Premature & Early
Menopause

Premature menopause or early menopause can happen naturally, or be induced by surgery, health conditions or medical treatment.

Premature menopause takes place when periods stop under the age of 40. One in a hundred women will go through menopause prematurely.
Early menopause happens when a woman's periods stop before the age of 45. Around 5% of women will go through early menopause.

Surgical Menopause

The only difference between early and premature menopause is the age at which it happens. It can occur naturally, or as a result of surgery. Surgical menopause happens immediately after a woman has her ovaries removed (oophorectomy) or uterus removed (partial or full hysterectomy). Reasons for a hysterectomy include cancer treatment, fibroids, endometriosis, adenomyosis or prolapse of the uterus. Surgical treatments or loss of ovaries during procedures relating to ectopic pregnancy, ovarian cyst removal or endometriosis can induce a sudden menopause. Sometimes sudden onset of menopause happens when women opt to remove their ovaries to reduce the risk of breast or ovarian cancer if they have high risk of the gene mutations BRCA1 or BRCA2. Other high-risk gene mutation is Lynch syndrome. These instances, are often referred to as “risk-reducing surgical menopause.”

What are the first signs of premature/early menopause?

In the absence of any medical or surgical cause, If you’re under 45 (or 40) and your periods are changing – lighter, heavier, longer, more or less frequent – your sleep is disrupted, and you feel an increasing sense of anxiety with the occasional or regular hot flush, you may be experiencing some of the first physical and mental health symptoms of menopause sooner than the average age of 51.

Blood tests and diagnosing menopause

Blood tests will establish if you’re in premature or early menopause by measuring your oestrogen levels and more importantly, the ‘driving hormones’, which come from the pituitary gland or ‘Master gland’, that drive several of the body’s essential hormone systems. You may have heard of FSH levels (follicle-stimulating hormone), some doctors may use this test as part of their investigation and diagnosis of menopause in younger women. Looking at FSH levels on their own, however, can be unreliable - your own account of what you are experiencing, and your symptoms are the best form of diagnosis for perimenopause or menopause. The test may need to be repeated as hormone levels can fluctuate wildly. Testing will also clarify whether you are still able to get pregnant.

What are the side effects of early menopause?

Whatever the cause, premature, early, or surgical menopause can make you more susceptible to health problems such as heart disease and osteoporosis now that hormones are no longer protecting organs and tissues. It’s important to talk to your doctor to discuss ways to protect your health. They’re likely to recommend making changes to diet, exercise and lifestyle to strengthen bones and the heart to reduce risk. Hormone replacement

Premature menopause refers to menopause that occurs before age 40 years, and early menopause refers to menopause that occurs at or before age 45 years, both ranges being well below the median age of natural menopause (age 51 years) [1]. Premature menopause or early menopause can be spontaneous or induced; if induced, it can be due to medical interventions such as chemotherapy or surgical interventions such as bilateral oophorectomy.

How long does early menopause last?

Once it has been 12 months since a woman’s last period, she’s post-menopausal. To date, early menopause can’t be reversed but research continues into treatment options for women going through this.

Managing early or premature menopause

There is a myriad of options for managing menopause symptoms ranging from moving more, eating a balanced diet, managing stress, and prioritising self-care too, natural therapies, CBT, and medical management via early or premature-specific hormone replacement therapy to replace the hormones that would otherwise be present.