Understanding Premature Menopause
Compassionate, evidence-based care for symptoms, long-term health, and family-building options before age 40.
Premature menopause—often called primary ovarian insufficiency (POI)—describes loss of typical ovarian function before age 40. It can bring hot flashes, irregular or absent periods, vaginal discomfort, and fertility challenges at a time when many are not expecting them. At Westside Women's Health, we focus on validating your experience, clarifying the diagnosis, protecting long-term health, and supporting your goals for symptom relief and family planning.
Fast Facts About Premature Menopause
Also known as primary ovarian insufficiency (POI)
Periods may be irregular or stop; ovulation can still occur unpredictably
Early estrogen loss impacts bone, heart, mood, and sexual health
Hormone therapy is often recommended until the average age of natural menopause (around 51), when appropriate
Common Symptoms
- Irregular or missed periods (oligo/amenorrhea)
- Hot flashes, night sweats, sleep disruption
- Vaginal dryness or discomfort with sex
- Mood changes, brain fog, or low energy
- Decreased libido or sexual satisfaction
- Fertility challenges
Why It Matters
When estrogen levels fall early, the effects extend beyond bothersome symptoms. Bone density may decline faster, cardiovascular risk can shift, and genitourinary symptoms may affect comfort and intimacy. Because some individuals still ovulate intermittently, both pregnancy planning and contraception need tailored discussion. Early recognition and a personalized plan help protect long-term health and quality of life.
Diagnosis & Evaluation
Evaluation begins with your history and exam, followed by targeted labs (e.g., pregnancy test when indicated; estradiol and FSH levels on two occasions; thyroid function; prolactin). Depending on age and context, your clinician may consider karyotype or genetic testing, assessments for autoimmune conditions, and bone density testing. Because spontaneous ovulation can occur, we discuss both fertility goals and contraception needs.
Premature vs. Typical Menopause
Premature Menopause / POI
- Onset before age 40
- Irregular/absent periods with low estrogen
- Intermittent ovulation possible
- Higher impact on bone and heart without treatment
- Often benefits from hormone therapy until ~age 51 if appropriate
Typical Menopause
- Average onset around age 51
- Permanent loss of ovulation/periods
- Estrogen decline aligned with expected life stage
- Preventive care still important
- Hormone therapy individualized based on risk/benefit
Treatment Options
Care is individualized and often includes hormone therapy (systemic estrogen with progestin if you have a uterus) to address symptoms and help protect bone and cardiovascular health until the typical age of menopause, when appropriate. Vaginal estrogen can improve dryness and comfort. We also discuss nutrition, calcium/vitamin D, weight-bearing exercise, sleep and stress support, and mood care. For family-building, options may include timed intercourse if ovulation occurs, assisted reproductive technologies, or donor egg IVF; we coordinate closely with fertility specialists. If hormone therapy is not right for you, we explore non-hormonal strategies for symptom relief and bone protection.
What to Bring to Your Appointment
- ✓Period and symptom timeline (cycle length, skipped months, hot flashes, sleep)
- ✓List of medications/supplements and prior hormone use
- ✓Any prior lab results or imaging (bone density if available)
- ✓Fertility goals or contraception preferences
- ✓Questions you want answered
Frequently Asked Questions
1Can I still get pregnant with premature menopause?
Spontaneous ovulation can occur in some people with POI, so pregnancy is still possible but less predictable. If you wish to conceive, we can discuss timelines, tracking, and referrals to fertility specialists. If pregnancy is not desired, contraception remains important.
2Is hormone therapy safe for me?
For many with POI, hormone therapy is recommended until the average age of menopause, provided there are no contraindications. Your plan is personalized based on your health history, preferences, and risk profile.
3How is premature menopause diagnosed?
Diagnosis relies on history, exam, and repeated hormone testing (e.g., FSH and estradiol). Additional tests may assess thyroid function, prolactin, genetics, or autoimmune conditions when appropriate.
4How does premature menopause affect long-term health?
Earlier estrogen loss can affect bone density, cardiovascular health, sexual comfort, and mood. Proactive care—hormone therapy when appropriate, lifestyle measures, and routine screening—helps protect long-term well-being.
5What if hormone therapy is not an option for me?
We can use non-hormonal medications and strategies for hot flashes and sleep, vaginal moisturizers and lubricants for comfort, pelvic floor physical therapy, and bone-protective measures. Your plan is tailored to your needs and preferences.
Personalized, Whole-Person Care
If you are facing symptoms of premature menopause or have been told you have POI, we'll help you navigate next steps—relief now, protection for long-term health, and support for your family-building goals.
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