What is menopause?
Menopause is your final menstrual period. You know you’ve reached menopause if you have not had your period for 12 months.
Most women reach menopause between the ages of 45 and 55 years.
The average age for Australian women to reach menopause is 51 to 52 years.
What is premature menopause?
Premature menopause is when you reach menopause before the age of 40 years.
What is early menopause?
Early menopause occurs between the ages of 40 and 45 years.
Up to 12% of women have their final period before they are 45 years of age. This percentage is likely to be higher if we include menopause caused by surgery and cancer treatment.
Symptoms of premature and early menopause
Symptoms of premature and early menopause are like those you would experience if you reached menopause at the expected age. Menopausal symptoms can be more severe after surgery or cancer treatment, due to the sudden change in oestrogen levels.
Common symptoms include:
- hot flushes
- night sweats
- sleep problems
- mood changes
- brain fog
- headaches or migraines
- sore breasts
- dry vagin*
- reduced sex drive
- itchy skin
- aches and pains
- weight gain, due to a slower metabolism
- tiredness.
Causes of premature and early menopause
Primary ovarian insufficiency (POI)
POI is when periods stop suddenly at an earlier age than expected. POI affects up to 1% of women but in 60% of cases a cause cannot be found.
The first symptoms of POI may be:
- irregular periods
- no periods after stopping the oral contraceptive pill
- inability to get pregnant.
Cancer treatment
Chemotherapy and radiotherapy treatments can cause the ovaries to stop working. But not all cancer treatments lead to menopause.
Surgical menopause
Menopause happens with removal of the ovaries, with or without the uterus being removed. This surgery may be necessary due to cancer or other health conditions, such as severe endometriosis.
Risk factors
Risk factors that may lead to POI include:
- periods starting before 11 years of age
- family history of premature or early menopause
- smoking
- epilepsy
- previous surgery on your ovaries.
Other risk factors:
- genetic abnormality – such as Turner syndrome or Fragile X syndrome
- autoimmune disorders – such as Addison’s disease, thyroid disease, type 1 diabetes, Crohn’s disease or coeliac disease
- metabolic disorders
- infection – such as mumps.
Diagnosing POI
If you are under 45 years of age and have irregular periods, or they have stopped for more than 3 months, you should see your doctor.
Your doctor may:
- ask questions about your medical and family history
- do a physical examination
- do other tests, such as a pregnancy test, hormone tests and an ultrasound.
After a diagnosis of premature or early menopause
Premature or early menopause can be very upsetting. It’s normal to feel a sense of loss, sadness and grief. You may also have mixed feelings about your body image, fertility, femininity and sexuality.
Psychological counselling and support groups can provide support. If you feel very emotional, anxious or depressed after your diagnosis, it’s important to talk to someone. Your doctor can refer you to a psychologist if needed.
If you are diagnosed with a genetic condition that caused your premature or early menopause, it might be helpful to speak to a genetic counsellor. Genetic counsellors are health professionals qualified in counselling and genetics. They can help you understand the condition, what causes it, how it is inherited (if it is) and how it may impact your health.
Managing premature and early menopause
If you are diagnosed with premature or early menopause, your doctor can refer you to different specialists. For example, an endocrinologist, gynaecologist, fertility specialist, psychologist or psychiatrist.
Women with premature or early menopause have reduced oestrogen levels, which increases long-term health risks of osteoporosis and heart disease.
Menopausal hormone therapy (MHT) or the oral contraceptive pill will help to reduce these risks and should be taken until the expected age of menopause.
If you are unable to take hormone therapy (for example, because of breast cancer, your doctor can recommend other therapies. They will base treatment on your symptoms, risk factors and family history.
More information
For more detailed information, related resources, articles and podcasts, visit Jean Hailes for Women’s Health.
