For many women, menopause can be an intimidating term. Not knowing exactly what to expect as they transition into the next stage of their reproductive life is not the most settling experience. Yet for, they start to experience symptoms of menopause at a much younger age than they anticipate. What causes some women to have premature menopause? And why is it important? Read on to find out.
What is premature menopause?
Your reproductive life starts with menstruation and culminates with menopause. Menopause happens when your ovaries run out of eggs and signal to your body that it is time to progress into a new phase of your life (1). The transition into menopause is a unique set of symptoms that is hard for some providers to comprehensively explain. To learn more about this transition period, read our blog Symptoms of Perimenopause. Menopause usually happens to women after the age of 45. Premature menopause happens when your body goes into menopause before age 40. This can either be due to a surgery that removes your uterus and/or ovaries or because of primary ovarian insufficiency (POI).
What are the signs and symptoms of premature menopause?
The signs and symptoms of premature menopause are very similar to normal menopause (6):
- Amenorrhea: not getting your period for three consecutive cycles (if you have irregular periods, read our blog post Why have I not gotten my period? to learn why)
- Body aches and pains, especially in your joints
- Anxiety and depression
- Hot flashes
- Night sweats
- Disturbed sleep
- Vaginal dryness
- Intense mood swings
What causes premature menopause?
The main causes of premature menopause can be broken down into four categories: your genetics, your environment, your lifestyle, and autoimmune disease-related.
Genetics play a large role in your chances of getting premature menopause. A woman whose mom had premature menopause is 6-8 times more likely to also go through menopause early (2). Your mom passes on some of her genes to you when you are born, which includes any potential errors in how those genes were coded. In this case, the gene that is important for reproductive health is disrupted, and that change is reflected in you as well (3).
Autoimmune diseases can also affect the age at which you go through menopause. These diseases are ones in which your body mistakenly attacks itself. In doing so, it may target the ovaries, destroying some of the egg and follicle cells that are in there. Rheumatoid arthritis, diabetes, and Hashimoto’s thyroiditis are some examples of autoimmune diseases that have been known to cause POI (3). To learn more about the importance of the thyroid on the entire body, read our blog post Thyroid Blog 1: Do I Have a Thyroid Problem?.
Cancer is another disease that can cause premature menopause. Specifically, the treatments for cancer are dangerous to the delicate egg cells in your ovaries. Chemotherapy works to reduce the spread of cancerous cells by killing any rapidly dividing cell, including those in your skin, hair, and your egg cells. It also damages blood vessels and the follicles which are used to carry your egg through your uterus during your period. The damage that radiation can do depends on how old you are and how much exposure you get to the electromagnetic waves. Your threshold for POI from radiation reduces with age, which means that someone who is older is more likely to get POI after radiation (3). Women undergoing cancer treatment may find it beneficial to freeze their eggs to use them later on when trying to conceive.
Your lifestyle is one area that you can control, and it is important to check in with yourself regarding habits that might be harming you in the long run. Take smoking as an example. Cigarettes contain toxic substances that damage your egg cells. Over time, it can cause your follicles to get exhausted and lead to estrogen deficiency and premature menopause (4).
Premature menopause risks
When your body goes into menopause, it significantly reduces its production of estrogen. Estrogen is one of your body’s natural protection hormones. It regulates brain function, bone health, skin health, and metabolism. The main producer of estrogen is the ovaries, so when the ovaries stop releasing eggs your estrogen drops. For women with premature menopause, this is risky because they are not yet at the normal age when their body should be experiencing these changes. A low level of estrogen has the strongest effects on the brain, the heart, and the bones.
Premature menopause increases a woman’s risk of dementia. This is because of estrogen’s role in controlling learning and information retrieval from the brain. Estrogen also helps protect against inflammation in the brain. Without estrogen, your brain is at a higher risk of brain inflammation which can lead to dementia development (5).
Not having enough estrogen can also increase your risk of developing cardiovascular diseases, like high blood pressure, high cholesterol, and type 2 diabetes. Estrogen helps relax your blood vessels to make blood flow more easily through them. As your vessels tighten up, they are more likely to clog and develop a blockage (2).
Another key risk of premature menopause is osteoporosis, a condition that makes your bones more brittle and prone to breakage. Women with POI were shown to have a 45% higher chance of getting a bone fracture than women who went through menopause at a normal age (7). Estrogen protects your bones by stopping the cells that break down bones and promoting the ones that build new bone tissue. It also enhances calcium absorption to make your bones extra strong. Not getting enough vitamin D and calcium can further increase a your risk of osteoporosis (2).
Although premature menopause can be scary, there are ways in which you can nourish your body and help it thrive. Evaluating how your lifestyle is affecting your ovaries can be a good place to start. Our team is more than happy to help you navigate this transition, providing knowledge and guidance to best support you.
References
- https://womenshealth.gov/menopause/early-or-premature-menopause
- Mishra, G. D., Davies, M. C., Hillman, S., Chung, H. F., Roy, S., Maclaran, K., & Hickey, M. (2024). Optimising health after early menopause. *Lancet (London, England)*, *403*(10430), 958–968. https://doi.org/10.1016/S0140-6736(23)02800-3
- Sochocka, M., Karska, J., Pszczołowska, M., Ochnik, M., Fułek, M., Fułek, K., Kurpas, D., Chojdak-Łukasiewicz, J., Rosner-Tenerowicz, A., & Leszek, J. (2023). Cognitive Decline in Early and Premature Menopause. *International journal of molecular sciences*, *24*(7), 6566. https://doi.org/10.3390/ijms24076566
- Hernández-Angeles, C., & Castelo-Branco, C. (2016). Early menopause: A hazard to a woman’s health. *The Indian journal of medical research*, *143*(4), 420–427. https://doi.org/10.4103/0971-5916.184283
- Karamitrou, E. K., Anagnostis, P., Vaitsi, K., Athanasiadis, L., & Goulis, D. G. (2023). Early menopause and premature ovarian insufficiency are associated with increased risk of dementia: A systematic review and meta-analysis of observational studies. *Maturitas*, *176*, 107792. https://doi.org/10.1016/j.maturitas.2023.107792
- Cheng, C., Liu, S., Yu, Z., Zhu, K., Liu, R., Li, X., & Zhang, J. (2025). Frontiers of premature ovarian insufficiency research: an analysis from the top 100 most influential articles in the field. *Gynecological Endocrinology*, *41*(1). https://doi.org/10.1080/09513590.2025.2470986
- Jones, A. R., Enticott, J., Ebeling, P. R., Mishra, G. D., Teede, H. T., & Vincent, A. J. (2024). Bone health in women with premature ovarian insufficiency/early menopause: a 23-year longitudinal analysis. *Human reproduction (Oxford, England)*, *39*(5), 1013–1022. https://doi.org/10.1093/humrep/deae037
