Premature Menopause

“Menopause, whether natural or induced, is called premature when it happens at age 40 or younger. This occurs in about 1% of women in the United States”.¹

Umbrella
What may the Premature Menopause Umbrella include?

Depending on the Source (DotS) this Umbrella may include:

Same or Not

Is early menopause the same as premature menopause? No. The (United States) Hormone Health Network’s explain:

“In the United States, the average age for menopause is 51 for non-smokers and 49 for smokers, with a typical age range somewhere between 47 and 55 years. Some women experience menopause sooner — before age 45 is considered early menopause, and before age 40 is considered premature menopause”.²

Terminology

Are premature menopause, premature ovarian failure and/or premature ovarian insufficiency (POI) the same?

In What Is POI: Premature Ovarian Insufficiency the (United Kingdom) Daisy Network explain:

“Premature menopause, premature ovarian failure and/or premature ovarian insufficiency (POI) are terms that are generally used to describe the same condition, whatever the cause. The words are often used interchangeably, which can be confusing at first. There is no internationally agreed wording, however the newer term for the condition is premature ovarian insufficiency, which may describe it more accurately as the ovaries may not have irreversibly ‘failed’ and premature ovarian insufficiency has important differences from the ‘normal’ menopause which occurs at an average age of 51”.³

Premature Menopause

What is premature menopause?

DotS the definition of premature menopause may vary. The (Australian) Jean Hailes for Women’s Health’s (JH) definition is:

“‘Premature menopause’ is when the final menstrual period occurs before a woman is 40”.⁴

The North American Menopause Society’s (NAMS) definition is:

“A. Menopause, whether natural or induced, is called premature when it happens at age 40 or younger. This occurs in about 1% of women in the United States”.⁵

The Australian Menopause Society’s (AMS) definition is:

“Premature menopause is menopause occurring before age 40 years and includes surgical removal of ovaries (bilateral oophorectomy). POI may also be included under this heading although cessation of ovarian function in POI is not always irreversible”.⁶

Premature Ovarian Failure

What is premature ovarian failure (POF)?

DotS the definition of POF may vary. In Spontaneous Premature Ovarian Insufficiency: Definitions and Epidemiology the AMS explain:

“Menopause occurring spontaneously in women younger than 40 years of age affects approximately 1% of women. This was previously referred to as premature ovarian failure; however, the preferred term is now premature (or primary) ovarian insufficiency (POI)”.⁷

Primary Ovarian Insufficiency

What is primary ovarian insufficiency (POI)?

DotS the definition of POI may vary. In Primary Ovarian Insufficiency (POI): Condition Information – What Is POI? the (United States) Eunice Kennedy Shriver National Institute of Child Health and Human Development’s definition is:

“Health care providers use the term POI when a woman’s ovaries stop working normally before she is 40 years of age”.⁸

In Primary Ovarian Insufficiency: Symptoms & Causes – Overview the (United States) Mayo Clinic’s definition is:

“Primary ovarian insufficiency — also called premature ovarian failure — occurs when the ovaries stop functioning normally before age 40. When this happens, your ovaries don’t produce normal amounts of the hormone estrogen or release eggs regularly. This condition often leads to infertility”.⁹

In Are We There Yet? Navigate Now With Our Guided Menopause Tour: Detour: Primary Ovarian Insufficiency (POI) the NAMS note:

“One way to get to menopause earlier than usual is a condition called POI. With POI, younger women (under 40) have no or only occasional periods and elevated FSH levels, which signify fewer eggs in their ovaries. Some women with POI may have typical menopause-related symptoms, others may not”.¹⁰

The NAMS also note:

“POI means lower estrogen levels, which means negative effects on your bone density and possibly your brain and sexual function. Timely diagnosis is key. So if this sounds like you, the next stop should be your healthcare provider”.¹¹

Premature Menopause and POI

How is premature menopause different from POI?

In Primary Ovarian Insufficiency: Symptoms & Causes – Overview the Mayo Clinic note:

“Primary ovarian insufficiency is sometimes confused with premature menopause, but these conditions aren’t the same. Women with primary ovarian insufficiency can have irregular or occasional periods for years and might even get pregnant. But women with premature menopause stop having periods and can’t become pregnant”.¹²

In Primary Ovarian Insufficiency: Summary – What Is Primary Ovarian Insufficiency (POI)? the (United States) MedlinePlus explain:

“POI is different from premature menopause. With premature menopause, your periods stop before age 40. You can no longer get pregnant. The cause can be natural or it can be a disease, surgery, chemotherapy, or radiation. With POI, some women still have occasional periods. They may even get pregnant. In most cases of POI, the cause is unknown”.¹³

Menopause and POI

How is menopause different from POI?

In Premature & Early Menopause: Terminology – Primary Ovarian Insufficiency (POI) the JH explain:

Premature Menopause Symptoms

Are the symptoms of premature menopause the same as for menopause?

Yes and no. In Premature & Early Menopause: Symptoms of Premature & Early Menopause. the JH explain:

“Symptoms of premature or early menopause are basically the same as for menopause at the expected age of 51-52; however, they are often more severe”.¹⁵

In Menopause FAQS: Premature, Early, and Induced Menopause – Q. I’m Only 36 Years Old, and I’ve Already Reached Menopause. What Specific Menopause Information Do I Need? the NAMS note:

“A. Women experiencing premature menopause that is not medically induced go through perimenopause and may have the same symptoms as women with natural menopause, including hot flashes, sleep disturbances, and vaginal dryness. However, compared with women who reach menopause at the typical age, women who experience premature menopause—whether natural or induced—spend more years without the benefits of estrogen and are at greater risk for some health problems later in life, such as osteoporosis and heart disease”.¹⁶

Premature Menopause Cause

What causes premature menopause?

According to the NAMS:

“Premature menopause that is not induced can be genetic, metabolic, autoimmune, or the result of other poorly understood conditions”.¹⁷

In What Is POI: What Causes POI? the Daisy Network elaborate on:

Hormone Therapy

What is one of the points of consensus about menopausal hormone therapy (MHT) and premature menopause?

One of the points of consensus in the Revised Global Consensus Statement on Menopausal Hormone Therapy: Section A: Benefit/Risk Profile of MHT – endorsed by seven menopause-related organizations – published online 20 June 2016, is:

What is iatrogenic menopause?

DotS the definition of iatrogenic menopause may vary. Iatrogenic menopause can be menopause caused by medical treatments such as chemotherapy or pelvic radiation treatments for cancer.

What is RCTs?

RCTs can be an abbreviation for Randomized Controlled Trials.

Health Care Provider

What if I think I have premature menopause or POI or POF?

If you think you have premature menopause or POI or POF, it may be in your best interest to choose to talk to your health care provider about this. The NAMS note:

“A. …You may need a complete evaluation to diagnose the reason for your menopause—it could be an underlying condition that needs treatment”.²⁰

In Premature & Early Menopause: Management & Treatment of Premature & Early Menopause Symptoms – Ongoing Management the JH explain about ongoing management:

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Topic Last Updated: 29 April 2020 – Topic Last Reviewed: 29 April 2020