Early signs and symptoms of spontaneous early menopause: Women’s experiences

Early indications of spontaneous early menopause (EM) or premature ovarian insufficiency (POI) can include changes to a woman’s menstrual periods, difficulties getting pregnant, or menopausal symptoms such as hot flushes, night sweats, low mood or irritability, fatigue, loss of libido, and vaginal dryness (see also Experiences of symptoms of early menopause – Part 1 and Experiences of symptoms of early menopause – Part 2).

Early signs and symptoms

Women who experienced spontaneous EM noticed several of these initial ‘signs’ that, in Debra’s words, ‘something wasn’t quite right.’ Changes to menstrual periods, hot flushes and night sweats were common indications. Some women recalled noticing longer or variable gaps between periods, or changes to the amount of bleeding.

For Jessica, the only indication of premature menopause was changes to her periods when she was 39. 

For some women, night sweats and hot flushes (vasomotor symptoms) were prominent initial signs of spontaneous EM, while for others they occurred in tandem with other symptoms.

Hot flushes were one of the first signs of spontaneous early menopause Jenni noticed.

Other signs of EM women experienced included difficulties conceiving, sleeping problems, feeling irritable, anxious or depressed, vaginal dryness, and bladder problems.

Lorena experienced menopausal symptoms after she stopped taking the pill at 23. She wondered if the pill had been a ‘masquerade’, hiding the fact that she had gone through menopause even earlier. 

A few women first realised that something was ‘wrong’ when they experienced difficulties becoming pregnant. Some experienced miscarriages, while Melinda went through IVF in her mid-30s because of her husband’s fertility problems, only to discover her ‘ovarian reserve was on the low side’. She said she and her husband were ‘very lucky’ to conceive their daughter, whom doctors called a ‘miracle baby’, given they later realised that Melinda had been in perimenopause at the time.

Making sense of the early signs of spontaneous EM

While some women suspected their symptoms could be spontaneous EM, most were not sure how to make sense of what they were experiencing. Other health conditions (current or past) could make the first signs of spontaneous EM difficult to interpret. These included thyroid problems, glandular fever, chronic fatigue syndrome, fibromyalgia, depression, endometriosis, fibroids, ovarian cysts, and a history of irregular periods.

Anna recalled wondering if night sweats signalled ‘an infection’, while Ella said her history of ‘erratic’ periods meant that she paid little attention when they stopped at age 25: ‘I didn’t even notice or worry, because I just thought ‘Well, that’s me – some people miss periods, that’s just me.’ Challenging life circumstances including busy jobs and parenting young children could also make it difficult for some women to identify their symptoms as spontaneous EM.

When her periods became irregular in her mid-30s and she started having night sweats, Sonia initially linked her symptoms to her lifestyle and previous illnesses.

Melinda ‘probably suffered longer than needed’ because she attributed her menopausal symptoms to being a mother of a toddler. 

A few women were unaware of the existence of spontaneous EM as a health condition, including Lorena who said: ‘I didn’t know if it was even possible. No idea.’ (See Seeking information about early menopause). In contrast, women with a family member who had experienced spontaneous EM or who worked in the health sector were more likely to identify it as a possible explanation for their symptoms.

Anna described how she came to the conclusion that her symptoms indicated she was experiencing EM.

Further information:

Talking Points (Women)

Other resources