Most simply put, premature menopause is the loss of ovarian function before the age of 40 (the average age of natural menopause is 52). Premature menopause is rare and occurs in just about one percent of people who menstruate in the U.S. The symptoms of premature menopause are similar to the symptoms many experience during perimenopause and natural menopause, which can include irregular periods or no periods, hot flashes, mood changes, anxiety or depression, sleep disturbances, sexual dysfunction and vaginal dryness. Premature menopause can be spontaneous or medically induced. It can be medically induced by surgical removal of both ovaries, chemotherapy, or radiation in the pelvic region. If it is medically induced, people typically skip perimenopause and go straight into menopause.
Spontaneous causes of premature menopause are most often genetic (i.e. chromosomal defects like Turner syndrome), metabolic (i.e. diabetes), autoimmune (i.e. thyroiditis), smoking, or, in some cases, unknown.
If there is no obvious cause, premature menopause is referred to as Premature Ovarian Insufficiency (POI), formerly known as premature ovarian failure. The term “failure” was changed to “insufficiency” because researchers found that some people have transient function of ovaries and may sporadically ovulate. It is a condition that occurs in younger folks, sometimes as young as their teens, characterized by skipping many periods in a row or having no periods at all. POI is most often diagnosed when a healthcare provider observes a patient with infrequent or no periods and the presence of menopausal symptoms. A blood test that measures Follicle-Stimulating Hormone (FSH) may confirm. FSH is the hormone that controls the menstrual cycle and stimulates the growth of eggs in the ovaries. FSH becomes persistently elevated in menopause. When the FSH level is elevated on two occasions, at least one month apart, this confirms POI.
Premature menopause or POI affects everyone differently, though it is common to have higher incidence of mental health issues like anxiety or depression along with a greater degree of sexual dysfunction compared to those who undergo natural menopause. One study on premature menopause found mood disorders and sexual problems were the most distressing among patients with this diagnosis.