Premature and early menopause

About early menopause and premature ovarian insufficiency (POI)

When you reach menopause your hormone levels drop and your ovaries stop producing and releasing eggs. It usually happens when you’re between 45 and 55.

If your ovaries stop working or you reach menopause between 40 and 45 it’s known as early menopause.

If your ovaries stop working before you’re 40 it’s called premature ovarian insufficiency (POI).

Early menopause and POI can happen naturally or can be caused by medical treatments like chemotherapy or having your ovaries removed.

About 1 in 6 women in Australia have early menopause or POI.

Symptoms of early menopause and POI

The main symptom of early menopause and POI is not having a regular period.

You might also get common symptoms of menopause, like:

• hot flushes and night sweats
• having trouble sleeping or concentrating
• feeling very tired
• having less interest in sex
• muscle and joint pains.

Some women with POI will only get irregular periods and no other symptoms.

Early menopause symptoms can be more intense if it’s caused by medical treatments. That’s because your hormone levels often drop more quickly.

Diagnosis and treatment

Talk to your GP if you're under 45 and you:

• have any menopause symptoms
• haven’t had your period for over 3 months.

Your doctor will give you a blood test to measure your follicle stimulating hormone (FSH) levels. They might also have a look at your ovaries using an ultrasound and check your other hormone levels.

If you’re diagnosed with early menopause or POI your doctor might do more tests to try and find a cause. They will usually do blood tests every few years to check your thyroid. In most cases of early menopause or POI, there is no obvious cause.

Your doctor will talk to you about what treatments are right for you. They’ll talk to you about things like:

• your emotional wellbeing
• fertility concerns
• how symptoms are affecting you.

Learn more about treatments and managing menopause symptoms.

Risk factors

You have a higher risk of early and premature menopause if you:

• started your periods early
• are below a healthy weight
• smoke.

It's also more likely if you have:

• family members with the same condition
• an autoimmune disease, like thyroid disease, rheumatoid arthritis or type 1 diabetes
• had certain infections, like mumps
• a genetic disease, like Turner's syndrome or Fragile X.

Fertility

It’s not usually possible to get pregnant if you have early menopause or POI but it can still happen for a small number of women. If you don’t want to get pregnant you should still use contraception if:

• your periods are irregular or infrequent but haven’t stopped
• you’re under 50 and your last period was less than 24 months ago
• you’re over 50 and your last period was less than 12 months ago.

If you’re at risk of POI because of things like cancer treatment you can freeze either eggs, embryos or ovarian tissue to try to use in the future. Doctors can also use injections to try to protect your ovaries if you’re having chemotherapy.

There are other options for having a family, like:

• using donor eggs
• adopting.

Losing your fertility because of early menopause can have a big impact on your emotional wellbeing. Talk to your doctor if you are still hoping to have children. They can talk to you about your options and help you find the right support.

Looking after yourself

Physical and sexual wellbeing

Low hormone levels after early menopause increase your risk of some health conditions.

These include:

• heart disease
• stroke
• weaker bones (osteoporosis)
• changes in your cholesterol levels
• weight gain, especially around your stomach.
• problems with sexual health for example uncomfortable sex or low sexual desire

Menopausal hormone therapy can help reduce these risks. Your GP can also suggest other ways to look after your health.

Emotional wellbeing

Going through early or premature menopause can feel different to going through it later in life.

You may feel:

• an overwhelming loss for your future
• loss of control over your body
• different about your relationships
• grief over being unable to create a new generation of your family
• worried about children you already have, and whether the same condition may affect their future.

Talk to your GP if these feelings start to affect your daily life, relationships or wellbeing.

Learn more about early menopause and POI on the:

• Premature and early menopause | healthdirect website
• Monash Centre for Health Research and Implementation website
• Australian Menopause Society website
• Jean Hailes website.

Information for First Nations women

Jean Hailes has information on menopause to support First Nations women.

Information in other languages

The Australian Menopause Society has videos in other languages about how menopause will affect your health and treatment options.

Jean Hailes has women’s health fact sheets in other languages and translated videos.