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What is premature menopause?

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Menopause is a normal part of ageing for women. But you might be surprised if you’re experiencing menopause symptoms earlier than expected. If you’re worried about starting menopause early, try not to become overwhelmed. Visit your GP for advice and help with your early menopause symptoms

Let’s explore the facts about what’s going on so you can ask your doctor all the right questions.

In this article, we cover the following:

  • Causes of early menopause
  • Symptoms of premature menopause
  • How premature menopause can affect fertility
  • The effects on your health and wellbeing

What is menopause?

Menopause is when you stop having periods as you go through hormonal changes. Your ovaries no longer produce a hormone called oestrogen and no longer release an egg each month.

Women usually go through menopause at around 51 years old. Menopause between 40 and 45 is called early menopause. Premature menopause is if it happens before you’re 40 years old.

What causes premature menopause?

There are some reasons why your menopause might start early, but for most women, there are no known reasons.

One of the most common reasons for premature menopause is that the ovaries stop producing eggs and the hormone oestrogen, sometimes called premature ovarian failure. For many women, there’s no specific reason why this happens.

Some conditions that can cause premature menopause are:

  • Autoimmune diseases, where your immune system damages normal body tissues
  • Genetic causes, where genes you have inherited lead to early menopause
  • Infections which can damage the ovaries, including malaria, tuberculosis and mumps

Premature ovarian failure happens to about 1% of women under 40 and about 0.1% under 30.

Premature menopause can also be caused by medical treatment for other conditions or diseases like cancer. These treatments might include:

  • Chemotherapy and radiotherapy – the risk of menopause becomes greater when higher doses of chemo are used or when radiotherapy is given near the ovaries
  • Hormonal treatment – might be used for breast cancer, with the risk of menopause depending on the type and dose of treatment given

Surgery on your ovaries can also lead to premature menopause. If both ovaries are removed, menopause will start immediately.

If you might have treatment that could lead to menopause, your doctor will discuss possible outcomes before you start your treatment.

Early menopause symptoms

The symptoms of premature menopause are the same as if it occurs later in life. Because menopause doesn’t happen very often in younger women, your symptoms may be missed or mistaken for another condition.

The first sign of menopause you may get is a change in the regular pattern of your periods. They may be lighter or heavier than usual, and they may happen more or less often than before. Eventually, your periods will stop altogether.

Other common symptoms can be:

  • Anxiety, mood changes and trouble sleeping
  • Problems with memory and concentration (often described as ‘brain fog’)
  • Headaches and joint pains
  • Hot flushes and sweating at night
  • Heart palpitations
  • Urine infections
  • Vaginal dryness and discomfort during sex
  • Reduced interest in sex

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Can you get pregnant if you experience early menopause?

If you’re younger, and especially if you might want to have children, it’s normal to worry about the effects of early menopause on your fertility. Menopause affects your ability to have children no matter when you go through it.

When you have been through menopause, you usually stop producing an egg (ovulating) every month. That means you won’t be able to get pregnant naturally.

If you experience menopause prematurely and want to have children, you may need IVF or other medical techniques to help you become pregnant. Speak with your GP or a fertility specialist to learn the best methods for you.

A minority of women (5 to 10%) can produce eggs during menopause and could still get pregnant.

If you don’t want to get pregnant, discuss the best contraception methods with your doctor.

Premature menopause, mental health and wellbeing

Going through menopause prematurely can affect your long-term health. Early menopause can lead to increased risk of:

  • Heart problems
  • Weaker bones (osteoporosis)
  • Weight gain

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Hormones to help manage symptoms

After discussing the risks and benefits, your doctor may recommend taking hormones to prevent some side effects of early menopause. They might recommend hormone replacement therapy (HRT) or the combined hormonal contraceptive pill. Some of these, including the Gina tablet, can be purchased over the counter (without visiting your doctor)after a consultation with a pharmacist.

These medicines may also help you deal with the unpleasant symptoms of menopause, such as hot flushes.

Your doctor will tell you how long you’re likely to be on this treatment, but you’ll usually take the medication at least until you reach the average age of menopause in your early 50s.

Hormonal treatment may not be suitable for everyone, for example, if you’ve had breast cancer in the past. Your doctor will often be able to find a treatment that works for you but may also want to refer you to a specialist for more tests or treatment.

Getting help with premature menopause

Although early menopause can impact your mental health, personal relationships, and work, don’t think you have to deal with it alone. Help is available from your GP, charities, online forums, websites and support groups.

Some helpful resources include The Daisy Network, The Menopause Charity and Menopause café.

These groups can help you learn how to manage the more unpleasant effects of menopause and how to stop it from getting in the way of the things you love.

A final note on premature menopause

If your doctor confirms premature menopause, it may come as a shock. Going through early menopause can raise many questions about symptoms, your health and what it means for your sex drive and fertility.

Your doctor can help you understand what premature menopause means and prescribe medications to help ease symptoms. Whatever early menopause means for you, there’s lots of support from charities, forums and your healthcare team.

Keep exploring our guides for more advice about your health, including how menopause can affect your health, weight and sex life.

References

www.nice.org.uk/guidance/ng23/ifp/chapter/premature-menopause-premature-ovarian-insufficiency
www.ncbi.nlm.nih.gov/pmc/articles/PMC2815011
www.nhsinform.scot/healthy-living/womens-health/later-years-around-50-years-and-over/menopause-and-post-menopause-health/early-and-premature-menopause
https://academic.oup.com/aje/article/187/4/696/4080179
www.nhsinform.scot/healthy-living/womens-health/later-years-around-50-years-and-over/menopause-and-post-menopause-health/signs-and-symptoms