Causes
Often no cause is found. Known causes include genetic conditions such as Turner syndrome and fragile X premutation, autoimmune conditions, surgery to remove both ovaries, chemotherapy and pelvic radiotherapy.
Diagnosis
Periods absent for four months or more, plus a raised follicle stimulating hormone level above 25 units per litre. Your practitioner will also check for causes, including genetic and autoimmune tests.
Hormone therapy
Hormone therapy until at least 51, the average age of menopause, is recommended unless there is a reason not to. At this age it replaces normal hormone levels rather than adding extra. The risks seen in older women do not apply in the same way. It protects bones, heart and brain. The combined contraceptive pill is an alternative for some women.
Fertility
The ovaries can still work on and off. About one woman in twenty with premature ovarian insufficiency conceives without treatment. Use contraception if you do not want to be pregnant. Pregnancy with donor eggs has high success rates. Ask for referral early.
Emotional impact
Diagnosis can bring grief, shock and loss of identity, especially before children or as a result of cancer. Counselling and peer support help. The Daisy Network is a charity for women with premature menopause.
Long term care
Have a bone density scan at diagnosis. Check blood pressure, cholesterol and blood sugar regularly. Keep up strength and impact exercise.
See a practitioner if
- Your periods stop for four months or more before 40
- Your periods become irregular before 45 with hot flushes
- You are having cancer treatment and want to protect fertility
Common questions
Is early menopause my fault?
No. Lifestyle does not cause premature ovarian insufficiency. Smoking can bring natural menopause forward by one to two years, but that is different.
Is hormone therapy safe for me?
For women under 45, hormone therapy mainly replaces missing hormones. The benefits for bone and heart are substantial.
Can I still get pregnant?
Sometimes, yes. Talk to a fertility specialist early about all your options.
Sources
- European Society of Human Reproduction and Embryology, guideline on premature ovarian insufficiency, 2024
- Australasian Menopause Society, premature ovarian insufficiency information sheet
- The Daisy Network
This page is education, not medical advice. Talk to your doctor or menopause practitioner about your own care. In an emergency, call your local emergency number.