Early Menopause, POI and You: What You Need To Know

What happens when these changes start earlier than expected, and how is early menopause diagnosed and treated?

How do I know if I am in Early Menopause?

Early Menopause refers to the onset of menopause before the age of 45, and under 40, it's referred to as 'Premature Menopause'. This means that your ovaries have stopped producing normal amounts of oestrogen, and no longer release an egg. If the cause isn't immediately obvious via a related condition, Early Menopause is diagnosed after you have ceased to have a period for at least one year.

How is Early Menopause different to Perimenopause?

Perimenopause is the transition phase that leads up to menopause, where hormone levels fluctuate and periods become irregular but don’t completely stop. While perimenopause is a precursor to menopause, early menopause is the complete cessation of menstrual periods before 45, accompanied by symptoms typical of menopause.

So what is POI, and does it cause Early Menopause?

POI, formerly known as premature ovarian failure, is when the ovaries fail to produce regular amounts of oestrogen or release eggs regularly before age 40. Women with POI may have irregular periods or even no periods at all. It's important to say that POI isn't necessarily "early menopause", as some women with POI might still have intermittent ovarian function and could even conceive.

What causes POI and Early Menopause?

The exact cause isn’t always known, but factors can include genetics and family history (for example, if your mother or maternal grandmother experienced early menopause or POI), autoimmune diseases, chemotherapy and radiation treatments. Surgical removal of ovaries and chromosomal defects can also play a part. And we can't ignore lifestyle factors either - smoking has been linked to early menopause, as has excessive exercise, and extreme weight loss or weight gain.

What symptoms should I look for?

Early Menopause symptoms echo those experienced by women in their midlife - hot (or cold!) flashes, night sweats, irregular cycle and missed periods, vaginal atrophy, mood swings and loss of sexual appetite too. Low oestrogen can affect your body and cause brain fog, poor sleep, restless legs and bladder issues, too. There are many symptoms of menopause to look out for and not every woman experiences the same ones, so it's worth understanding how it might personally affect you.

If I suspect I might have Early Menopause, how do I get a diagnosis?

If you suspect you're experiencing early menopause or POI, it’s crucial to see your GP in the first instance. They'll take a detailed history and then can refer you to gynaecology or to an endocrinologist. You can expect to undergo a set of tests; blood work, physical examinations and even imaging if necessary to check for underlying causes.

POI is diagnosed usually via bloods testing for Follicle-stimulating hormone (FSH), Luteinizing hormone (LH) and Estradiol: Low levels of estradiol (a form of estrogen) are often seen in women with POI. You may have a transvaginal ultrasound to check ovarian activity.

Are there any support networks I can access?

While research is limited into the causes of POI and early menopause, support networks can help you to manage the emotional and mental load of managing these conditions, especially if they affect your fertility.

The Daisy Network: A UK-based charity dedicated to those experiencing POI, offering information, support, and a sense of community.

Women's Health Concern: A patient-focused organisation offering advice, factsheets, and a helpline to discuss various women's health issues, including early menopause.

The British Menopause Society: Provides resources, educational materials, and local specialist lists for those experiencing early menopause.

Experiencing early menopause or POI can be emotionally challenging and it's important to seek out information, support, and healthcare, so you can advocate for yourself with confidence.

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