Premature Menopause

  • Medical Author:
    Melissa Conrad Stöppler, MD

    Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.

  • Medical Editor: Charles Patrick Davis, MD, PhD
    Charles Patrick Davis, MD, PhD

    Charles Patrick Davis, MD, PhD

    Dr. Charles "Pat" Davis, MD, PhD, is a board certified Emergency Medicine doctor who currently practices as a consultant and staff member for hospitals. He has a PhD in Microbiology (UT at Austin), and the MD (Univ. Texas Medical Branch, Galveston). He is a Clinical Professor (retired) in the Division of Emergency Medicine, UT Health Science Center at San Antonio, and has been the Chief of Emergency Medicine at UT Medical Branch and at UTHSCSA with over 250 publications.

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What causes premature menopause?

One medical causes of premature menopause is known as premature ovarian failure. Technically, premature ovarian failure is not the same as premature menopause. In premature ovarian failure, the ovaries stop functioning normally before the age of 40. Women with premature ovarian failure may still occasionally have menstrual periods, but they typically experience infertility. Premature ovarian failure is usually accompanied primary ovarian insufficiency. Premature ovarian failure is usually accompanied by the symptoms of premature menopause.

Premature menopause can also be caused by treatments for cancers or other conditions that involve chemotherapy and/or radiation therapy to the pelvis. These treatments can damage the ovaries and result in ovarian failure.

Surgery to remove the ovaries, either for benign or malignant conditions, results in premature menopause if both ovaries are removed. Surgery to remove the uterus results in menopause only in the sense that menstrual bleeding does not occur. In that case, the ovaries will continue to produce hormones.

Other infrequent causes that may lead to premature menopause include drugs, chronic diseases, pituitary and hypothalamic tumors, psychiatric disorders, and other relatively rare or undefined conditions.

Who is at risk for premature menopause?

Premature ovarian failure affects about 1 out of every 1000 women from ages 15 to 29 and about 1 out of every 100 women aged 30 to 39. It can be related to genetic (inherited) factors, to illnesses like autoimmune diseases, thyroid disease, viral infection, hormonal disorders, and eating disorders. The risk of premature ovarian failure risk increases in women who have relatives with the condition.

Women at risk for surgical or treatment-induced menopause are those who are undergoing treatment for cancer or other conditions that require surgical removal of the female organs.

What are the symptoms of premature menopause?

The symptoms of premature menopause are those of typical menopause. They can include:

Irregular periods usually precede the menopause and can begin years before periods actually cease.

What tests are used to diagnose premature menopause?

No special tests are needed to determine the absence of menstrual periods, but sometimes women begin having symptoms of menopause and irregular periods. At that point, they may be tested to determine their ovarian function. For example, tests may be done to rule out pregnancy or other causes of missed menstruation, such as certain thyroid diseases. The level of follicle-stimulating hormone (FSH) is often measured in the blood to determine whether a woman is nearing menopause and to ascertain the functional status of her ovaries. FSH stimulates the ovaries to produce estrogen, so levels of this hormone rise when estrogen levels drop. FSH levels that are higher than 40 mIU/ml are considered diagnostic of the menopause. Levels of ovarian hormones, such as estradiol, may be also measured, as low levels (levels less than 32 pg/ml) are suggestive of menopause.

Medically Reviewed by a Doctor on 5/17/2016

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