Menopause, the transition during which your periods stop due to lower hormone levels in the body, usually takes place between the ages of 45 and 55 (although each individual’s experience of menopause can be very different). For some people, though, menopause can occur much earlier than expected. In this piece, we’ll look at what early menopause means, why it happens and how to manage it.  

What is early menopause?

Although rare, 5% of women do undergo natural menopause before the age of 45, known as early menopause, and 1% before they reach 40, known as premature menopause. Early or premature menopause usually occurs when the ovaries underproduce certain hormones, particularly oestrogen.

This is sometimes referred to as premature ovarian failure or ovarian insufficiency, and can be caused by a variety of factors such as chromosome abnormalities, infections such as malaria or tuberculosis, or certain cancer treatments. Smokers and underweight women are more likely to experience an earlier menopause.

Early menopause will affect your ability to conceive naturally, and we understand just how upsetting and detrimental to your mental health this new reality can be. Today however, treatment options such as Hormone Replacement Therapy are available to boost hormone levels and ease menopause symptoms. Furthermore, alternative methods for conception such IVF, egg donation, egg freezing, surrogacy and adoption are all viable options to assist with family forming in the case of premature ovarian failure.

Why does it happen?

There are a number of reasons why early menopause can occur, although in 90% or women who experience premature menopause, the reason will be unknown. Early menopause can happen if:

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Your ovaries stop working

This is a natural cause for early menopause, and is sometimes referred to as ‘premature ovarian failure’ or ‘primary ovarian insufficiency.’ If your ovaries cease to produce normal levels of hormones, especially oestrogen, this can trigger menopause. Research has yet to demonstrate exactly why some women’s ovaries might stop functioning, but in some cases it could be because of:

• Certain infections, such as mumps, malaria or tuberculosis, although this is extremely rare  

• Autoimmune conditions, in which the immune system attacks the body’s own tissue

• Chromosomal abnormalities – in women, Turner syndrome is an example of this kind of condition.

Early menopause can sometimes be hereditary . If any of your relatives went through menopause at a very young age (20s or early 30s) this may be something to look out for.

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You've had your ovaries removed

Surgical removal of the ovaries before age 40 is usually due to ovarian cancer, ovarian cysts, endometriosis or severe premenstrual syndrome. It may or may not involve removal of the uterus. ​

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You've had cancer treatment

Cancer treatments such as chemotherapy or radiotherapy can lead to premature ovarian failure, which could be either permanent or temporary. The risk of cancer treatments triggering early menopause will depend on:

• Where on your body the radiotherapy is focused (risks are higher if the focus is around your brain or pelvis)  
• The type of treatment administered  
• Your age (the risk is lower if you are pre-pubescent when you receive the treatment).  

What are the symptoms of early menopause?

Along with your periods becoming less frequent and eventually stopping, which is the main symptom of menopause, early menopause may result in other symptoms typical of normal menopause, including:

• Problems with concentration, memory or 'brain fog'
• Difficulty sleeping
• Reduced libido or sex drive
• Vaginal dryness or discomfort during sex
• Hot flushes and night sweats
• Low mood
• Low self-esteem or anxiety

How can you treat early menopause?  

Early menopause is  either with the combined contraceptive pill or with hormone replacement therapy (HRT) which makes up for the hormones you are no longer producing. Unless you have certain types of cancer which can preclude your ability to receive hormone treatment, your GP will most likely recommend that you stay on the combined pill or continue to receive HRT until around the normal age for natural menopause (a rough average of 51 years).

Do also ask your GP or your Fertifa Patient Advisor about lifestyle changes you can make to protect your health as effectively as possible.  

What other support might I need?

Going through early menopause can be a difficult and distressing experience, and permanent early menopause will have an impact on your ability to conceive children naturally. You may find it helpful to seek support from organisations and groups that provide expert advice, mental health services and bring together people with shared experiences.

The NHS recommends several groups – have a look at the list towards the bottom of this page and talk to your Fertifa Patient Advisor if you’d like to discuss your support options further. If you're a Fertifa patient looking to speak to someone in our in-house clinical team about more support or advice around early menopause, get in touch through the Fertifa app. We're here to help you every step of the way, and more.