Early menopause is menopause between ages 40 and 45. Premature menopause is menopause before 40. Both mean more years with low estrogen, which can raise the risk of bone loss, heart disease and other problems. For most women in this group without a reason to avoid it, The Menopause Society recommends hormone therapy at least until about age 52.
Most women reach menopause around 52. The Menopause Society defines:
Menopause still means the same thing at any age: 12 months in a row with no period, not explained by pregnancy, birth control or another cause.
POI is not quite the same as menopause. NICHD explains that POI used to be called "premature menopause" or "premature ovarian failure", but those names don't fit well. A woman with POI may still have periods now and then, and she may still get pregnant. After menopause, normal periods don't return.
The signs are the same as menopause at any age, just sooner:
Missed periods can have many other causes. MedlinePlus lists pregnancy, breastfeeding, hormonal birth control, heavy exercise, sudden weight loss, severe stress, an overactive thyroid, pituitary problems and PCOS, among others. That is why a clinician checks for other causes before calling it menopause. NIA notes that if periods stop at a young age, a blood test to check hormone levels may be suggested.
Our perimenopause symptoms checklist can help you track changes over several weeks before your visit.
According to The Menopause Society and NICHD, causes include:
It depends on whether the ovaries are removed. The Menopause Society defines surgical menopause as removal of both ovaries. If you have surgery to remove your ovaries and don't take hormones, you will stop having periods and may have menopause symptoms right away (NIA).
The Menopause Society notes that removing both ovaries causes a much more sudden drop in estrogen and progesterone than natural menopause, and also a large drop in testosterone. Hot flashes and other symptoms are often more frequent and more severe after this surgery.
If only the uterus is removed and the ovaries stay, periods stop, but the ovaries keep making hormones. Ask your surgeon which organs were removed, because it changes your options.
Losing ovarian hormones years early means more time with low estrogen. The Menopause Society's 2022 statement says women with POI or premature or early menopause may be at higher risk of:
These risks are linked mostly to low estrogen. That is why treatment focuses not just on symptoms, but also on protecting bones and the heart.
For many women, yes. The Menopause Society says that, unless there is a reason to avoid it, hormone therapy is recommended at least until the average age of menopause, about 52. It also says the results of the large Women's Health Initiative trials, which studied older women, do not apply to women with POI or premature or early menopause.
Other points from the statement:
Hormone therapy still has risks, and it is not right for everyone. For example, it is generally not used by people with certain cancers, a history of blood clots or stroke, or liver disease. Our guide Is HRT safe? covers the risks in detail.
Can I get pregnant if I have POI? It is possible. NICHD notes that women with POI may still get pregnant, and The Menopause Society says about 5% of women with POI may conceive without treatment. Talk to your clinician about birth control or fertility, depending on your goals.
Is early menopause genetic? Sometimes. About 10% to 20% of women with POI have a family history of it (NICHD). Ask your mother or sisters when they reached menopause, if you can.
Do I need HRT if I feel fine? Even without symptoms, The Menopause Society recommends hormone therapy for women with premature or early menopause who have no reason to avoid it, mainly to protect bones and heart. Discuss your own risks and benefits with your clinician.
What are the signs of menopause at 40? Irregular or missed periods, hot flashes, night sweats, sleep problems and vaginal dryness are common. Other conditions can cause the same signs, so get checked.
Does surgical menopause feel different? Often, yes. Symptoms can start suddenly and be more severe than in natural menopause (The Menopause Society).
Talk with us about early or premature menopause. Book a visit or call (210) 903-1030. In-clinic in San Antonio • Telehealth for women located in Texas Yaso Wellness Health Clinic, 1907 Goliad Rd, San Antonio, TX 78223
Education only, not medical advice. Not everyone is a candidate for hormone therapy. In an emergency, call 911.
Leticia Vargas, MD, OB/GYN, sees patients at Yaso Wellness Health Clinic in San Antonio. About Dr. Vargas
Education only, not medical advice or a diagnosis. In an emergency, call 911.
