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Menopause FAQs: Premature, Early, and Induced Menopause

About 1 in 100 women have menopause before the age of 40, but it’s not always known why it happens, nor is it always abnormal. Read the answers by our experts to your most frequently asked questions about early menopause and learn more about its causes and symptoms if it is happening to you.

Q. What is premature or early menopause?
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. Premature menopause that is not induced can be genetic, metabolic, autoimmune, or the result of other poorly understood conditions. Menopause that occurs before age 40 should be evaluated thoroughly.

Q. What is induced menopause?
A. Induced menopause refers to menstrual periods that stop after surgical removal of the ovaries, chemotherapy or radiation damage to the ovaries, or from the use of other medications to intentionally induce menopause as part of the treatment of certain diseases. Women who have induced menopause experience the hot flashes, vaginal dryness, trouble sleeping, and other symptoms of menopause but without the gradual onset of a natural menopause. Seek out a certified menopause practitioner for help finding information about and your options when undergoing induced menopause.

Q. I’m only 36 years old, and I’ve already reached menopause. What specific information do I need?
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.

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

Q. What is primary ovarian insufficiency?
A. Primary ovarian insufficiency is a condition in which younger women, sometimes as young as in their teens, skip many periods in a row or have no periods at all. A blood test may report signs of menopause and of very few eggs left in the ovaries. Ovulation may still occur once in a while, so pregnancy is possible even though it appears as though a woman is in menopause. Women with this condition should talk to their clinicians about possible associated conditions, psychological support, childbearing options, and whether contraception or hormone therapy is appropriate. Even though there are several known causes of primary ovarian insufficiency, there is still a lot to be learned.

Q. I’m facing a hysterectomy with removal of my ovaries, so I’m going to have an induced menopause. Is it different from natural menopause?
A. Menopause symptoms related to induced menopause can be similar to those from natural menopause, including hot flashes, sleep disturbances, and vaginal dryness. But premenopausal women who experience induced menopause can have more intense symptoms, and therefore, a greater need for treatment to control them than women who undergo natural menopause. And because you may be going through menopause at a young age, you need ongoing monitoring and sometimes treatment to lower your risk of menopause-associated diseases, such as osteoporosis, later in life.

Q. How can I find a menopause specialist?
A. The North American Menopause Society maintains a search feature on this website for those women in the United States or Canada who are looking for an expert interested in helping them manage their health through menopause and beyond. Healthcare providers who have passed a competency examination leading to the prestigious credential of NAMS Certified Menopause Practitioner (NCMP) are noted in the displayed results.

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