Early Menopause: Everything You Need To Know

Written by - Reviewed by Consumer Health Digest Team

Published: Jun 5, 2013 | Last Updated: Apr 1, 2019

Menopause is a common topic nowadays, yet some subjects aren’t discussed enough. The average onset of menopause among American women is 51, but due to different factors, some women enter their menopause earlier. What is early menopause? What are early menopause symptoms and treatment options? Keep reading to get your answers and find out more about causes, potential health risks, and other important info about going through the “change” prematurely.

What is Early Menopause?

The average age of menopause in most countries is 50. Therefore, if a woman starts menopause before the age of 40, it is considered early menopause. There are various causes for early menopause, discussed later in this article.

The menopausal transition occurs when a woman’s ovaries stop producing much-needed hormone estrogen. This hormone regulates your reproductive cycle and influences most aspects of your health and wellbeing. Basically, anything that damages your ovaries and negatively affects estrogen production can lead to early menopause.

What are the Symptoms of Early Menopause?

Symptoms of early menopause are quite similar to those of menopause which occurs in normal age. The process is triggered by hormonal fluctuations which then go on to induce a multitude of other signs and symptoms. It is important to mention that severity and frequency of early menopause symptoms vary according to the cause. Generally, women start experiencing some symptoms during perimenopause, the time before the actual menopause. When you don’t get your period for 12 months straight, it means you entered menopause.

Women whose ovaries were surgically removed usually skip perimenopause and enter early menopause right away. They tend to experience severe symptoms. On the other hand, when you enter menopause in a natural manner, symptoms are usually mild.

So, what are the most common signs and symptoms associated with early menopause? Here they are:

  • Bladder irritability and incontinence
  • Changes in memory and cognitive abilities
  • Dry skin, mouth, and eyes
  • Hot flashes
  • Low sex drive
  • Mood swings
  • Night sweats
  • Sleep difficulties
  • Vaginal dryness
  • Vaginal pain during intercourse
  • Weight gain

Symptoms that say you’re about to enter early menopause usually include:

  • Spotting
  • Heavy bleeding
  • Periods lasting longer than a week
  • Period after almost a year of no bleeding at all

Bear in mind that every woman is different and you experience these symptoms differently, as well. When you the above-mentioned changes in your body, even alterations in the menstrual cycle only, you should consult your doctor who will diagnose the problem.

Other- Early Menopause Signs and Symptoms

1. Vaginal Dryness:

Vaginal dryness can occur during early menopause as a result of fluctuating levels of estrogen in a woman’s body. One of the many functions of this hormone is to keep the vaginal tissues elastic, thick, and moist. Hence, if the body cannot maintain optimum levels of estrogen, it causes the vaginal walls to be dry. They also become thinner than normal and less elastic. Research studies have shown that this symptom is more prevalent during the early menopause than during natural menopause.

2. Bladder Irritability:

When a woman enters early menopause, one of the most common, and most embarrassing, symptoms are bladder irritability. This bladder irritability is also directly related to lower estrogen because this hormone is also responsible for proper bladder function. Bladder irritability is evidenced by bladder leaks at unexpected times. Simple activities like sneezing or coughing can trigger these bladder leaks.

3. Hot Flashes:

Early Menopause

Most women in early menopause realize that they are likely going through the early stages of menopause when they have hot flashes. This is probably because hot flashes are the most common menopause symptom, with 75% of menopausal women experiencing them. When a woman has a hot flash, she has a severe feeling of heat on the upper part of her body, so much so that she feels like her body is on fire. Hot flashes are normally accompanied by sweating, heart palpitations, flushed skin, and a high temperature.

4. Irregular/Missed Periods:

During early menopause, a woman may begin to experience changes in her menstrual cycle. These changes can be stressful to a woman who is used to having her period in a certain way at a particular time. For example, some women may start having a much heavier menstrual flow than normal, or it may actually become much lighter. In some cases, the period may occur for much fewer days than normal, or for a longer time period. In most cases, however, women skip a few months without having their menstrual period at all.

5. Emotional Changes:

During the early menopause, a woman may experience emotional changes. A woman experiencing these changes has strong emotional reactions to external stimuli. Even if a woman has been even-tempered for her whole life, she may find it difficult to control her temper and feelings of despair during early menopause. As she swings from happiness to anger, sadness, or depression, it may make it difficult for those closest to her to communicate with her.

6. Insomnia:

During the early menopause, a woman may suffer from insomnia. This means that she is unable to initiate or maintain sleep. Insomnia can be caused by a hot flash that occurs at night. Insomnia may aggravate other symptoms of early menopause, including fatigue, emotional changes, and irritability.

7. Night Sweats:

Night sweats during early menopause occur when a woman has a hot flash while she is asleep. She sweats profusely, as a result, and her bedding and night clothes are usually drenched in sweat.

8. Irritability or Difficulty Concentrating:

During early menopause, a woman may find that she becomes particularly irritable. Situations which would have normally not phased her, make her terribly upset. She may also find that she has difficulty concentrating on simple tasks.

9. Decreased Sexual Desire:

Decreased sexual desire during early menopause is a direct effect of lower levels of progesterone and estrogen in the body. These hormones are not only responsible for the menstrual cycle, but also for sexual desires and functions. Lower or fluctuating levels of these female hormones decrease a woman’s libido.

What Causes Early Menopause?

It would be impossible to pinpoint a single cause that induces early menopause. In many cases, a combination of different causes is responsible for entering the change before you reach 40. Let’s see what they are.

A common medical cause of early menopause is a condition called premature ovarian failure. Here, a woman’s ovaries cease to function normally before she turns 40 and although you can still get your period from time to time, you can experience troubles with fertility. The condition is, in most instances, accompanied by primary ovarian insufficiency.

Yet another common medical cause of early menopause is a treatment for cancer or some other health conditions that require radiation therapy and/or chemotherapy in the pelvis area. These particular treatments tend to damage the functionality of your ovaries and disturb the production of estrogen.

In addition, a surgical removal of one or both ovaries can also lead to early menopause. Besides these, other common medical causes of entering menopause prematurely include:

  • Psychiatric disorders
  • Hypothalamic and pituitary tumors
  • Chronic diseases
  • Drugs
  • Autoimmune diseases
  • Chromosome defects
  • Epilepsy

Other Causes of Early Menopause

1. Natural Causes of Early Menopause:

Natural causes can sometimes cause early menopause. This means that a woman has reached this stage without any external influences. For example, the woman’s female family members may have reached menopause early, hence she is more likely to reach menopause before her 40s.

2. Medical Causes of Early Menopause:

There are several medical treatments that can bring about early menopause. Pelvic radiation treatments or chemotherapy for the treatment of cancer can cause permanent damage to the ovaries. This will lead to an end of the menstrual period and menopause is likely to begin immediately, or a few months after the end of the treatment. If a woman has had surgery to remove the uterus or the ovaries, she will immediately go into menopause. Her menstrual period stops and her hormonal levels drop significantly, leading to the onset of severe menopause symptoms.

3. Other Causes of Early Menopause:

Certain autoimmune diseases can work against the body by attacking the ovaries. If the ovaries are damaged, they stop producing estrogen and progesterone, and a woman starts early menopause at that stage. Smokers are also at risk of early menopause because their smoking damages the ovaries.

Effects of Early Menopause

A woman in early menopause has the same health risk as those who go through natural menopause. The main difference is that a woman who goes through menopause before she is 40 has got more years without the protective effects of estrogen in her body. Hence, the may be at a greater risk of osteoporosis (loss of bone mass), cardiovascular disease and certain types of cancers.

Emotional Impact of Early Menopause

Early menopause can be emotionally challenging for a woman. If, for example, a woman is still planning to have children, and realizes that she has reached menopause, it may be emotionally devastating for her. Furthermore, early menopause symptoms are usually more severe than symptoms during natural menopause.

What are the Risk Factors for Early Menopause?

Although every woman can enter early menopause, some women are at a higher risk. Common risk factors include:

  • Smoking – this unhealthy habit is bad news for your health. Besides increasing risk of a number of diseases and health conditions, it can also lead to early menopause. Why? Smoking exhibits anti-estrogen effects. A study from the Nature Genetics found that long-term or regular smokers are more likely to enter menopause earlier. Generally, women who smoke tend to start menopause about two years earlier compared to their non-smoker counterparts
  • BMI – studies show that underweight women are at a higher riskof starting their menopause prematurely. Estrogen is stored in fat tissue meaning women who are underweight have fewer estrogen stores which deplete faster
  • Genetics – you are more likely to start early menopause if someone in your family also did
  • Other Risk factors: thyroid disorders, viral infections, eating disorders, stress

Other Risk Factors

A recent research study at Johns Hopkins University School of Medicine indicated that women who enter early menopause are at a higher risk for stroke and heart disease. Doctors, therefore, recommend that as far as possible, women should avoid factors that may influence the early onslaught of menopause, e.g. smoking.

Health Complications

The onset of early menopause indicates the existence of a health problem in many cases. In addition, it is linked to different health concerns and risk including:

  • Cataract formation
  • Colon and ovarian cancer
  • Dementia
  • Heart disease
  • Infertility
  • Osteoporosis
  • Parkinson’s-like symptoms
  • Premature death
  • Tooth loss

Just because health risks exist, it doesn’t mean you’ll have them if enter early menopause. With adequate treatment and proper management, you can improve quality of life and decrease the severity of symptoms.

Because women who enter early menopause have lower levels of estrogen for a longer period of time, their overall health is lower than normal. They are also susceptible to complications brought about by menopausal symptoms, which adversely affect not only their health but also their relationships with those close to them.

How is Early or Premature Menopause Diagnosed?

In order to diagnose early or premature menopause, a doctor will normally run blood tests. These tests are run to confirm that the menopause symptoms a woman is experiencing are not as a result of other conditions which exhibit similar symptoms. These include certain types of cancers and hyperthyroidism.

It is important to see your doctor as soon as you notice the above-listed symptoms along with menstrual irregularities. Although there is no specific test for the diagnosis of early menopause, your doctor may recommend some tests to evaluate ovarian function. For instance, your healthcare provider may order some tests (including pregnancy test) to eliminate the most common causes of missed periods. Moreover, your doctor may also measure follicle-stimulating hormone (FSH) to determine whether you’re near menopause and inspect the functional status of your ovaries.

How to Treat Early Menopause?

The first thing to bear in mind is that there are no early menopause treatment options that would reverse menopause and delay it until you reach 51. That being said, different treatments are available for management of symptoms you experience by lowering their intensity and frequency.

Early menopause symptoms are usually treated in the same way as natural menopause symptoms. Treatment options include hormone replacement therapy (HRT), natural herbal medicines and lifestyle changes.

Common early menopause treatment options include:

  • Hormone replacement therapy (HRT)- prevents common menopausal symptoms, most effective for hot flashes and night sweats. Speaking of hormone therapy, you also have the option to use vaginal estrogen to treat dryness and painful intercourse
  • Menopausal hormone therapy (MHT) – estrogen and progesterone supplements like Relizen reduce menopause symptoms and decrease bone loss
  • Antidepressant medications- intake of selective serotonin reuptake inhibitors (SSRIs) helps manage menopause and address mental and emotional problems that are common at this stage of your life

Management Tips

Women who entered their menopause early can improve quality of life by adhering to doctor’s instructions and making some lifestyle tweaks. For example:

  • Avoid or limit alcohol intake
  • Avoid triggers (situations, foods, clothes) that induce hot flashes
  • Consider scheduling an appointment and talking it out with a therapist
  • Eat Omega-3 fatty acids
  • Exercise regularly and increase activity levels (e.g. use stairs instead of elevator)
  • Get enough of sleep
  • Increase consumption of fruits and vegetables
  • Increase intake of foods that are rich in calcium and vitamin D
  • Keep weight in a healthy range
  • Manage stress
  • Quit smoking
  • Turn to loved ones for support


Although the average onset of menopause is 51, some women can enter the change early. Common causes of early menopause are health problems, heredity, unhealthy lifestyle, and other factors. Throughout this post, you learned more about early menopause symptoms and treatment options that show you can still have a normal, fulfilled and happy life.

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