You reach menopause once you do not have your period for an entire year.
Menopause is natural and occurs when the ovaries stop producing eggs. It causes a drop in estrogen hormone and a range of characteristic symptoms.
In the United States, most women transition into menopause in their early 50s. Around 5% of women will reach menopause between the ages of 40 and 45 years.
Sometimes, the onset of menopause occurs naturally a few years earlier by the age of 35 years, called premature or early menopause. Just 1% of women experience early menopause.
Younger women experience menopause due to specific conditions or treatments such as surgical removal of the ovaries or cancer therapy.
Sex and gender exist on spectrums. This article uses the term “women” when discussing people assigned female at birth to reflect language that appears in source materials.
While gender is solely about how you identify yourself, independent of your physical body, you may need to consider how your personal circumstances will affect diagnosis, symptoms, and treatment. Learn more about the difference between sex and gender here.
Common signs and symptoms of premature menopause
The common signs and symptoms of early menopause are similar to those of regular menopause and include:
- stopped menstruation
- hot flashes
- night sweats
- migraine
- tension headaches
- irregular heartbeat
- decreased sex drive
- vaginal dryness
- incontinence or more frequent or painful urination
- sleep disturbances like insomnia
- mood changes like irritability, depression, and anxiety
- difficulty concentrating
- unintended weight gain
If you are above the age of 45 years, a healthcare professional will often confirm menopause based on symptoms alone.
If you are younger than the age of 45 years, a healthcare professional may also check:
- your medical history, including past medication and surgical treatments
- family medical history, for example, if your mother had premature menopause
- levels of follicle-stimulating hormone, measured at least twice and several weeks apart
- any health factors such as thyroid hormones to exclude other causes of your symptoms
Can you reverse early menopause?
As per a 2015 review, early menopause can cause an increased risk of certain health conditions, including:
- heart disease
- bone loss (osteoporosis)
- neurological conditions like dementia
- mental health conditions like depression
Vs. premature ovarian insufficiency (POI)
Premature ovarian insufficiency (POI) is when the ovaries stop functioning like they should before the age of 40 years.
Unlike menopause, women with POI may still have some ovarian activity, occasional menstruation, and the ability to conceive naturally.
Over time, POI can progress to menopause as ovulation and menstruation completely stop.
Common causes of early menopause
A healthcare professional can sometimes identify the cause of early menopause, though this is not always possible.
Causes of early menopause may include:
- Genetics: A 2021 study identified several genes that may increase the chance of premature menopause, though we need more research to confirm this.
- Smoking: According to a large 2016 study involving 93,000 women, smoking increases your chances of early menopause.
- Too high or low weight: Another 2021 study suggests that having overweight and having a large waist circumference may cause early menopause. Also, as per a 2018 research review, having underweight doubles this risk.
- Chromosome anomalies: Some chromosome differences, such as in Turner syndrome, may cause premature menopause, sometimes in early adulthood.
- Autoimmune conditions: A 2021 paper explains that autoimmune conditions like thyroid disease, multiple sclerosis, and rheumatoid arthritis have a link with POI and early menopause.
- Cancer treatments: As per a 2016 article, chemo and radiation therapy may cause menopause at any age.
- Surgery to remove the ovaries: A 2022 research review found that having both ovaries removed (oophorectomy) may lead to menopause, regardless of your age at the time of surgery.
- Epilepsy: According to a 2018 report, women with epilepsy are more likely to experience premature menopause.
It is not possible to reverse menopause or make your ovaries regain function.
Instead, a healthcare professional may recommend management strategies to reduce symptoms of menopause.
In the future, reversing or delaying menopause may become possible. For instance, researchers are exploring ovarian rejuvenation and melatonin treatments for delaying menopause. However, it will take time for these treatments to become a reality.
Can you get pregnant during early menopause?
A 2019 research review explains that with POI, you may still be able to conceive naturally.
Meanwhile, women with early menopause cannot conceive since menopause means they no longer ovulate. In vitro fertilization treatment or implantation of a fertilized egg could still lead to pregnancy in some cases.
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