Frequently asked questions

1. What is early or premature menopause
2. Why does early and premature menopause occur?
3. How often does premature ovarian failure occur?  
4. What symptoms are associated with early menopause? 
5. What are ways of coping with menopausal symptoms? 
6. How do I know if I have early menopause? 
7. Will early menopause affect my fertility? 
8. Are there long-term health risks associated with early menopause? 
9. What is osteoporosis? 
10. Should women diagnosed with early menopause have a bone density measurement? 
11. What treatment is recommended for women diagnosed with early menopause? 
12. What is HRT or HT, and how to use it? 
13. What are the effects of HRT? 
14. What are common side effects of HRT?
15. Who should not take HRT?

1. What is early or premature menopause?

Menopause (when menstrual periods permanently stop) is called ‘early’ if it occurs before the age of 45 years and ‘premature’ if it occurs before the age of 40 years.

2. Why does early and premature menopause occur?

Early or premature menopause occurs when the ovaries ‘run out of eggs’ and oestrogen and progesterone (ovarian hormones) are produced in only very small amounts. The periods then stop and menopause symptoms may occur.

The reason why the eggs (follicles) disappear from the ovaries is unknown but normally after age 35, the number of eggs seems to reduce more rapidly. In women who experience early or premature menopause, this reduction in egg numbers starts earlier.

Early menopause can:

• Occur spontaneously (see also Premature Ovarian Failure*)
• Be caused surgically when a woman has her ovaries removed (see Surgical Menopause)
• Be caused chemically by chemotherapy
• Be caused by radiotherapy when directed at the lower abdomen

3. How often does premature ovarian failure occur?

Premature ovarian failure occurs in about one per cent (1 in 100) of women before the age of 40 and 0.1 per cent (1 in 1000) before the age of 30. Overall the risk of early menopause for all reasons (including surgical and as a result of cancer treatment) is about 8-10 per cent before the age of 45.

4. What symptoms are associated with early menopause?

Younger women may experience similar menopausal symptoms to older women although these may be more severe. Psychological distress, sexual function and altered body image may all be experienced. The psychological and physical effects as well as the impact of early menopause vary between women.

For more information see Emotional Wellbeing or Symptoms

5. What are ways of coping with menopausal symptoms?

There are many ways of coping, though it often depends on the severity of the symptoms. Many women cope with mild symptoms without any medication.
Regular exercise often helps because this promotes wellbeing, enhances relaxation and sleep, and may reduce menopausal symptoms.

Good eating habits with foods rich in phytoestrogens such as soy products or linseed may be beneficial.
Women with mild to moderate symptoms may prefer to take herbal or plant hormone therapies, which should be either monitored or prescribed by a qualified naturopath or herbalist with an interest in women's health. Women with more severe symptoms usually find hormone therapy (HRT) the most beneficial.

For more information see Management

6. How do I know if I have early menopause?

Early menopause may be considered if your periods are becoming irregular and infrequent, or you develop symptoms similar to the menopause change. The diagnosis of early menopause can be difficult to make and depends on the absence of menstrual periods for a prolonged time and menopausal range hormone levels measured via blood tests.

For more information see About early and premature menopause 

7. Will early menopause affect my fertility?

Yes, most women are unable to conceive a baby after going through early menopause. When spontaneous early menopause happens, there is a very small possibility of getting pregnant naturally. For more information see Early menopause and fertility

8. Are there long-term health risks associated with early menopause?

The risks of developing osteoporosis or heart disease appear to be higher for women with early menopause than for women reaching menopause at the expected age. For this reason, it is important that advice is sought from your health practitioner.

For more information on bone health and heart health see Long-term health risks

9. What is osteoporosis?

Osteoporosis occurs when bones lose their strength and density, and become fragile and fracture (break) more easily due to a loss of calcium and bone framework. This disease particularly affects women in their middle and later years and is painless until a fracture occurs. However, the risk of developing osteoporosis appears to be higher for women with early menopause. It is quite different from osteoarthritis which affects joint surfaces and is painful.

10. Should women diagnosed with early menopause have a bone density measurement?

Yes, all women going through early menopause should have bone density measurement.

11. What treatment is recommended for women diagnosed with early menopause?

Hormone replacement therapy (HRT) is recommended for women diagnosed with early menopause in order to replace the hormones the body is missing.

It is recommended to

• ease menopausal symptoms
• maintain bone density and reduce the risk of osteoporosis
• reduce risk of early onset of cardiovascular and heart disease

For more information see Management

12. What is HRT or HT, and how to use it?

Hormone replacement therapy (HRT) – also known as hormone therapy (HT) – is a treatment used to restore the important female hormones that the ovaries stop producing after menopause. Oestrogen is the main hormone prescribed to relieve menopausal symptoms. If a woman still has her uterus she must also take progesterone-like hormone (progestogen).

Progesterone protects the uterus lining from over-stimulation by oestrogen, which in the long-term may lead to uterine cancer. Women who have had a hysterectomy do not need progestogen. Women experiencing loss of libido (sex drive), lack of energy and on-going fatigue, even when taking oestrogen therapy, sometimes benefit from low-dose testosterone replacement. However, it is important to discuss with the individual woman psychological and relationship issues as well.

There are different ways of taking HRT and different combinations of the three hormones; oestrogen, progesterone and testosterone. Usually oral tablets are prescribed but there are also skin patches, a skin gel, implants and vaginal preparations such as creams or pessaries.

The patch is applied to the skin on the lower body once or twice weekly, the gel is applied daily and the implant (hormone pellet) is inserted under local anaesthetic beneath the skin and usually lasts four to six months. In all the non-oral routes the hormones are absorbed directly into the blood stream whereas with tablets they are absorbed through the intestine first.

For more information see Hormones and HRT

13. What are the effects of HRT?

Oestrogen prevents postmenopausal bone loss of calcium and protects against osteoporosis, and oestrogen reduces the risk of colon or bowel cancer. The WHI study originally published in 2002, showed no increase in risk of heart disease and stroke in the 50-59 age group, and a small increase in risk in the 60-79 year old group. There was a small increase in risk of breast cancer after 4-5 years of HRT.

However, in a younger woman taking HRT for menopausal symptoms the risks are likely to be very small. All women should discuss their individual circumstances with their doctor.

14. What are common side effects of HRT?

The most common undesirable effects from oestrogen therapy are breast soreness and nausea. These symptoms generally improve over time or by altering the dose or treatment method. The progestogen may cause side effects including bloating, depression and mood swings which are similar symptoms to premenstrual syndrome.

15. Who should not take HRT?

Most women are able to take HRT. However, in some groups of women, therapy is not advisable and alternatives should be used where possible. These include women who have had cancer of the breast or uterus, a history of thrombosis (blood clots in veins or lung), severe liver disease or undiagnosed vaginal bleeding, heart disease or stroke.

Further resources

Fact sheets

 Early and Premature Menopause 98.33 Kb

 Early or Premature Menopause and Emotional Wellbeing 53.98 Kb

Content updated June 21, 2010