Every woman will go through menopause, but some will experience it prematurely, ahead of the normal curve. Women faced with early menopause may experience a variety of feelings about this early transition, from relief to fear to disappointment. In addition to the emotions you may experience, there are significant health and wellness implications to consider, as early menopause may predispose you to some serious, and even dangerous, medical conditions.
Understanding what causes early menopause, including hereditary factors, can help you to seek early and appropriate treatment. This proactive approach can make all the difference when it comes to protecting your health and quality of life.
What Is Early Menopause?
Menopause is defined as the point when menstrual periods have stopped for 12 months. Caused by a sharp decline in female sex hormones, it signals the end of a woman’s reproductive years and typically happens between the ages of 45-55.
For some women, however, menopause comes much sooner. Early menopause is when this hormonal transition occurs between the ages of 40 and 45. When it occurs before the age of 40, it is referred to as premature menopause, also called primary ovarian insufficiency when there is no apparent medical or surgical cause. In the United States, about 5% of women experience early menopause, and 1% suffer premature menopause.
Early menopause may occur naturally, or it may be triggered by a bilateral oophorectomy—the surgical removal of both ovaries—which often occurs alongside a hysterectomy. Hysterectomy without removal of the ovaries will stop menstruation but will not cause immediate menopause. Still, it may cause menopause to start a year or two earlier than it would have naturally.
Is Early Menopause Hereditary?
The age at which your mother entered menopause is often said to be a good indication of when you will go through this transition yourself. But is early menopause hereditary? The answer is complicated, as early menopause can be triggered by genetic, reproductive, and environmental factors.
- Family history. Women who have a family history of early menopause may be at increased risk.
- Child of a multiple pregnancy. Being born a twin, triplet, or other multiple increases the risk of early menopause.
- Specific genetic variants. Several genetic variants have been identified as causative factors. Inheriting some combinations of these mutations may make women more likely to experience premature or early menopause.
- Early menstruation. Starting menstrual periods at or before age 11 may be a risk factor for early menopause.
- Never given birth. Women who have never given birth may be at increased risk of premature or early menopause.
- Cigarette smoking. Women who smoke have a greater chance of early menopause and may experience more severe symptoms.
- Weight. Women who are underweight in early to mid-adulthood face a higher risk of early menopause. One recent study found that women with a body mass index (BMI) under 18.5 had a 30% increased likelihood of menopause before the age of 45.
- Chemotherapy or radiation. Some cancer treatments may cause women to experience early menopause. In many cases, there are treatment options available to prevent this, and young women hoping to conceive later in life should talk to their oncologists for guidance.
A variety of medical conditions may also increase the likelihood of early menopause. These include autoimmune and inflammatory conditions, including thyroid disease, rheumatoid arthritis, and inflammatory bowel disease. Other conditions include chronic fatigue syndrome, epilepsy, and HIV/AIDS.
Why Is Early Menopause Cause for Concern?
Early menopause can trigger complex emotions. Whether you are relieved to no longer have to deal with periods and worry about birth control, mourning the loss of your reproductive capacity, fear physical changes, or experiencing difficult feelings about your identity as a woman, these reactions are all normal—and you may experience several, contradictory feelings at the same time. Practicing self-care and getting support as you negotiate these emotions can be invaluable.
In addition to the emotional effects of early menopause, women who experience menopause before the age of 45 tend to have more severe menopause symptoms than women who go through this transition later. These may include vasomotor symptoms (hot flashes, night sweats, palpitations), mood and sleep disturbances, and sexual dysfunction. These symptoms can deeply affect your well-being, your relationships, and your everyday functionality.
Significantly, there are also long-term health risks associated with early menopause, including:
- Cardiovascular disease
- Type 2 diabetes
- Neurological disorders, including Parkinson’s, dementia, and cognitive dysfunction
- Mood disorders and sexual dysfunction than women who experience later menopause
Unfortunately, the dangers of these serious medical conditions may add up to a substantial risk of early death for women who transition to menopause at an early age.
Finding Treatment and Support for Early Menopause
The emotional and physical impact of early and premature menopause means that women at increased risk of these conditions should ideally be monitored for symptoms and declining hormone levels. Whether you are undergoing medical treatment with the potential to affect estrogen and progesterone production or your risk of early menopause comes from hereditary factors, finding a doctor who specializes in the intricacies of hormone health can be a wise investment.
Hormone replacement therapy (HRT) is used by millions of women around the world to address menopause symptoms and improve quality of life at any age. But due to the serious health complications associated with early menopause, HRT is particularly critical for women who experience early menopause. In general, the best outcomes are achieved when HRT is initiated as soon as ovarian failure is confirmed and continues at least through the age when natural menopause would occur. While this is especially important for preventing osteoporosis, carefully selected therapy can help to manage uncomfortable short-term symptoms and minimize the risk of long-term health problems associated with early menopause.
Knowing the risk factors for premature and early menopause—hereditary, reproductive, and environmental—can help you identify whether you should be on the lookout for hormonal changes at a younger age. Taking a proactive and preventive approach can help safeguard your future health and ensure you have the support you need at every stage.