Early menopause

Women whose periods stop completely and permanently before age 40 are said to have premature menopause. The symptoms of early menopause are the same as those of natural menopause at the usual time of life.

Why menopause comes early

Premature menopause may arise because of:

  • surgery or treatment that removes or damages the ovaries (called ‘induced menopause’). When early menopause is caused by surgery, the immediate drop in hormones can produce more noticeable and more disruptive symptoms
  • primary ovarian insufficiency (POI). Women with POI have irregular and infrequent periods, but can still sometimes become pregnant. Contraception is needed to avoid pregnancy. POI may go on for many years before menopause and can cause menopausal symptoms even prior to menopause.

Risks associated with premature menopause:

  • increased vulnerability to bone loss and heart disease
  • intense, complex emotional responses particularly if you are being treated for cancer or another serious illness. 

Early menopause is particularly difficult for women who have not yet started or completed their families because of the low chance of becoming pregnant. There may be still options for parenting, and these can be discussed with a fertility specialist.

Menopause after cancer treatment

Cancer chemotherapy and radiation therapy are intended to injure or kill cancer cells and prevent tumours from growing, but both can also damage healthy tissue, including the ovaries. 

If you require cancer treatment, you should discuss your plans for future pregnancies and the available options for fertility preservation with your doctors before you begin treatment. 

In addition to causing menopausal symptoms (including vaginal dryness) by injuring the ovaries, some chemotherapy and pelvic radiation treatments can irritate and inflame the vagina and vulva. With some types of radiotherapy, some women need physiotherapy to prevent permanent shrinkage of the vagina.

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