Tue Jul 01 / Ashwini Achutharaman, RD Intern & Dr. Abrar Al-Shaer, PhD, RD

What Causes Premature Menopause?

Understanding the causes of premature menopause, its symptoms, and the risks it presents, including its impact on brain health, cardiovascular function, and bone density.

menopause hormone health
Middle-aged woman holding her head in discomfort while sitting next to a table labeled 'Premature Menopause,' symbolizing the emotional and physical symptoms of early menopause.

For many women, menopause can be an intimidating term. Not knowing exactly what to expect as they transition into the next stage of their reproductive life is not the most settling experience. Yet, for some women, they start to experience symptoms of menopause at a much younger age than they anticipate. What causes some women to have premature menopause? And why is it important? Read on to find out.

What is premature menopause?

Your reproductive life starts with menstruation and culminates with menopause. Menopause happens when your ovaries run out of eggs and signal to your body that it is time to progress into a new phase of your life. The transition into menopause is a unique set of symptoms that is hard for some providers to comprehensively explain. To learn more about this transition period, read our blog Am I in Perimenopause? Symptoms, Signs, and What to Expect.

Premature menopause happens when your body goes into menopause (i.e., no period for 12+ months) before age 40. This can either be due to a surgery that removes your uterus and/or ovaries or because of primary ovarian insufficiency (POI).

What are the signs and symptoms of premature menopause?

The signs and symptoms of premature menopause are very similar to normal menopause:

  • Amenorrhea: not getting your period for three consecutive cycles
  • Body aches and pains, especially in your joints
  • Anxiety and depression
  • Hot flashes
  • Night sweats
  • Disturbed sleep
  • Vaginal dryness
  • Intense mood swings

What causes premature menopause?

The main causes of premature menopause can be broken down into four categories: genetics, environment, lifestyle, and autoimmune disease-related.

Genetics

Genetics play a large role in your chances of getting premature menopause. A woman whose mom had premature menopause is 6-8 times more likely to also go through menopause early. Your mom passes on some of her genes to you when you are born, which includes any potential errors in how those genes were coded. In this case, the gene that is important for reproductive health is disrupted, and that change is reflected in you as well.

Autoimmune diseases

Autoimmune diseases can also affect the age at which you go through menopause. These diseases are ones in which your body mistakenly attacks itself. In doing so, it may target the ovaries, destroying some of the egg and follicle cells that are in there. Rheumatoid arthritis, diabetes, and Hashimoto’s thyroiditis are some examples of autoimmune diseases that have been known to cause POI.

Cancer

Chemotherapy and radiation treatments for cancer are dangerous to the delicate egg cells in your ovaries. Chemotherapy works to reduce the spread of cancerous cells by killing any rapidly dividing cell, including those in your skin, hair, and your egg cells. Radiation can also damage blood vessels and the follicles that carry your egg through your uterus during your period. Women undergoing cancer treatment may find it beneficial to freeze their eggs to use them later when trying to conceive.

Lifestyle

Your lifestyle is one area that you can control, and it is important to check in with yourself regarding habits that might be harming you in the long run. Smoking, for example, contains toxic substances that damage your egg cells. Over time, it can cause your follicles to get exhausted and lead to estrogen deficiency and premature menopause.

Premature menopause risks

When your body goes into menopause, it significantly reduces its production of estrogen. Estrogen is one of your body’s natural protection hormones. It regulates brain function, bone health, skin health, and metabolism. The main producer of estrogen is the ovaries, so when the ovaries stop releasing eggs your estrogen drops. For women with premature menopause, this is risky because they are not yet at the normal age when their body should be experiencing these changes. A low level of estrogen has the strongest effects on the brain, the heart, and the bones.

Risks include:

  • Dementia: Estrogen helps protect against inflammation in the brain, and without it, brain inflammation can increase the risk of dementia.
  • Heart disease: Estrogen helps relax blood vessels, so without it, vessels may tighten, leading to a higher risk of cardiovascular issues.
  • Osteoporosis: Estrogen protects bones by stopping the cells that break them down. Premature menopause increases the risk of bone fractures.

Effects of Low Estrogen

Although premature menopause can be scary, there are ways in which you can nourish your body and help it thrive. Evaluating how your lifestyle is affecting your ovaries can be a good place to start. Our team is more than happy to help you navigate this transition, providing knowledge and guidance to best support you.

For more information and guidance on managing symptoms and understanding your body, feel free to reach out to us.

References

  • Women’s Health.gov - Early or Premature Menopause
  • Mishra, G. D., Davies, M. C., Hillman, S., Chung, H. F., Roy, S., Maclaran, K., & Hickey, M. (2024). Optimising health after early menopause. Lancet (London, England), 403(10430), 958–968. DOI
  • Sochocka, M., Karska, J., Pszczołowska, M., Ochnik, M., Fułek, M., Fułek, K., Kurpas, D., Chojdak-Łukasiewicz, J., Rosner-Tenerowicz, A., & Leszek, J. (2023). Cognitive Decline in Early and Premature Menopause. International Journal of Molecular Sciences, 24(7), 6566. DOI