Has menopause come too soon?

The menopause marks the end of fertility and is a perfectly natural part of life's cycle. Menopause usually occurs around the age of fifty, but it can come earlier. In 1% of women it occurs before the age of forty and this is termed Premature Ovarian Insufficiency (POI) or 'Premature Menopause'. In 0.1% of women it occurs before the age of thirty.

So, what is Premature Ovarian Insufficiency (POI)?

An expert article written by one of the UK's most experienced Consultant Gynaecologists, Mike Savva explains how women with Premature Ovarian Insufficiency will experience the usual symptoms of menopause and they will also have an even greater risk of osteoporosis and heart disease resulting in an increase in overall mortality. It is however the loss of fertility that is often the most distressing consequence of POI.

What causes POI?

The familial connection means that you are more likely to suffer POI if your mother or older sister have been diagnosed with this condition. However, early menopause can also result from the treatment of cancer with chemotherapy or from some types of surgery.

Other causes of POI can include the following:

  • Mumps and some viral infections may increase the risk of POI
  • HIV increases the risk of developing an early menopause
  • There is sometimes an association with auto-immune diseases such as Addison’s diseasethyroid disease and vitiligo
  • Chromosomal disorders such as Turners syndrome can also lead to POI but these cases are very rare.

How can POI be treated?

The good news is that the symptoms of POI can be treated with hormone replacement therapy (HRT). The treatment also reduces the risk of osteoporosis and heart disease. 

Mike Savvas explains how HRT is best given trans-dermally as this method avoids the first pass effect through the liver and avoids any excess risk of thrombosis. He says, "We favour 17β-oestradiol which is identical to the hormone produced by the human ovary and is manufactured in the laboratory."

Symptoms of POI to look out for

Symptoms of the Menopause

 Prevalence (%)


Vasomotor instability (Hot Flushes/night sweats)     36 - 87
Sleep disturbances     40 - 60
Mood Symptoms 15 - 78
Weight Gain 60 - 70
Muscle/joint pain   48 - 72
Palpitations       44 - 50
Headache 32 - 71
Poor memory   41 - 44
Urinary symptoms   25 - 30
 Sexual dysfunction         20 - 30

See Premature Ovarian Insufficiency article for further information.

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