An Early Menopause Guide: Causes & Long-Term Effects

Women go through menopause as a natural part of aging. During this process, the menstrual cycle of a woman stops as a result of decreased estrogen and progesterone levels.

This usually happens around the age of 51, but it is possible to enter menopause before or after. The transition to menopause usually begins in your 40s (1).

Still, if you're younger than 40 and having typical menopause symptoms like hot flashes or vaginal dryness, it may be worth noting. Early menopause is a phenomenon that can occur as a result of other health conditions. Let’s take a closer look.

What Is Menopause?

The menopause transition is the time when a person’s menstrual cycle gradually comes to an end.

Throughout this process, the body produces less and less of the female sex hormones that regulate reproductive health (estrogen and progesterone), which means that ovulation and menstruation slow down before coming to a complete stop. Menopause itself doesn’t begin until 12 consecutive months have passed without a menstrual period (1).

Though the transition to menopause usually begins around age 45, it can happen earlier for some. When this occurs, it’s often known as “early menopause.” When menopause begins before a person reaches age 40, it’s known as “premature menopause.” (2)

Symptoms of Early Menopause

• Hot flashes and night sweats. These occur primarily due to low estrogen levels and cause sudden feelings of heat and sweating. You may also experience flushing or a hot flush that spreads over the face, neck and upper torso.

• Vaginal dryness. This can make sex uncomfortable or painful because there is less lubrication in the vagina during arousal. 
• Breast tenderness (tumescence). Breasts may become swollen, firm and tender during perimenopause because they're producing less estrogen.
• Mood swings. Perimenopausal women can experience mood changes (irritability, depression, anxiety, etc.) due to fluctuations in hormone levels.

• Fatigue and insomnia. Sleep disturbances influenced by hormonal changes can make it challenging to get enough rest.
• Loss of libido. Decreased sexual desire can be common during menopause, whether due to hormone changes or their impact on mood (2).

Causes of Early Menopause

• Genetic conditions like Turner syndrome, which affects one in every 2,000 to 2,500 women and causes them to enter menopause around age 40 (3,4).
• Smoking
• Chemotherapy or radiation exposure from cancer treatment
• Surgeries that remove your ovaries or uterus 
• Getting your first period before age 11
• Family history of early menopause 

Long-Term Effects of Early Menopause

Those who enter menopause early may face health risks, such as osteoporosis and heart disease, associated with prolonged estrogen deficiencies. They may also be prone to sexual dysfunction due to having more severe menopausal symptoms (2).

In some cases, there may be further long-term repercussions of early menopause, depending on your age and family history (5). An earlier loss of fertility is another significant change that may be of concern to some.

Fortunately, early menopause is often highly treatable with the right support. Your doctor can conduct appropriate testing to determine any underlying causes of early menopause and work with you to find solutions that fit your needs.

Final Thoughts

Menopause is a natural process that women experience as they age. When it happens earlier than expected, it can be the result of other health conditions, due to family history and genetics, or other unknown causes (2). 
The symptoms of early menopause may be uncomfortable and disruptive for some women, but they can also be less disruptive for others. It’s best to talk to your healthcare provider about your experiences to determine what might be going on beneath the surface.

1. Cleveland Clinic. (n.d.) “Menopause.” Retrieved July 20, 2023, from https://my.clevelandclinic.org/health/diseases/21841-menopause 
2. Cleveland Clinic. (n.d.) “Premature and Early Menopause.” Retrieved July 20, 2023, from https://my.clevelandclinic.org/health/diseases/21138-premature-and-early-menopause 
3. Cleveland Clinic. (n.d.). Turner syndrome: Causes, symptoms, diagnosis & treatment. Cleveland Clinic. https://my.clevelandclinic.org/health/diseases/15200-turner-syndrome 
4. Shankar Kikkeri N, Nagalli S. Turner Syndrome. [Updated 2022 Aug 8]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK554621/
5. Australasian Menopause Society. (n.d.). “Adverse long-term health outcomes associated with premature or early menopause.” Retrieved November 25, 2022, from  https://www.menopause.org.au/members/ims-menopause-live/adverse-long-term-health-outcomes-associated-with-premature-or-early-menopause