Most women experience menopause between the ages of 45 and 55, with the average age being around 51. Here’s a general guide to when menopause typically happens:
- Before age 40 – Around 1% of women experience premature menopause, often due to Premature Ovarian Insufficiency (POI)
- Between ages 40 and 45 – About 5% of women experience early menopause
- Ages 45 to 55 – This is when most women reach menopause
- After age 55 – Around 5 to 10% experience menopause later than average
When menopause happens before the age of 40, it usually signals that something isn’t working as it should. One possible reason is Premature Ovarian Insufficiency, or POI.
Let’s break down what that means.
What is Premature Ovarian Insufficiency?
Premature Ovarian Insufficiency (POI) is a condition where the ovaries stop working properly before the age of 40.
The ovaries are responsible for releasing eggs and producing hormones such as oestrogen. Oestrogen plays a key role in regulating periods and protecting bone, heart and brain health.
In POI, the ovaries stop releasing eggs regularly and produce much lower levels of oestrogen. This can lead to irregular or absent periods, menopausal symptoms and fertility difficulties.
It’s important to understand that POI is not exactly the same as early menopause. With POI, the ovaries may still function occasionally. Some women continue to have intermittent periods, and there remains a small chance of natural pregnancy.
What causes POI?
The exact cause is not always clear, but several factors may contribute:
- Genetic factors – It can run in families
- Autoimmune conditions – The immune system may mistakenly attack the ovaries
- Cancer treatment – Chemotherapy or radiotherapy can damage ovarian tissue
- Surgery – Removal of the ovaries or damage during pelvic surgery
- Unknown causes – In many cases, no clear cause is identified
Signs and symptoms of POI
If you are under 40 and experiencing any of the following, it is worth speaking to your GP:
- Irregular or missed periods
- Hot flushes or night sweats
- Difficulty sleeping
- Mood changes or irritability
- Vaginal dryness or discomfort during sex
- Difficulty becoming pregnant
It can be easy to dismiss these symptoms as stress or lifestyle-related. Unfortunately, POI is sometimes overlooked or misdiagnosed, particularly in younger women.
How is POI diagnosed?
Diagnosis usually involves:
- Blood tests to check hormone levels, including oestrogen and follicle-stimulating hormone (FSH)
- Ultrasound scanning to assess the ovaries
- A detailed medical and family history
Persistently elevated FSH levels alongside low oestrogen may indicate that the ovaries are not functioning as expected.
How can POI be treated?
There is currently no cure for POI, but treatment focuses on managing symptoms and protecting long-term health.
Hormone Replacement Therapy (HRT)
Oestrogen replacement is usually recommended until around the average age of menopause, approximately 50 to 51. HRT helps manage symptoms such as hot flushes and protects bone and heart health.
Fertility support
Some women with POI may conceive naturally, but many explore assisted reproductive options such as IVF with donor eggs. Fertility counselling can be an important part of care.
Emotional support
A diagnosis of POI can be emotionally challenging, particularly where fertility is concerned. Counselling or peer support groups can make a significant difference.
Lifestyle support
Regular weight-bearing exercise, a balanced diet, avoiding smoking and attending regular health checks are especially important to protect long-term health.
Why early diagnosis matters
An early diagnosis allows you to:
- Manage symptoms more effectively
- Protect your bones and cardiovascular health
- Explore fertility options if this is important to you
The sooner POI is identified, the sooner you can put a plan in place to support your health.
Final thoughts
Premature Ovarian Insufficiency is not widely discussed, but it affects more women than many realise. If you are experiencing symptoms or have concerns, seek advice. You are not overreacting, and you are not alone.
There are treatment options, support networks and healthcare professionals who understand this condition and can help you navigate it.
Helpful UK resources
- Daisy Network – www.daisynetwork.org
A UK charity supporting women with POI since 1995. - The British Menopause Society – www.thebms.org.uk
Provides evidence-based information on menopause and related conditions, including POI. - Fertility Network UK – www.fertilitynetworkuk.org
Offers information and emotional support around fertility and reproductive health. - NHS – www.nhs.uk
Reliable information on Premature Ovarian Insufficiency, including symptoms, diagnosis and treatment. - Menopause Matters – www.menopausematters.co.uk
An educational resource covering menopause, early menopause and POI, including treatment options and lifestyle guidance.