It is important to explain all of your symptoms to your doctor, especially if your periods are irregular and if you are experiencing any of the symptoms suggestive of menopause. Your doctor needs to do a full physical examination and do investigations to diagnose the cause of your symptoms, including loss of periods.

Some other causes for loss of periods or irregular periods are:

• Pregnancy
• High levels of the hormone prolactin
• Disorders of the thyroid or adrenal gland
• Excessive exercise, especially at an elite level
• Eating disorders such as anorexia
• Drug abuse
• Family history of premature menopause
• Rare chromosomal and genetic abnormalities
• Abnormalities or blockage of the uterus or vagina
• Severe stress

The criteria for diagnosis of POF are:

1. At least four months without a period.
2. Two blood tests of Follicle Stimulating Hormone (FSH) with result >40mu/ml at least one month apart. The FSH and oestradiol levels need to be performed on the third day of the period if you are still having cycles.

Other tests include:

• Pregnancy test
• Prolactin - this is the hormone usually involved with breastfeeding; but when raised, it causes periods to stop
• Transvaginal ultrasound to check for evidence that the ovary is functioning (involves counting the number and size of the follicles or eggs in the ovary, the volume of the ovaries and assessing the thickness of the lining of the uterus or endometrium)
• Check for any blockage that is stopping menstrual blood flowAfter early menopause is diagnosed other tests may be recommended to check for some of the possible causes and associated conditions:

• Thyroid function test and thyroid antibodies
• Adrenal antibodies
• Chromosomal and genetic tests
• Blood sugar and cholesterol levels
• Bone density (DEXA)
• Tests for fragile X syndrome

 
However, in about 60 per cent of women, the cause of early menopause is never found.

It is important to find a supportive and sympathetic doctor to help you adjust to the diagnosis of early menopause. Your doctor will help to counsel you, prescribe appropriate hormonal replacement therapy and refer you to relevant specialists when necessary.  It is also important that your doctor continues to see you regularly over the years to reassess your health needs including reviewing your medications.  Often it is necessary to have a team of health professionals monitor you through the years after you have been diagnosed.  You may need to seek out a specialist early menopause clinic or individual practitioners such as infertility specialists, endocrinologists, psychologists or psychiatrists. 

Most women are unprepared for the diagnosis of early menopause and may respond to the diagnosis with many different feelings including:

• Disbelief
• Grief, sadness, depression, loss
• Anger, confusion, resentment
• Loneliness, isolation
• Loss of control over body and fertility
• Loss of body image with concern about loss of femininity and sexuality
• Feeling ‘old before my time’
• Fear of partners, friends and family rejection