Premature menopause and early menopause are conditions where a woman goes through menopause at an earlier age than is typically expected. Both conditions can result in women being unable to become pregnant. If there is no obvious medical or surgical cause for the premature menopause, this is called primary ovarian insufficiency (POI). Primary ovarian insufficiency is also referred to as premature ovarian insufficiency.
The name premature ovarian failure (POF) is no longer used because women who are told they have early menopause can have intermittent ovulation, menstrual bleeding or even pregnancy after being told they have ovarian “failure.”
Menopause is a stage in a woman’s life when menstruation (periods) ends. Natural menopause typically happens when a woman is in her early 50s. This is a normal part of the aging process and means that a woman can no longer become pregnant. There are three stages to natural menopause:
Women typically go through natural menopause in their early 50s. The average age is between 51 to 52.
The difference between premature menopause and early menopause is when it happens. Premature menopause occurs before a woman is 40. Early menopause is when a woman undergoes menopause before age 45.
Many of the causes of premature menopause can also be causes of early menopause. The two types of menopause also share many of the same symptoms.
Premature menopause happens to about 1% of women under age 40. Early menopause, occurring in women under age 45, is seen in about 5% of women.
Premature menopause can be caused by a medical condition or treatment or it may have no known cause (spontaneous). Possible factors that could cause premature menopause include:
Women may start having irregular menstrual cycles for a few years prior to the last menstrual period. If your cycles are irregular, you should speak with your doctor to look into possible causes. The symptoms of premature and early menopause include many of the typical menopause symptoms. These can include:
Loss of estrogen at a younger age is associated with increased risks of various medical problems. These risks include:
If you begin to have symptoms of menopause before the age of 40, your healthcare provider will do several tests and ask questions to help diagnose premature or early menopause. These tests can include:
Women who have not had a menstrual period for 12 straight months, and are not on any medication that could stop menstruation, may have gone through menopause.
Management of the condition can vary depending on why menopause started earlier than normal. Given the health risks associated with early menopause, hormone replacement therapy (HRT) is routinely recommended to all women with premature menopause or primary ovarian insufficiency, unless there is a compelling reason it can’t be used. There is a lot of confusion about the safety of hormone therapies. Many of the risks of hormone therapy used after natural menopause are not thought to apply to women who have premature menopause. It is important to discuss the pros and cons of hormone therapy with your doctor. Some healthcare providers have additional certification in the management of menopause, and these providers will be a valuable resource when receiving conflicting information about the safety of hormone therapy.
Unless the ovaries have been surgically removed, it can be difficult to diagnose a woman younger than age 45 with “menopause” as opposed to primary ovarian insufficiency (POI). Women with POI can have intermittent ovulation, which may or may not be accompanied by a menstrual bleed. Other women may be able to get pregnant through in vitro fertilization with egg donation. It is important to work with a fertility specialist to explore options.
Options available to you will vary depending on whether you have interest in having children in the future. In some cases, fertility may be restored and pregnancy could be possible. Assisted reproductive technology (ART), including in vitro fertilization (IVF) might be considered.
If you do not want to get pregnant while on hormone-replacement therapy, your doctor will talk to you about contraceptive options.
Talk to your healthcare provider about possible causes of premature or early menopause and your questions regarding fertility.
Last reviewed by a Cleveland Clinic medical professional on 10/22/2019.