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Your guide to early or premature menopause

Menopause typically occurs in women aged 45 to 55, but some may experience symptoms earlier. Coming to terms with early or premature menopause can be overwhelming, especially for those who wish to have children. This guide covers the signs and symptoms of early menopause, as well as fertility treatments that can support you on your journey to parenthood.

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In this guide:

Early or premature menopause can affect your chances of conception, so it’s important to consult your doctor or a fertility clinic if you begin experiencing symptoms.

In this guide, we explore:

- The definitions of early and premature menopause

- The causes and symptoms to watch for

- How different fertility treatments can help

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What is early or premature menopause?

Early menopause is diagnosed when menstrual periods stop before the age of 45, while premature menopause, often referred to as premature ovarian insufficiency (POI), occurs before the age of 40.

In the UK, approximately 5% to 10% of women are affected by early menopause, while 1% are impacted by premature menopause. Both conditions affect ovarian function and present similar symptoms, including hot flushes, mood swings, and infertility issues. However, there are treatments available to manage these symptoms and assist those who wish to build a family.

How is early or premature menopause diagnosed?

There is no specific test for diagnosing early or premature menopause. Doctors generally make a diagnosis by considering various factors, including age, symptoms, and the regularity of the menstrual cycle.

Blood tests are not typically necessary unless a woman under 40 is exhibiting symptoms; in such cases, a blood test may be conducted to rule out early signs of this condition. This could include checking follicle-stimulating hormone (FSH) levels to assess ovarian function. Other tests may be performed to evaluate chromosomes, bone density, and thyroid hormones, as thyroid issues can present similar symptoms.

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Causes of early or premature menopause

Early or premature menopause occurs when the ovaries stop functioning, leading to a decline in oestrogen levels, which impacts the menstrual cycle. Here are some of the causes that can trigger the condition.

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Surgical procedures

Surgical procedures that involve the removal of the ovaries, known as oophorectomy, can trigger early or premature menopause. A hysterectomy, which is the removal of the uterus, can also induce the condition, even if the ovaries are left intact. In some cases, the associated symptoms can appear suddenly and be quite severe.

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Autoimmune conditions

Autoimmune conditions, such as thyroid disorders, lupus, and rheumatoid arthritis, can lead the body to attack ovarian tissue, resulting in early menopause. Additionally, changes in hormone levels during early menopause can exacerbate symptoms related to these autoimmune conditions.

Cancer treatment

Radiation therapy, particularly when targeting at the pelvic area, can cause premature menopause. Furthermore, chemotherapy can damage ovarian follicles and disrupt hormone production, leading to a decrease in oestrogen levels and the onset of menopausal symptoms.

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Other causes

Other causes include genetics. If a biological family member had early or premature menopause, your risk may be higher. Additionally, lifestyle factors such as smoking, being underweight, and having started menstruation at an early age can also contribute to early or premature menopause.

Symptoms of early or premature menopause

Every individual's symptoms can vary and they can be affected both physically and mentally.

Most women who experience early or premature menopause may exhibit different symptoms. Common symptoms include hot flushes, night sweats, vaginal dryness or soreness, difficulty sleeping, low mood, anxiety, reduced sex drive, joint and muscle pain, sensitive teeth, confusion and difficulty concentrating.

If you are experiencing any symptoms or have any concerns, contact your doctor immediately.

How does early or premature menopause affect fertility?

Early or premature menopause can significantly affect fertility in several ways. When your menstrual cycles become irregular, conceiving becomes more challenging due to a decline in the quality and quantity of eggs. This phase is known as perimenopause, which is the transitional period leading up to menopause. During this time, hormonal changes occur until menstruation completely ceases.

Once your periods stop, natural conception is no longer possible. However, fertility treatments, such as IVF using donor eggs can still make conception possible.

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When to see a fertility specialist

If you are experiencing symptoms of early or premature menopause or if you have not conceived after one year of unprotected sex (or six months if you are over 35), it is important to contact your doctor.

We understand how overwhelming a diagnosis of early or premature menopause can be. At TFP Fertility, we are here to support you in exploring your next steps and identifying suitable fertility treatments to help you on your journey to parenthood. Rest assured, our fertility experts will provide guidance and support every step of the way.

Treatment

Fertility treatment options

Hormone therapy

Hormone therapy (HRT) keeps your oestrogen levels topped up to protect against the risk of fragile bones and heart disease. HRT isn't a fertility treatment, but it can help with symptoms of early menopause.

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In vitro fertilisation (IVF) with an egg donor

If you can no longer make your own eggs, it's still possible to carry and deliver a healthy baby using IVF with a donor egg. The donor eggs can be from someone you know or chosen from our donor bank. After the egg is fertilised with your partner's sperm, the embryo is transferred to your womb.

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Intracytoplasmic sperm injection (ICSI)

ICSI is an additional step during the IVF process that is recommended for patients with male factor infertility or that are using frozen eggs. It involves injecting a single healthy sperm directly into the egg.

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Egg freezing

If you're entering early stages of early menopause or premature menopause, but are not ready to start a family, egg freezing is a good way of preserving your fertility. Freezing your eggs gives you the flexibility to have children when the time is right for you.

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Surrogacy

Surrogacy involves another person carrying and giving birth to a child that you'll become the legal parent of. This is where eggs from another donor are used to create the embryos rather than the surrogate's eggs.

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