Early menopause (premature ovarian insufficiency or POI) occurs when the ovaries stop functioning normally before age 40, leading to irregular or absent periods and reduced fertility. It affects 1 in 100 women under 40 years of age, and 1 in 1,000 under 30 years of age.
Common Symptoms
- Hot flashes/night sweats.
- Irregular or missed periods (for 4+ months).
- Sleep disturbances, fatigue, or mood swings.
- Vaginal dryness or pain during sex.
- Brain fog or difficulty concentrating.
- Emotional distress (grief, anxiety about fertility).
Possible causes
- Genetic conditions (e.g., Turner syndrome, Fragile X premutation).
- Autoimmune diseases (e.g., thyroiditis, lupus).
- Medical treatments: Chemotherapy, radiation, or ovarian surgery.
- Infections (rare, e.g., mumps).
- Idiopathic: No identifiable cause (most cases).
Diagnosis
- Check hormone levels:
- High FSH (follicle-stimulating hormone) and low estrogen.
- AMH test (measures ovarian reserve).
- Rule out causes: Genetic testing, autoimmune screening, or pelvic ultrasound.
Health risks
Early menopause increases long-term risks of:
- Osteoporosis (weakened bones).
- Heart disease.
- Cognitive decline/dementia (if untreated).
- Depression or anxiety.
Treatment & Management
Hormone Replacement Therapy (HRT)
- Benefits: Relieves symptoms, protects bones/heart, and improves quality of life.
- Options: Oestrogen patches/gels + progesterone (if uterus intact).
- Duration: Usually recommended until at least age 51 (natural menopause age).
Fertility Support
- Egg freezing (if diagnosed early).
- IVF with donor eggs (most common route for pregnancy).
Lifestyle Adjustments
- Weight-bearing exercise (protects bones).
- Calcium & vitamin D (1,200 mg/day calcium, 800–1,000 IU vitamin D).
- Avoid smoking (worsens bone/heart health).
Emotional Well-Being
- Counselling therapy to cope with grief, identity, or relationship changes.
- Support groups (e.g., The Daisy Network).
eGynaecologist Advice
- HRT is strongly recommended to protect bones, heart, and brain, and consulting a gynaecologist is essential for protecting long-term health.
- You must consult your gynaecologist if you miss periods for 3+ months under age 40.
- Concerns about fertility must be discussed at early opportunity with your gynaecologist.
Frequently Asked Questions
Can early menopause be reversed?
No, but HRT can manage symptoms and reduce health risks.
Will I age faster?
No, but untreated low oestrogen increases certain health risks. HRT helps mitigate these.
Can I still get pregnant?
Spontaneous pregnancy is rare (5–10% chance), but options like donor eggs exist.
Is HRT safe?
Yes, for most women under 50, benefits outweigh risks. Discuss family history (e.g., blood clots) with your doctor.
Will I go through menopause again at 50?
No – HRT is adjusted around age 50 to match natural menopause timing.
