What Is Early Menopause?

Early menopause—sometimes incorrectly referred to as premature menopause—is menopause that begins before the age of 45.

Menopause is when you stop having your period for a year and you are not pregnant. It is a normal part of the aging process.

Most people enter menopause in their 50s, but some people start menopause early. In some cases, early menopause happens naturally, but there can also be other causes.

Here is an overview of early menopause, including its symptoms, causes, diagnosis, treatment, and more. 

Symptoms of Early Menopause

The symptoms of early menopause are similar to what people experience when they go through menopause. However, some people who go through early menopause experience more severe symptoms.

The symptoms of early menopause cover a wide range, and people may experience some, all, or few of them to different degrees.

If you are going through early menopause, you may have:

• Hot flashes
• Night sweats
• Vaginal dryness and painful sex
• Frequent urge to urinate
• Increased number of urinary tract infections (UTIs)
• Emotional changes or mood swings
• Trouble sleeping
• Tender breasts
• Rapid heartbeat
• Headaches
• Dry skin and eyes
• Aching joints
• Changes in sex drive
• Trouble with concentration
• Hair thinning or loss
• Weight gain

Causes

According to the Department of Health & Human Services' Office on Women's Health, about 5% of women experience natural early menopause. Only about 1% of women experience premature menopause (before the age of 40).

There are several reasons that a person might go into menopause early, including:

• Medications such as hormone treatments, particularly those that are used to treat certain reproductive cancers, can play a role.
• Smoking increases a person's chances of experiencing early menopause. Smokers may also have more severe symptoms of menopause than people who do not smoke.
• Medical treatments such as chemotherapy or radiation of the pelvis can damage the reproductive organs and cause infertility or early menopause. 
• Family history can influence a person's risk of early menopause. If someone in your family went through menopause early, it's more likely that you will.
• Surgical removal of the uterus or ovaries can cause a person to go through menopause early. Removal of the ovaries can cause menopause symptoms right away. If the uterus is removed but not the ovaries, menopause is unlikely to occur because the ovaries still produce hormones. If you undergo a hysterectomy, you may experience early menopause.
• Health conditions such as an autoimmune disease, HIV, or chronic fatigue syndrome can make a person more likely to experience early menopause. Some people with missing chromosomes may also experience abnormal menstrual cycles.

Diagnosis

If you are in your 50s, you will probably be able to tell when you start going through menopause based on the symptoms you have. If you're younger and think that you might be going through early or premature menopause, you'll want to see your doctor.

While your symptoms might be related to early menopause, they could also be signs of something else. Only your doctor can determine whether your symptoms are from menopause or another cause.

Your doctor will ask you questions about your menstrual cycle and about the symptoms you are having. They might also order blood tests to check levels of certain hormones, including:

• Follicle-stimulating hormone (FSH)
• Estrogen
• Anti-Mullerian hormone (AMH)
• Thyroid-stimulating hormone (TSH)

Treatment

Menopause is usually a natural process that doctors do not specifically treat. However, if you think you are going through menopause early, it's important to talk to your doctor.

Going through menopause early can increase your risk of certain health conditions, including:

• Neurological conditions (such as dementia)
• Sexual difficulties (loss of libido)
• Heart disease
• Osteoporosis
• Mood disorders

Reducing Risk

Certain treatments may help prevent some of the health risks that are associated with menopause—which range from weak bones and cardiovascular disease to premature death.

Your doctor may suggest hormone replacement therapy (HRT) to mitigate the risks associated with early or premature menopause.

Easing Symptoms

There are also prescription treatments that may help with menopausal symptoms, such as:

• Vaginal estrogen (to help with dryness)
• Antidepressants for depression (may also help with hot flashes)
• Medications to slow bone loss that can lead to osteoporosis

Hormone Replacement Therapy (HRT)

Hot flashes are one of the most common symptoms of menopause at any age, affecting more than 80% of people during the transition. Hot flashes can also be one of the most difficult symptoms to manage and can significantly impact a person's quality of life.

If you're going through menopause early, your symptoms—including hot flashes—might be more intense.

Mild hot flashes can usually be treated with lifestyle changes, but if you have severe hot flashes, you might need hormone replacement therapy (HRT) to get relief.

If You Cannot Take HRT

People with certain medical conditions or risk factors may not be able to take HRT. If this is the case for you, your doctor will talk to you about the options, such as different types of medication and lifestyle changes.

Antidepressants in the classes of selective serotonin reuptake inhibitors (SSRIs) and serotonin-norepinephrine reuptake inhibitors (SNRIs) can be an effective alternative treatment for hot flashes—even in people who do not have symptoms of depression. Other drugs that doctors prescribe for hot flashes include gabapentin or venlafaxine (Effexor).

If you are not a candidate for HRT, making some lifestyle changes might help ease the symptoms of early menopause. You may want to try:

• Using vaginal moisturizers regularly and vaginal lubricant during penetrative sex
• Exercising regularly (which can help with some symptoms like insomnia and hot flashes)
• Getting plenty of sleep (however, this can be challenging if your symptoms are interrupting your sleep)
• Layering clothing to cope with hot flashes
• Eating a balanced diet (which can help improve bone health and help with weight management)
• Quitting smoking

Coping

Coping with early menopause can be tough, especially if you have numerous or severe symptoms. Some people also feel strong emotions about the loss of fertility that comes with menopause.

However, with new medical advances such as in vitro fertilization (IVF), it’s possible for some people who go through menopause early to still get pregnant through egg donation.

It can be daunting to deal with the symptoms and potential long-term effects of early menopause. Some people find counseling or therapy helpful during this time.

A Word From Verywell 

If you have hot flashes, night sweats, and other common symptoms of menopause and you’re younger than 50, talk to your doctor. While these symptoms can indicate that you are going through early menopause, they can also be signs of other conditions.

There are risk factors associated with going through early menopause. Your doctor might want you to take certain treatments, such as hormone replacement therapy, to reduce these risks.

If you are concerned about the loss of fertility associated with menopause, your doctor can also talk to you about your options. In some cases, people who go through menopause early are still able to get pregnant through the use of IVF or other fertility treatments.

While doctors do not generally treat menopause, there are still strategies that you can use to reduce your symptoms and cope more effectively with the transition. These include lifestyle changes, medication, and support from a mental health professional.