Dealing with Early Menopause

Menopause is a normal part of every woman`s life and usually occurs between the ages of 45 and 55. But in some women, menopause can happen earlier, this is known as early, or premature, menopause. 

Early menopause is defined as menopause between the ages of 40 and 45, and premature menopause before the age of 40. Sometimes this happens because of certain types of surgery or medical treatments, but often the cause of early menopause is unknown. 

Early menopause occurs spontaneously (without surgery or medical treatment) in around 5% of women and premature menopause in around 1% of women. Premature menopause under the age of 30 is rare, affecting around 0.1% of the population.

Read on to find out more about early menopause symptoms, causes, prevention, and what you can do if you think you may be affected.

The main symptoms of early or premature menopause are irregular periods or no periods (amenorrhea) for more than 3 months. Other symptoms of early menopause include: 

• Hot flashes (a sudden feeling of heat that spreads across the body). 
• Mood swings, depression, or anxiety.
• Night sweats. 
• Vaginal dryness, pain, or discomfort during sex.
• Loss of interest in sex.
• Difficulty concentrating. 
• Memory problems.

Aside from early menopause, there are several other causes of irregular or absent periods including: 

• Pregnancy
• Stress
• Illness, such as Polycystic Ovary Syndrome
• Some medications or contraceptives
• A change in your diet or exercise routine
• Low body weight. 

If your periods are irregular, or you haven’t had a period for more than three months, make an online GP appointment with Medicspot and discuss your symptoms with NHS trained doctor.

The medical terms for early menopause are primary ovarian insufficiency or premature ovarian failure, which are other ways of saying that your ovaries are not working properly. 

This may be caused by one of two things — follicular depletion or follicular dysfunction. 

Follicles are tiny fluid-filled sacs in the ovaries where eggs grow and mature. Baby girls are born with over a million immature follicles that continue to produce eggs throughout their life until menopause occurs in middle age. 

In follicular depletion, the follicles “run out” leading to menopause. This is a normal occurrence in women between the ages of 45 and 55, but may happen to younger women, causing early menopause. 

In follicular dysfunction, there are still follicles in the ovaries, but they are not working properly. 

Some causes of follicular depletion or follicular dysfunction include: 

• Normal ageing causes your hormone levels to decrease, and the number of follicles in your ovaries to decline, resulting in the end of your periods. This is a normal process and most commonly happens between the ages of 45 and 55. 
• A Family History of early menopause, such as a mother or sister entering the menopause before the age of 45, makes it more likely that you will also experience early menopause. 
• Toxins like cigarette smoke increase the risk of early menopause. Recent studies have also suggested that chemicals such as perfluorocarbons (PFCs) in the environment can affect oestrogen levels and lead to early menopause. PFCs are found in many rivers and lakes and may contaminate fish and animals we eat. 
• Cancer treatments such as chemotherapy and radiotherapy can damage the ovaries and cause your periods to stop temporarily or permanently. 
• Chromosomal Disorders are disorders where you are born with an abnormality in your chromosomes. Women with certain chromosomal disorders like Turner`s syndrome or Fragile X syndrome are at higher risk of early menopause.
• Autoimmune conditions occur when your body`s immune system mistakenly attacks its own cells. Some autoimmune conditions like rheumatoid arthritis can increase your risk of early menopause.
• Infections like mumps can damage the ovaries and trigger early menopause.
• Surgeries like removal of the womb (hysterectomy) or removal of one of your ovaries (single oophorectomy) can cause your hormone levels to fall, triggering early menopause. Some types of pelvic surgery or surgery for cervical cancer can also increase the risk of menopause. If you have both ovaries removed (bilateral oophorectomy) you will immediately be in menopause. 

Sometimes early menopause is unavoidable and may occur due to factors outside your control. But there are some lifestyle choices you can make that may minimise the risk. These include: 

• Eating a healthy diet may be linked to the age at which you reach menopause. A UK study appeared to show that women who ate a diet high in oily fish, beans, and legumes experienced menopause later than those who ate a diet high in refined carbohydrates like rice and pasta. A higher intake of vitamin B6 and zinc were also linked to later menopause. 
• Maintaining a healthy weight is important for many aspects of your health including your reproductive health. Being overweight or underweight can increase your risk of early menopause. 
• Not smoking or giving up smoking is one of the best things you can do for your overall health. Smoking can have a negative effect on your reproductive health, and smokers reach menopause on average 2 years earlier than non-smokers. 

Going through early menopause can be a time of many changes, and may raise many questions about your future, health, and even life expectancy. 

Early menopause has been previously linked to earlier development of type 2 diabetes and shorter life expectancy. 

One study published in the Journal of the North American Menopause Society looked at 3,650 post-menopausal women and examined the link between early menopause and life expectancy. The study concluded that women who had experienced early menopause had a life expectancy of 3.1 years (without diabetes) and 3.3 years (with diabetes) less than those who experienced normal or late menopause. 

If you are concerned about the long-term implications of early menopause, make an appointment with your GP to discuss your concerns.

If you think you may be going through early menopause, make an appointment with your GP as soon as possible. Your doctor will ask you some questions about your general health, medical history, any medications you are taking, and what symptoms you are experiencing.

If you are under 40, you are likely to be offered 2 blood tests, taken 4 to 6 weeks apart (to allow for natural changes in your hormone levels). These tests measure your levels of follicle-stimulating hormone (FSH), an indicator of ovarian deficiency.

Menopause can be a daunting time for many women, and early menopause can bring even more challenges. If you are worried about your symptoms and think you may be in early menopause, make an appointment with your GP as soon as possible. Your doctor can run tests for early menopause as well as look for any other underlying health issues that could be causing your symptoms. Alternatively, you can make a same-day online GP appointment with Medicspot and have a video consultation with one of our NHS-trained GPs at a time that suits you.

 Our GPs can diagnose and offer treatment options for early menopause based on your age and symptoms. They can also recommend further tests if required. 

Rapid home test kits for menopause are also available from Medicspot. These quick and simple urine tests measure the amount of FSH in your urine and give you the results within minutes. We recommend that if you buy these, you buy two, and take them 4 to 6 weeks apart.

NHS Conditions: Early Menopause February 2nd, 2021 (Accessed July 20th, 2022) 

NHS Inform: Early and Premature Menopause May 10th, 2022  (Accessed July 20th, 2022) 

 Healthline: Dealing with Early Menopause January 22nd, 2019  (Accessed July 20th, 2022) 

PubMed: Environmental Health: Environmental pollutants, a possible etiology for premature ovarian insufficiency: a narrative review of animal and human data April 2017  (Accessed July 20th, 2022) 

Menopause.org.au: Early menopause-chemotherapy and radiotherapy October 2020 (Accessed July 20th, 2022)

PubMed: Body mass index and age at natural menopause: an international pooled analysis of 11 prospective studies February 19th, 2018 (Accessed July 20th, 2022)

Australasian Menopause Society: Early onset of menopause and diabetes may limit life span (Accessed July 20th, 2022)

The Journal of the North American Menopause Society: Age at natural menopause and life expectancy with and without type 2 diabetes April 2019 (Accessed July 20th, 2022)

PubMed: Dietary intake and age at natural menopause: results from the UK Women’s Cohort Study April 30th (Accessed July 20th, 2022)

CDC: Perfluorocarbons (PFCs) November 2009 (Accessed August 9th 2022) 

OASH: Early or premature menopause February 22nd, 2021 (Accessed August 11th 2022)