What is premature and early menopause?

If menopause happens before 40 years of age, it is called premature menopause. If it happens between 40 and 45 years of age, it is called early menopause.

Perimenopause is the time before menopause when your periods become less regular.

Menopause is when you have not had a period for 12 months. It usually happens between 45 and 55 years of age.

The next life stage is known as post-menopause.

What are the symptoms of premature and early menopause?

Symptoms of premature and early menopause may feel similar to those of natural menopause but may be more severe.

Common symptoms include:

• periods may become less frequent and stop
• hot flushes or night sweats
• trouble sleeping
• headaches or joint pain
• vaginal dryness and urinary (wee) symptoms
• lower interest in sex (low libido)
• mood changes — such as feeling sad, anxious, irritable or having difficulty concentrating

These symptoms may happen because your body makes less oestrogen, a hormone that helps with many body functions.

CHECK YOUR SYMPTOMS — Use the Symptom Checker and find out if you need to seek medical help.

What causes premature and early menopause?

For many people the cause of premature or early menopause is not known. It may be caused by:

• premature ovarian insufficiency (POI) — when your ovaries stop working properly
• genetic conditions — such as Turner syndrome or it may run in your family
• autoimmune diseases — such as thyroid disease, type 1 diabetes, lupus and rheumatoid arthritis
• cancer treatments — such as chemotherapy or radiotherapy (this may be temporary or permanent)
• surgery that removes both ovaries — this causes menopause (called induced menopause) right away
• certain infections

When should I see my doctor?

See your doctor if you have signs of premature or early menopause or if you are worried about your symptoms.

Your doctor may refer you to a:

• gynaecologist (specialist in female health)
• psychologist
• endocrinologist (hormone specialist)
• dietitian

FIND A HEALTH SERVICE — The Service Finder can help you find doctors, pharmacies, hospitals and other health services.

How is premature and early menopause diagnosed?

Your doctor may diagnose premature or early menopause based on your:

• age
• symptoms
• period history

They may also do tests such as:

• a pregnancy test
• blood tests
• a chromosome (genetic) test
• an x-ray of your pituitary gland

ASK YOUR DOCTOR — Preparing for an appointment? Use the Question Builder for general tips on what to ask your GP or specialist.

How is premature and early menopause treated?

Treatment depends on your symptoms and preferences. Your doctor will talk with you about different options, such as:

• menopause hormone therapy (also known as hormone replacement therapy) —replaces the oestrogen your body would normally make until around 50 years of age
• non-hormonal prescription medicine — may help if hormone replacement therapy is not the right choice for you
• lifestyle and behavioural changes — regular exercise, healthy eating, good sleep and stress management can ease your symptoms and improve wellbeing

Some people try supplements or herbal remedies. There is no strong evidence that these work for premature and early menopausal symptoms.

If you have vaginal dryness, you can use lubricants to feel more comfortable.

Living with premature or early menopause

Premature and early menopause can affect your body and emotions. With the right support you can manage your symptoms and improve your health.

Can I still get pregnant?

It may be hard or impossible to get pregnant naturally if you have early or premature menopause. This is because your ovaries have stopped working earlier than usual.

You may be able to get pregnant through oocyte (egg) donation. This means eggs from a donor are fertilised in a laboratory and placed in your uterus.

Use contraception during premature and early menopause if you do not want to become pregnant.

Managing emotional wellbeing

Premature and early menopause may affect how you feel. You may find it helpful to talk to a mental health professional or a support group.

Lifestyle changes

There are things that you can do to support your health if you have premature or early menopause:

• exercise regularly
• limit how much alcohol you drink
• quit smoking
• eat a healthy diet that includes calcium and vitamin D
• get enough sleep

What are the complications of premature and early menopause?

If you go through premature or early menopause, you may have a higher chance of some health challenges. This is because your body stops making enough oestrogen earlier than usual. Oestrogen is a hormone that helps protect your bones, heart and brain.

Without treatment, low oestrogen levels over time can increase your chance of:

• infertility — premature and early menopause can make it hard or impossible to get pregnant naturally
• osteoporosis (bone thinning)
• heart disease
• dementia
• mental health challenges

Can premature and early menopause be prevented?

Premature and early menopause cannot be prevented.

Lifestyle changes can help reduce symptoms and lower your chance of complications.

Resources and support

• Jean Hailes has a fact sheet on premature and early menopause. Jean Hailes also has easy read fact sheets and videos in an accessible format to help people living with disabilities understand information.
• Australasian Menopause Society has fact sheets on many topics related to menopause.
• Cancer Council has information about early medical or surgical menopause.
• NSW Health has a list of menopausal symptoms to help you have conversations with your doctor. The list is available in English and other languages, including an easy-read version. There is also a checklist for Aboriginal and/or Torres Strait Islander females.

Partners and families can learn more at:

• Jean Hailes — information for partners
• NSW Health — understanding menopause for partners and families
• Australia’s National Infertility Network — support for females living with infertility and their families

You can also call the healthdirect helpline on 1800 022 222 (known as NURSE-ON-CALL in Victoria). A registered nurse is available to speak with you 24 hours a day, 7 days a week.