Premature menopause: Causes and diagnosis« Back to Articles
The average age for a woman to go through the menopause in the UK is 51. But premature menopause can occasionally occur much younger than this, perhaps when a woman is in her 30s, 20s or even her teens. For some people it can have a devastating effect on their physical and mental health, especially if they wish to become pregnant.
What causes premature menopause?
There are a range of different reasons why a woman may go through the menopause far too early. Sometimes medical treatments such radiotherapy or chemotherapy can bring on the menopause, or sometimes it’s because the ovaries have needed to be removed altogether.
In many cases, the cause of early menopause isn’t obvious. However, besides cancer and medical treatments, patients may experience premature menopause due to:
If there is some kind of defect in the female sex (X) chromosome, or in any of the genes that control sex hormones, then this can lead to premature menopause. A common genetic condition that affects fertility is Turner syndrome, where one of the X chromosomes is deleted. Rarer genetic conditions, such as Fragile X syndrome, can also bring about premature menopause.
Autoimmune conditions will attack the body’s own tissue and immune system. If the ovaries are damaged by an autoimmune condition, then this can result in premature menopause. However, this is a rarer reason for premature menopause affecting only around 5% of women with premature ovarian insufficiency.
A patient’s lifestyle choices can also have a big impact on their chances of experiencing extremely early menopause. Smoking for example is particularly well known for having anti-oestrogen effects that could be a key contributing factor.
Weight is also important. Fat tissue stores oestrogen, so if a person is considerably underweight - i.e their BMI is less than 18.5 - the again their chances of premature menopause may be higher.
Diagnosing premature menopause
A diagnosis of premature menopause should be made using the patient’s age and symptoms. A thorough history will also need to be taken from them, including whether a close family member has gone through menopause early themselves. You should also check to see if the patient is currently having cancer treatment, has had cancer treatment in the past, or is taking any medication that could be triggering menopause early.
If your patient is under 40 and has intonated that their periods are either very infrequent or non-existent, their levels of FSH (follicle-stimulating hormone) will need to be checked via a blood test. Two blood tests should in fact be offered, each one taken 4-6 weeks apart. The reason for this is because FSH levels vary during different stages of the menstrual cycle. The patient may also require a referral to a gynaecologist or other reproductive specialist to confirm the diagnosis.
Would you like to better support your patients through the menopause, and other common gynae issues?
If you are a nurse or other healthcare professional who regularly see peri-menopausal patients you may find our two CPD courses Caring for women around the menopause and Gynae core skills for first contact practitioners helpful. Designed to increase your knowledge around the menopause as well other gynaecological issues, both courses cover the basics in a flexible and adaptable way.
For many women, these are difficult subjects to discuss from both a physical and emotional viewpoint. Worth 4 hours and 7 hours of CPD respectively, both courses are well worth considering if you’re looking to brush up your skills. They’re held online too via Zoom, making them extremely convenient.
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