Early menopause

Menopause before the age of 40 is called 'premature menopause' and before age 45 is called 'early menopause'.

At any age, menopause often starts with a change in menstrual periods (skipping periods), hot flushes and night sweats. It is not known whether symptoms from premature or early menopause are more severe or longer-lasting than those at natural menopause.

Why menopause comes early

Premature menopause may be spontaneous (just happen) or may follow:

  • Surgery to remove both ovaries (called surgical menopause).
  • Treatment for cancer, such as chemotherapy or radiation to the pelvis.

Natural premature or early menopause is sometimes called 'premature ovarian insufficiency' or (POI). See Australasian Menopause Society for more information.

Although premature or early menopause means that fertility is reduced, pregnancy can sometimes occur and women who wish to avoid pregnancy should still use contraception. 

Younger menopausal women who do not have medical reasons preventing them from using menopausal hormone therapy (MHT) are generally advised to take MHT until around the age of 50 years. In addition to treating menopausal symptoms, MHT also prevents bone loss (osteoporosis) and fracture.

Younger women may also find premature or early menopause distressing because of the impact it has on their fertility and quality of life. Visit the Daisy Network website for support services and advice. 

Menopause after cancer

In younger women, treatments for some cancers can lead to premature or early menopause. Below is a list of some of the known side effects of cancer therapies. 

  • For women with breast cancer:
    • Endocrine therapy for oestrogen-sensitive breast cancer can cause hot flushes and nights sweats.
    • Aromatase inhibitor treatments can cause vaginal dryness.
    • MHT is not recommended to treat menopause symptoms (also for women with some other hormone-dependent cancers).
  • Radiation treatment for cervical cancer or some bowel cancers may affect the elasticity and size of the vagina. Treatments are available to prevent and manage this. 

Managing these symptoms after cancer can be difficult. At the Women’s, the Menopause Symptoms after Cancer (MSAC) service is available to provide advice and treatments for troublesome symptoms.

Women at high risk of cancer, who are considering having their ovaries removed prior to natural menopause and young women who experience menopause due to cancer treatment, are encouraged to attend the MSAC service. As well as clinical support and treatments for symptoms, the service can provide advice and information about fertility preservation.​


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