Premature Menopause

For some women, the menopause comes early. If this happens before the age of 40 years, it is called premature menopause or premature ovarian failure (POF). This can have a major physical and psychological impact on a woman's health.

Causes

For many women with premature menopause, the cause is unknown. It may be due to the ovaries running out of eggs too soon. However, in some women, it happens because they had their ovaries removed early for various diseases, e.g. endometriosis or ovarian tumours. In other women, it may be because they received drug treatment (chemotherapy) for certain cancers in their body, and this affected the ovaries. It can also result from radiotherapy (radiation treatment) to the ovaries, again as part of cancer treatment. For some other women, an early menopause can be part of a genetic difference.

Diagnosis

There are a number of reasons why a woman's periods may stop before the age of 40 years, and for most women, a blood test will be necessary to find out the cause. It may well be that blood tests need to be taken over a period of time to see whether this is a temporary or permanent problem.

The main blood tests to diagnose the problem are a check of FSH (follicle stimulating hormone) and oestradiol. With an early menopause, the level of FSH is high and the level of oestrogen low. Your doctor may also wish to check your chromosomes if there is any uncertainty as to the cause of the premature menopause.

Symptoms

The symptoms are very similar to those of a natural menopause at any age, with hot flushes and sweats being the commonest symptom. Other symptoms include vaginal dryness, phoney aches and pains, poor sleep and fatigue.

However, there may be psychological symptoms, such as depression, anxiety, low libido and low self-esteem. Worries about a loss of fertility are a major problem for some women.

Treatment

Treatment is very important for a woman with an early menopause to replace those hormones to prevent long-term problems, such as osteoporosis and heart disease. HRT would normally be given as sequential HRT. This is likely to restart periods, although will not restart fertility.