Understanding Menopause - Stages of Menopause

What is Premature Menopause?

Premature menopause is menopause that happens before the age of 40 — whether it is natural or induced. Women who enter menopause early get symptoms similar to those of natural menopause, like hot flashes, emotional problems, vaginal dryness, and decreased sex drive. For some women with early menopause, these symptoms are severe. Also, women who have early menopause tend to get weaker bones faster than women who enter menopause later in life. This raises their chances of getting osteoporosis and breaking a bone. Premature menopause can happen for the following reasons:

Chromosome defects. Defects in the chromosomes can cause premature menopause. For example, women with Turner's syndrome are born without a second X chromosome or born without part of the chromosome. The ovaries don't form normally, and early menopause results.

Genetics. Women with a family history of premature menopause are more likely to have early menopause themselves.

Autoimmune diseases. The body's immune system, which normally fights off diseases, mistakenly attacks a part of its own reproductive system. This hurts the ovaries and prevents them from making female hormones. Thyroid disease and rheumatoid arthritis are two diseases in which this can happen.

Surgery to remove the ovaries. Surgical removal of both ovaries, also called a bilateral oophorectomy [OH-uh-fuh-REK-tuh-mee], puts a woman into menopause right away. She will no longer have periods, and hormones decline rapidly. She may have menopausal symptoms right away, like hot flashes and diminished sexual desire. Women who have a hysterectomy, but have their ovaries left in place, will not have induced menopause because their ovaries will continue to make hormones. But because their uterus is removed, they no longer have their periods and cannot get pregnant. They might have hot flashes since the surgery can sometimes disturb the blood supply to the ovaries. Later on, they might have natural menopause a year or two earlier than expected.

Chemotherapy or pelvic radiation treatments for cancer. Cancer chemotherapy or pelvic radiation therapy for reproductive system cancers can cause ovarian damage. Women may stop getting their periods, have fertility problems, or lose their fertility. This can happen right away or take several months. With cancer treatment, the chances of going into menopause depend on the type of chemotherapy used, how much was used, and the age of the woman when she gets treatment. The younger a woman is, the less likely she will go into menopause.

How to Find Out if You Have Premature Menopause

Your doctor will ask you if you've had changes typical of menopause, like hot flashes, irregular periods, sleep problems, and vaginal dryness. Normally, menopause is confirmed when a woman hasn't had her period for 12 months in a row.

However, with certain types of premature menopause, these signs may not be enough for a diagnosis. A blood test that measures follicle-stimulating hormone (FSH) can be done. Your ovaries use this hormone to make estrogen. FSH levels rise when the ovaries stop making estrogen. When FSH levels are higher than normal, you've reached menopause. However, your estrogen levels vary daily, so you may need this test more than once to know for sure.

You may also have a test for levels of estradiol (a type of estrogen) and luteinizing hormone (LH). Estradiol levels fall when the ovaries fail. Levels lower than normal are a sign of menopause. LH is a hormone that triggers ovulation. If you test above normal levels, you've gone through menopause.

Additional Resources on Premature Menopause:

Publications

Do I have Premature Ovarian Failure? - This article discusses Premature Ovarian syndrome (POF), its symptoms, and it's patterns. Hormones, genes, the immune system, and other factors may all play a role in POF.

http://www.nichd.nih.gov/publications/pubs/pof/

Frequently Asked Questions - Menopause and Menopause Treatments - This fact sheet discusses menopause symptoms and treatments, including postmenopausal hormone therapy (HT) and the practical steps women can take to alleviate symptoms and prevent diseases like osteoporosis and heart disease.

http://www.womenshealth.gov/faq/menopaus.htm

Health Care Maintenance for Women Undergoing Risk-Reducing Ovarian Surgery - This publication explains menopause symptoms and the associated health concerns for women who are considering risk-reducing ovarian surgery.

http://ovariancancer.gog199.cancer.gov/PrematureMenopause_082404.pdf

Early Menopause Guidebook (Copyright © NAMS) - This booklet explains premature menopause and its causes. It lists the symptoms and treatments associated with menopause, and gives information on postmenopausal health concerns.

http://www.menopause.org/edumaterials/earlyguidebook/emgtoc.aspx

Hysterectomy: Does it cause early menopause? (Copyright © MFMER) - This brief publication answers the question as to whether hysterectomy causes early menopause. A doctor provides her insight into the issue.

http://www.mayoclinic.com/health/hysterectomy/AN01430

http://www.clevelandclinic.org/health/health-info/docs/3200/3288.asp?index=10335

Menopause: A New Beginning (Copyright © NAMS) - This easy-to-read book describes everything about menopause and includes information specifically for women going through menopause following a hysterectomy.

http://www.menopause.org/edumaterials/easyreadenglish.pdf

http://www.americanpregnancy.org/womenshealth/pof.htm

Organizations

= Indicates Federal Resources

Content last updated May 29, 2008.