Premature menopause is menopause that happens before your 40s, and it can even happen in your 20s. A variety of treatments and support groups exist to help you through this transition.

Menopause starts for most people in their late 40s or early 50s. But in early or premature menopause, the drop in estrogen production and the end of menstruation comes much earlier — sometimes in your 20s.

Menopause is premature when it occurs before age 40. If you’re in your 20s and going through menopause, you’re going through premature menopause.

Premature menopause is sometimes called primary ovarian insufficiency (POI) because the ovaries stop producing estrogen the way they should.

Research from 2019 notes that around 3.7% of women experience POI and 12.2% experience early menopause.

Premature menopause vs. early menopause

Early menopause refers to menopause that happens before you’re 45 years old but after age 40. The average age for menopause in the United States is 51 years old.

The symptoms of menopause are the same whether it’s experienced in your 20s or your 50s. Symptoms might include:

Menopause symptoms can vary from one person to another.

It isn’t always possible to determine the exact cause of premature menopause. Some known causes and risk factors include:

  • Family history: Premature menopause can occur due to genetics. You may want to speak with any biological relatives about the age they stopped having periods. Knowing their symptoms could help you get a sense of what to expect.
  • Smoking: Research from 2022 has linked cigarette smoking to early menopause. A research review(that included some animal studies) found that e-cigarette vapors also affect reproduction. But scientists don’t yet know how smoking e-cigarettes might affect menopause.
  • Ovarian surgery: Pelvic or ovarian surgery is sometimes the cause of premature menopause. If surgery has caused you to go into menopause, your symptoms may be more severe than if you started menopause more gradually, according to 2019 research.
  • Exposure to toxins: People who have had chemotherapy or radiation therapy to treat cancer have a higher risk of premature menopause. A 2015 research review also found that humans and animals exposed to estrogen-disrupting chemicals in some pesticides and phthalates may have an increased risk of earlier menopause.
  • Viral infections: Some viruses have been linked to premature menopause, though their role isn’t clear. HIV, mumps, cytomegalovirus, tuberculosis, malaria, and other viruses may potentially cause ovarian changes and premature menopause.
  • Genetic differences: Research from 2019 suggests that more than 75 different genes can contribute to POI and premature menopause. Most influence ovary development and function, cell division, or DNA repair. Turner syndrome and fragile X syndrome are genetic conditions that can cause premature menopause.
  • Autoimmune disorders: Autoimmune disorders can sometimes damage the ovaries, bringing about premature menopause. Some conditions associated with premature menopause include:

Premature menopause poses some health risks. Talk with a healthcare professional about these risks so you can protect your physical and emotional health.

Health conditions and concerns that could happen due to premature menopause include:

  • Heart disease: Lower estrogen levels can cause changes in your blood vessels and your heart, possibly leading to a higher risk of heart problems.
  • Anxiety, depression, and other mood changes: Hormone changes can cause significant emotional shifts. Anxiety, depression, and lower self-esteem are common.
  • Eye conditions: A 2021 study reports that around 79% of menopausal women developed dry eye disease and other conditions affecting the eye surface.
  • Infertility: It’s harder for people in premature menopause to become pregnant naturally. Working with a fertility specialist may help.
  • Hypothyroidism: For some people, hormones produced by the thyroid gland drop after menopause, which can cause changes in metabolism and energy levels.
  • Osteoporosis: Lower estrogen levels can sometimes weaken bones and make them more vulnerable to fracture.

What about children?

Permanent premature menopause may affect your ability to have children. Be sure to discuss all available options with a doctor, including:

POI is often diagnosed when someone talks with a healthcare professional about missing several periods. If you’ve missed three or more periods in a row, talk with a doctor.

Here’s what to expect during the diagnosis:

If your doctor thinks you may have POI, you may have a pelvic ultrasound to determine the cause.

Premature menopause cannot yet be reversed, but researchers are trying to improve the outlook. Treatments have different goals, such as:

  • reducing your menopause symptoms
  • protecting your heart, bone, and sexual health
  • providing emotional support
  • connecting you with fertility specialists if you want to become pregnant

Your treatment options could include:

It can be a shock to experience menopause in your 20s.

Premature menopause may come with mixed emotions. This change can be especially hard if your plans include pregnancy and childbirth.

Whether you’re experiencing physical, psychological, or emotional symptoms, it’s important to take care of yourself during this transition. Think about whether a therapist, nutritionist, support group, or other specialists could help.

Here are some places where you may be able to find support:

Premature menopause, sometimes called primary ovarian insufficiency, happens when your ovaries stop producing as much estrogen, your periods stop, and it becomes more difficult to become pregnant naturally.

It can happen before you’re 40 years old or even in your 20s.

The causes can vary from genetics to exposure to estrogen-disrupting chemicals. But premature menopause causes all the same symptoms associated with typical menopause.

Treatments may help with your symptoms and your future well-being. A healthcare professional can help you decide which is right for you.

Menopause in your 20s can be unexpected, but you’re not alone. When you’re ready to reach out, you can find the professional guidance and personal support you need.