Early Menopause: Causes and Symptoms

As women, we all know we’ll reach menopause one day. But what happens if that day comes sooner than expected? 

In this article, we’ll cover everything you need to know about early menopause – including:

• Why it can happen
• Long-term risk factors to be aware of 
• Common signs and  early menopause symptoms to expect 

We’ll also share some tips for symptom management. 

Ready? Let’s go! 

Early Menopause Explained

The global average age of menopause is between 45 and 55. When menopause is reached before 45, it’s considered to be early. This is called early menopause.

There are a number of health challenges associated with early menopause. Most notably – the emotional impact of no longer being able to conceive naturally. There is also an increased risk of:

• Osteoporosis
• Heart disease
• Low mood
• Depression
• Anxiety

For the majority of cases, the underlying cause of early menopause is unknown. However, certain individuals may have an increased risk of reaching menopause early. This includes those who:

• Have a family history of early menopause
• Started their period before the age of 11
• Have never given birth or have given birth fewer than three times
• Smoke
• Have an autoimmune disease
• Have HIV or AIDS
• Have undergone certain cancer treatments
• Have had one or both ovaries surgically removed

Read on for a closer look at the different factors that can lead to early menopause. 

What Causes Early Menopause?

Family History of Early Menopause

If your mother, sister, aunt, or someone else in your family reached menopause early, you’re more likely to reach it early too. In one research study, 37.5% of individuals who reached menopause early reported a family history of early menopause. Results from another study show the heritability of menopausal age to be around 44%. 

Age of First Period

If you had your very first period before the age of 11, you’re also at a greater risk of early menopause. This is backed by a multinational research study which found starting your period early (before age 11) increases the risk of premature and early menopause by 80%. 

Number of Childbirths

You are also more likely to reach menopause early if you have never given birth or if you’ve given birth once or twice. In a study of women in Norway, women who had never given birth had the lowest average age at menopause, while women who had given birth at least three times had the highest average age at menopause. 

Smoking

Smoking is another factor that increases the risk of early menopause. For example, in a study of cases from 1989 to 2011, both former and current smokers were more likely to experience early menopause. However, the risk is not as high for those who smoked less than 10 cigarettes per day and quit smoking by age 25. 

Autoimmune Diseases

Autoimmune diseases such as rheumatoid arthritis, Crohn’s disease, and thyroid disease can also cause menopause to occur early. Research suggests this is due to inflammation, which can interfere with ovarian functioning and hormone levels. 

HIV or AIDS

Having HIV or AIDS is also a risk factor for early menopause. Research suggests an estimated 5-30% of individuals with HIV experience early menopause. Menopause is also estimated to occur, on average, five years earlier in women with HIV. 

Chemotherapy, Radiation, and Hormone Therapy

Cancer treatments such as chemotherapy, radiation, and hormone therapy are known to increase the risk of early menopause. For example, certain chemotherapy drugs can damage the ovaries. In turn, this increases the risk of early menopause. 

Other therapies and treatments that increase the risk of early menopause include radiation in the pelvic area and hormone therapy medications such as GnRHa, goserelin, and leuprolide. 

Surgical Removal of the Ovaries and/or Uterus

Naturally, if one or both of your ovaries have been surgically removed before the age of 45, you will experience menopause right after surgery. This is sometimes referred to as ‘surgical menopause’. 

Early Menopause Symptoms and Signs

You are considered to have reached menopause when you go at least 12 months in a row without having a period. 

However, this transition from regular periods to no periods does not happen overnight. Instead, it can take up to eight years for the body’s hormone patterns to completely adjust. Even in cases of early menopause. 

This transition is called perimenopause. This is the time when you’ll experience the typical symptoms of menopause. Such as: 

• Irregular periods
• Hot flashes
• Night sweats
• Mood changes
• Irritability
• Sleep disturbances
• Vaginal dryness and discomfort
• Low libido
• Weight gain
• Changes in metabolism
• Thinning of the hair and hair loss
• Dry and itchy skin

It’s important to note that everyone’s body and journey to menopause is different. You may experience some symptoms worse than others. Your symptoms can also evolve over time. Try to be patient with yourself, and seek help from your doctor if you find yourself struggling. 

Health Challenges Associated with Early Menopause

When menopause happens sooner than expected, there are certain long-term health risks and challenges to be aware of. 

To start, reaching menopause early means you will no longer be able to conceive naturally. This can be difficult to process emotionally. Even if you don’t want to become pregnant, knowing your body can’t anymore can be hard to accept. If you do still want to grow your family after menopause, it’s possible with the help of surrogacy or adoption. If you are at risk of reaching menopause early, it’s worth exploring these options ahead of time to prepare yourself. 

Early menopause also increases the risk of osteoporosis and heart disease. During the reproductive years, estrogen helps to keep bones strong. It also helps control cholesterol levels while also keeping arteries and blood vessels healthy. When estrogen levels decline during perimenopause and remain low throughout menopause, this can have a negative impact on bone and heart health. Depending on your medical history, your doctor may suggest certain lifestyle changes to help mitigate these risks. 

Lastly, individuals who reach menopause early may struggle more with their mental health. They may find it difficult to cope with no longer being able to conceive. They may also feel embarrassed or depressed about being ‘old’ or reaching menopause before their peers. The hormonal rollercoaster of perimenopause can also cause mood swings, irritability, and low libido. In turn, this can have a negative impact on the relationship with their partner and the way they feel about themselves. If you have reached menopause early and are struggling with your mental health, reach out to your doctor or a counselor for support. 

Diagnosis and Testing

Monitoring Your Hormones at Home

It can be difficult to know whether or not your body is headed for early menopause. Even if you know you’re at risk of early menopause, it doesn’t necessarily mean you’ll definitely reach menopause early. 

The only way to know exactly what’s going on inside your body is by testing your reproductive hormone levels directly. This is possible with Mira’s Menopause Transitions Kit. This kit (which includes the Mira Hormone Monitor, Fertility Max Wands, and Ovum Wands) enables you to regularly track four key reproductive hormones in urine, including:

• Estrogen-Estradiol Metabolite (E3G) – a biomarker for estradiol
• Pregnanediol Glucuronide (PdG) – a biomarker for progesterone
• Luteinizing Hormone (LH)
• Follicle-stimulating Hormone (FSH)

When tracked over time with the Mira App in Menopause Transitions Mode, you can see exactly what your hormones are doing in real time. You’ll also be able to see exactly where you are along your menopause journey. From late reproductive stage all the way to postmenopause. 

Seeking Advice from Your Doctor

When you go at least 12 consecutive months without a period, you will have ‘officially’ reached menopause. Typically, there will be no need for blood testing or a pelvic exam at this time. 

If you meet this criteria for menopause early (before the age of 45) but haven’t spoken about it to your doctor yet, it’s still a good idea to check-in with them. They will want to discuss the risk factors of early menopause with you. They will also want to assess the impact early menopause may have on any existing health conditions. 

Your doctor may also ask how you’re coping mentally and emotionally with the changes. This is the time to bring up any menopause symptoms that are interfering with your day-to-day life. Your doctor can then recommend potential lifestyle changes and medical treatments that can help.

Managing Early Menopause Signs and Symptoms

The symptoms of menopause often start long before you’ve technically reached menopause. In fact, the transitional period of perimenopause can last up to eight years. This means those who enter menopause early can start experiencing perimenopausal symptoms as early as their mid to late thirties. 

During this time, it’s still possible to become pregnant. However, your chances of conception become increasingly lower over time. If you are actively trying to plan a pregnancy, speak with your doctor. They can provide practical advice on getting pregnant during perimenopause. 

When it comes to managing the physical and psychological symptoms of perimenopause, there are certain lifestyle changes, medications, and natural remedies for menopause that can help. 

Common lifestyle recommendations include:

• Maintain a balanced, nutrient-rich diet
• Stay active with regular exercise
• Keep stress levels low
• Avoid ‘triggering’ foods and drinks – such as alcohol, caffeine, and spicy foods
• Get plenty of rest and commit to a sleep routine

There are also some natural supplements for menopause that can help. For example, supplements like black cohosh, ginseng, evening primrose oil, and red clover may help ease menopause symptoms. 

If you have tried making lifestyle changes but you’re still struggling, it’s time to make an appointment with your doctor. They can provide guidance on potential hormonal and non-hormonal medications that can help. Common hormonal medications include synthetic estrogen, progesterone, testosterone. Common non-hormonal medications include clonidine, gabapentin, and certain antidepressants.

Final Thoughts

Entering the transition to menopause before other people your age can be frustrating and isolating. 

The best thing you can do for yourself during this time is to build a support system around you. Speak with your partner and a trusted friend or relative. Reach out to your healthcare provider. You can even reach out to us in our Hormone Health Clinic for Fertility. Our hormone health specialists can help you navigate all things related to the transition to menopause – such as: 

• Testing your hormones
• Interpreting your charts and 
• Implementing positive lifestyle changes

There are also a number of online communities that provide information, support, and connection. A great place to start is with communities like The Menopause Charity, The Menopause Society, and Let’s Talk Menopause. 

Frequently Asked Questions