Early Menopause: Am I Concerned? Symptoms, Diagnosis, and Support

When a woman stops having her periods before the age of 40, it is often commonly referred to as early menopause. In reality, the more appropriate medical term is Premature Ovarian Insufficiency (POI). This condition does not always mean that the ovaries have permanently stopped functioning but rather that they produce fewer eggs and hormones (notably estrogen) irregularly or insufficiently.

Am I concerned about early menopause?

If you are a woman under 40 and notice:

• Periods becoming irregular, then stopping

• Hot flashes or night sweats

• Vaginal dryness or decreased libido

• Sleep disturbances or mood swings

• Difficulty getting pregnant despite trying

If you answered yes to several of these questions, you may be experiencing premature ovarian insufficiency (POI), also known as early menopause. It is important not to delay consulting a specialist.

Who is at risk?

Some women have a higher risk of premature ovarian insufficiency:

• Family history of early menopause or fertility issues

• History of aggressive treatments (chemotherapy, radiotherapy)

• Autoimmune diseases (thyroiditis, lupus)

• Known genetic disorders (e.g., Turner syndrome, FMR1 gene premutation)

• Previous ovarian surgery

However, in the majority of cases (about 75%), no specific cause is identified.

How is the diagnosis made?

Diagnosis is based on several factors:

• Absence or irregularity of periods for more than 4 months

• Hormonal tests: high levels of FSH (follicle-stimulating hormone) measured twice, 4 weeks apart, is a key criterion

• Estradiol level: often low

• Pelvic ultrasound: may show small ovaries with few or no visible follicles

In some cases, a karyotype (chromosome analysis) or genetic testing is recommended, especially for very young women or those without medical history.

Exploration of possible causes

• Genetic causes (e.g., Turner syndrome, FMR1 gene premutation)

• Autoimmune diseases

• Previous treatments (chemotherapy, radiotherapy, ovarian surgery)

• Viral infections (rare)

• Idiopathic causes: in about 75% of cases, no precise cause is found

  
  

Fertility and support

Spontaneous pregnancy is possible but less frequent than in women with normal ovarian function. If conception fails, egg donation through assisted reproductive technology (ART) is often necessary.

Importance of hormone replacement therapy (HRT)

HRT is crucial for:

• Preserving bone health and preventing osteoporosis

• Reducing cardiovascular risks associated with estrogen deficiency

• Improving quality of life: sleep, mood, vaginal dryness, general wellbeing

Additionally, HRT may slightly increase the chances of spontaneous pregnancy, highlighting its central role in management.

Some statistics

• POI affects about 1 in 100 women before age 40, and 1 in 1,000 before age 30

• In 75% of cases, no identifiable cause

• Less than 10% of women regain regular cycles or spontaneous fertility

  
  

In summary

Premature ovarian insufficiency is a still too little-known condition requiring adapted multidisciplinary management. If you experience suggestive symptoms or cycle disturbances before 40, consult a specialist gynecologist to get a precise diagnosis and optimal support.

Take good care of yourself.

Best regards,

Dr. Sandra Yene Amougui

If you have questions or wish personalized support, do not hesitate to contact me. I am here to support you every step of the way.