Menopause, or a woman’s final menstrual period, typically occurs when she is in her late 40s to early 50s.
For about 1% of women, however, menopause can occur before age 40. Women who experience premature menopause have a higher risk of osteoporosis and heart disease because they spend more years without the benefits of estrogen.
Premature menopause can be induced—a result of surgery or medical treatments such as chemotherapy—or it can occur naturally. The causes of natural premature menopause vary and are often idiopathic, or unknown. Risk factors include genetics, family history and autoimmune diseases such as rheumatoid arthritis. Smoking puts women at risk as well.
Premature Menopause or POI?
Like menopause in older women, premature menopause that occurs naturally is confirmed only when a woman has gone 12 months without a period. Until then, perimenopause (the time when estrogen production wanes and periods gradually end) can appear similar to primary ovarian insufficiency (POI), a condition in which a woman produces less-than-optimal amounts of estrogen and ovulates on an irregular schedule.
The distinction is important for two reasons:
- Menopause signals the end of a woman’s estrogen production, while women with POI continue to produce estrogen.
- Unlike women who have gone through menopause, women with POI may still become pregnant, although POI often results in infertility.
The symptoms of POI are similar to those of menopause or estrogen deficiency.
Women who experience menopause naturally may have similar symptoms regardless of their age. According to Amanda Murchison, M.D., a Carilion Clinic obstetrician and gynecologist, symptoms during perimenopause can include:
- Irregular periods
- Hot flashes
- Night sweats or difficulty sleeping
- Mood swings
- Vaginal dryness and lowered libido
It is especially important for women under 40 who experience these symptoms to check in with their primary care provider or gynecologist, as menopause marks the end of fertility and the lack of estrogen over many years can increase a woman’s risk of:
- Heart disease
- Sexual problems
- Early death
According to Obstetrics and Gynecology specialist Kimberly Simcox, D.O., women of any age who experience these symptoms should check in with their physician. They can rule out other conditions and determine whether medical intervention, such as hormone replacement therapy, is needed.
Hormone replacement therapy primarily focuses on replacing the estrogen that your body no longer makes after menopause. Dr. Simcox notes that there are two main types of estrogen therapy: systemic hormone therapy and low-dose vaginal products. She recommends that you consult with your gynecologist to determine if these treatments would be safe and effective for you.