptoms, how regular your periods are and if you have a biological family history of early menopause.

Specific tests could include:

• A physical exam
• Pelvic ultrasound
• Blood tests to look at your hormone levels
• Thyroid function tests
• Blood tests to rule out other health conditions

If you haven’t had a period for 12 straight months, and aren’t on any medication that stops menstruation, you may have reached menopause.

Can early menopause be treated?

Treatment can vary depending on why menopause started earlier than normal. Providers recommend hormone replacement therapy (HRT), unless there’s a reason hormone therapy is unsafe (like if you’ve had breast cancer).

HRT replaces some of the lost hormones in your body. This helps reduce the symptoms and side effects of menopause. Providers typically prescribe HRT until you turn 51 (the time when most people reach menopause).

Talk with your provider about the pros and cons of hormone therapy. If early menopause affects your fertility, a fertility specialist can help you explore options for having a child.

Can you reverse early menopause?

You can’t reverse menopause or make your ovaries function again. But your provider can help reduce the symptoms and side effects of menopause.

When should I see my healthcare provider?

Contact a healthcare provider if you have signs of menopause before age 40. They can help figure out if you’re entering menopause or if another condition is causing your symptoms.

Can I still get pregnant with premature menopause or early menopause?

Both premature and early menopause affect getting pregnant because you’re not ovulating regularly. But unless you’ve gone 12 consecutive months without a period, you may still get pregnant. If getting pregnant or having children is important to you, work with a fertility specialist to explore your options.

It’s possible to get pregnant through in vitro fertilization (IVF) after menopause. You can use eggs from a donor or your own eggs (if you freeze your eggs). Surrogacy and adoption are also options.