Some women experience their periods stopping much earlier than the average age of menopause (age 51). When the ovaries stop producing hormones before the age of 40, this is premature ovarian insufficiency. It affects about one in 100 women before the age of 40 and five in 100 women before the age of 45. The causes are mostly unexplained, although autoimmune conditions, chromosomal problems, viral illnesses and sickle cell disease are associated. Premature ovarian insufficiency is more likely if you have a family history of early menopause or if you’ve had chemotherapy, radiation therapy, major pelvic surgery involving the ovaries (particularly for severe endometriosis) or autoimmune disease.
However, premature ovarian insufficiency is a particularly tricky diagnosis and there is a lot we don’t understand about it – including the fact that in some women, having their periods stop prematurely may not be a permanent thing.
If you suspect you have premature ovarian insufficiency it is important that you don’t just ignore it. If your ovaries are not producing enough hormones, you will be at increased risk of osteoporosis, heart disease and dementia. You should be on hormones until at least the average age of menopause to prevent these problems.
If fertility is an issue, it is important to get a timely assessment of ovarian reserve and discuss with a fertility specialist to better understand your realistic fertility options. But not all hope is lost - as I said earlier, in some women the ovaries do seem to ‘wake up’ and its thought that around 5% of women who have had a diagnosis of primary ovarian insufficiency can go on to conceive naturally.
Coming to terms with a diagnosis of primary ovarian insufficiency, plus the possibility of not having one’s own children is a very challenging experience. Things do change: regular monitoring is key to see if the hormones are changing or the ovaries have kickstarted, and remember you are likely to be on hormones for years and your own requirements are likely to change. Extensive discussion around fertility options is also important, and again, options may change as time goes on. This is why it is important to work closely with a doctor in the most broad and holistic way to fully comprehend all the possibilities of what this diagnosis means for you.