Early Menopause

Primary Ovarian Insufficiency

What is early menopause? — Menopause is the time in a woman's life when she naturally stops having periods. Menopause usually occurs between the ages of 45 and 55. But in some women, menopause happens early – before the age of 40.
Some women with this condition keep having periods every once in a while. They might even be able to get pregnant. Instead of calling it "early menopause," doctors prefer to call it "primary ovarian insufficiency" (POI). You might also hear it called "premature ovarian failure" (POF), but most doctors no longer use that term.
What causes early menopause? — Early menopause happens when something causes the ovaries to stop working well. Normally, the ovaries release an egg about once a month. This is called "ovulation," and it makes pregnancy possible (figure 1).
In women with early menopause, the ovaries start running out of eggs. As a result, they might:
Release eggs less often than normal
Stop releasing eggs completely
Why did my ovaries stop working? — Most of the time, doctors don't know what causes early menopause. In some women, causes include:
Problems with their genes
Cancer treatments
Certain autoimmune diseases, in which the body's infection-fighting system attacks healthy organs (such as the ovaries)
What are the symptoms of early menopause? — The first thing most women notice is missed periods, or periods that are lighter than normal. Other symptoms you might have are:
Hot flashes, which feel like a wave of heat that starts in your chest and face and then moves through your body
Extreme sweating at night
Trouble sleeping
Changes in your mood, such as feeling very irritable
Dryness in your vagina
Pain during sex
What other symptoms should I watch for? — Certain symptoms can be clues about what is causing your condition. Make sure to tell your doctor about any symptoms you have. This will help him or her figure out what is going on, and what treatment you might need.
Should I see a doctor or nurse? — See your doctor or nurse if you are younger than 40 and your periods have been irregular for at least 3 months.
Are there tests I should have? — Your doctor or nurse will decide which tests you should have based on your age, other symptoms, and individual situation. Common tests include:
A pregnancy test
Blood tests – The most common blood tests measure hormone levels. They can show why your periods are irregular. There are also other blood tests that can help doctors figure out why you have early menopause.
Genetic tests – If your hormone tests show that you do have early menopause, you will probably have other blood tests that can show if something is wrong with your chromosomes. (Chromosomes are structures in cells that contain thousands of genes.) The main test to look at chromosomes is called a "karyotype."
How is early menopause treated? — The most important part of treatment is getting support. Finding out that you have early menopause can be upsetting. You might feel anxiety, sadness, or grief. Tell your doctor if you are feeling this way. There are also doctors, nurses, and therapists who are experts in this area. It might help to find a support group so you can talk to other women who are dealing with similar things.
Depending on what is causing your condition, your doctor can also suggest specific treatment. The most common way to treat early menopause is with hormones, such as estrogen. These replace what the ovaries are not making anymore. Hormones will reduce your symptoms, especially hot flashes and night sweats. They will also help protect your bones and maybe your heart. Experts recommend that women with early menopause take hormones until at least age 50.
What if I want to get pregnant? — There might still be hope. About 5 to 10 percent of women with early menopause are able to have a baby on their own. When women can't get pregnant on their own, they can still get pregnant with new technologies. These methods use eggs that come from another woman. Tell your doctor if you want to try to get pregnant.
All topics are updated as new evidence becomes available and our peer review process is complete.
This topic retrieved from UpToDate on: Mar 30, 2020.
Topic 15606 Version 6.0
Release: 28.2.2 - C28.105
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