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Premature menopause (premature ovarian failure) is the permanent end of menstrual periods before age 40 because the ovaries become unable to produce hormones because ovulation stops.

• Symptoms are the same as those of natural menopause.
• Tests are done to identify the cause.
• Various measures, including estrogen (used only for a few years) and other drugs, can relieve or reduce symptoms.
• The only way to become pregnant, if desired, is to have eggs from another woman implanted in the uterus.

Hormonally, premature menopause resembles natural menopause. The ovaries produce very little estrogen.

Premature menopause has many causes:

• Genetic abnormalities: Chromosomes, including the sex chromosomes, may be abnormal. Sex chromosome abnormalities include Turner syndrome and disorders that confer a Y chromosome (which normally occurs only in males).
• Autoimmune disorders: The body produces abnormal antibodies that attack the body's tissues, including the ovaries. Examples are thyroiditis, vitiligo, and myasthenia gravis.
• Metabolic disorders: Addison's disease and diabetes are examples.
• Viral infections: Mumps is an example.
• Chemotherapy for cancer
• Radiation therapy
• Surgical removal of the ovaries: Surgery to remove the uterus (hysterectomy) ends menstrual periods but does not cause menopause as long as the ovaries are functioning.
• Toxins: Tobacco is an example.

Premature menopause causes the same symptoms that occur with natural menopause, such as hot flashes and mood swings. Having a Y chromosome increases the risk of cancer of the ovaries.

Diagnosis

Doctors suspect premature menopause when women younger than 40 have menopausal symptoms. A pregnancy test is done, and levels of estrogen and follicle-stimulating hormone (which stimulates the ovaries to produce estrogen and progesterone Some Trade Names
CRINONEENDOMETRIN
) are measured on multiple occasions to confirm the diagnosis.

Additional tests may be done to help doctors identify the cause of premature menopause and thus evaluate a woman's health risks and recommend treatment.

For women younger than 35, a chromosome analysis may be done. If a chromosomal abnormality is detected, additional procedures and treatment may be required.

Treatment

Estrogen and other therapies used during natural menopause are used to treat symptoms.

If women with premature menopause wish to become pregnant, doctors recommend in vitro (test tube) fertilization (see Infertility: Assisted Reproductive Techniques). Another woman's eggs (donor eggs) are implanted in the uterus after they have been fertilized in the laboratory. Estrogen and a progestin are also given to enable the uterus to support the pregnancy. This technique gives women up to a 50% chance of becoming pregnant. Otherwise the chance of becoming pregnant is less than a 10%.

Women who have a Y chromosome need to have their ovaries removed to decrease the risk of developing ovarian cancer.

Last full review/revision June 2007 by Susan L. Hendrix, DO