Premature menopause is the permanent cessation of menses before the age of 40 and it affects 1% of women. In contrast to menopause, the premature menopause is not considered a normal but rather a pathological condition that needs extra attention.


The causes of premature menopause are not clear in 60% of cases and could be attributed to a combination of factors.

Premature menopause could be due to:

  • Family history
    If your mother suffered from premature menopause, it is very likely that you might experience the same.
  • Smoking
    Women who smoke could enter menopause 2 years earlier compared to those who do not smoke. Also, they might experience more intense side effects, such as hot flushes and sweating
  • Pelvic chemotherapy or radiotherapy
    These treatments could damage the ovaries and lead to premature menopause in the majority of cases. The risk is greater is women who undergo treatment in older age.
  • Surgical removal of the ovaries
    The surgical removal of the ovaries is going to lead immediately to menopause. If the woman is young, the symptoms are going to be more severe.
  • Autoimmune diseases
    Rarely autoimmune diseases could affect the ovaries causing premature ovarian failure.
  • Chromosomal abnormalities
    Women who are missing a chromosome (women with Turner syndrome) or have a genetic condition, might experience premature menopause.
  • Chronic fatigue syndrome
    Women who suffer from chronic fatigue syndrome might experience fatigue, muscle pains, memory loss, insomnia etc. These women are more likely to have premature menopause.


If you experience menstrual disorders or do not have a period for 12 consecutive months, you should visit your gynaecologist. The diagnosis is reached combining:

  • The clinical symptoms (hot flushes, menstrual irregularities, vaginal dryness, subfertility)
  • The family history
  • Specific blood tests: FSH, LH, AMH, oestradiol, prolactin, thyroid function tests
  • Pelvic gynaecological ultrasound

Are there any dangers related to premature menopause?

Due to the low levels of oestrogens, women in premature menopause are at increased risk of:

  • Cardiovascular diseases
  • Osteoporosis
    Women in premature menopause might start losing bone mass two years earlier than women who reach menopause at the age of 50, thus increasing their risk of osteoporosis.
  • Severe menopausal symptoms
  • Depression
    Premature menopause is associated with depression, memory loss and, according to some researchers, Parkinson’s disease.

Treatment of premature menopause

The main treatment of premature menopause is hormonal replacement treatment (HRT).

Before starting any form of HRT is essential to assess the history of each woman and to exclude any contraindications to HRT i.e. breast cancer, liver disease, history of thrombosis or severe thrombophilia etc. If there are no contraindications, and provided that women are going to have regular check-ups, the treatment is long-term and lasts at least until the average age of menopause (52 yrs).

Lifestyle changes, smoking cessation, exercise and healthy diet, are equally important for women in premature menopause.

Women, who are thinking of having a baby, need to have IVF and it is almost certain that are going to need egg donation.