Early Menopause & POI
Specialist care for women experiencing menopause under 45
If you are experiencing menopause symptoms before the age of 45 — whether naturally, due to surgery, chemotherapy, or a diagnosis of premature ovarian insufficiency (POI) — you need specialist support, not generic advice. Our Hull-based BMS-accredited menopause specialists provide dedicated care for early menopause, including hormone replacement therapy tailored to your age, fertility considerations, and long-term health.
Book My ConsultationWhat Is Early Menopause?
Early menopause is defined as menopause that occurs naturally between the ages of 40 and 45. Premature ovarian insufficiency (POI) is when menopause occurs before the age of 40, either naturally or as a result of surgery, chemotherapy, or radiotherapy. Both require specialist assessment and management because the long-term health implications — particularly for bone density, cardiovascular health, and mental wellbeing — are significant. Many women with early menopause or POI are misdiagnosed or told to wait, when in fact early hormone replacement is usually recommended.
Causes of Early Menopause and POI
Early menopause and POI can occur for several reasons. Natural early menopause (40 to 45) and POI (under 40) often have no identifiable cause, though autoimmune conditions, genetic factors (such as Turner syndrome or Fragile X premutation), and family history can all play a role. Surgical menopause occurs when both ovaries are removed (bilateral oophorectomy), causing an immediate and often severe onset of symptoms. Chemotherapy and radiotherapy can also induce menopause, sometimes temporarily and sometimes permanently. Whatever the cause, specialist support makes a real difference to long-term outcomes.
Symptoms of Early Menopause
The symptoms of early menopause are the same as those of natural menopause, but they are often more severe and more psychologically difficult to manage because of the age at which they occur. Common symptoms include hot flushes, night sweats, mood changes, anxiety, brain fog, sleep disruption, vaginal dryness, reduced libido, joint pain, and irregular or absent periods. For women under 40, the emotional impact of an unexpected menopause diagnosis can be significant, and psychological support is often a key part of treatment.
Treatment for Early Menopause and POI
The current NICE guideline (NG23) recommends hormone replacement therapy for most women with early menopause or POI until at least the average age of natural menopause (51), unless there is a medical reason not to take it. HRT in this age group is not just about symptom relief — it is also about protecting long-term bone density, cardiovascular health, and cognitive function. Our specialists prescribe body-identical oestrogen and progesterone, with testosterone added where appropriate, and we co-ordinate care with your NHS GP, fertility specialist, or other consultants as needed.
Did You Know?
POI affects roughly 1 in 100 women under 40, and around 5 in 100 women under 45 experience early menopause. Despite this, average diagnosis takes over 4 years and many women see 3 or more doctors before receiving a correct diagnosis. (Source: National Institute for Health and Care Excellence, NG23)
Common Myths vs Facts
You are too young for menopause
Menopause before 45 is more common than most people realise. POI affects 1 in 100 women under 40, and early menopause affects another 5 in 100 under 45. If your periods have stopped for 3 months or more, or you have menopausal symptoms with ongoing cycles, you deserve a specialist assessment regardless of your age.
HRT is dangerous for younger women
For women with early menopause or POI, HRT is generally recommended until at least the average age of natural menopause. The benefits — including protection of bone density, cardiovascular health, and cognitive function — usually outweigh the risks. Our specialists assess your individual risk profile and prescribe the safest, most effective option.
You cannot get pregnant after an early menopause diagnosis
Even with a POI diagnosis, around 5 to 10 per cent of women may still ovulate occasionally, and spontaneous pregnancies have been documented. If you do not want to conceive, contraception is recommended. If you do, our specialists can refer you to a fertility clinic for individualised advice.
What to Expect at Your First Appointment
- 1
A 60-minute specialist consultation with a BMS-accredited menopause specialist experienced in early menopause and POI
- 2
A full review of your menstrual history, symptoms, family history, and any relevant investigations
- 3
Discussion of your fertility intentions and onward referral where appropriate
- 4
Blood tests arranged if needed, including FSH, oestradiol, AMH, thyroid, and autoimmune screening
- 5
A personalised treatment plan covering HRT, lifestyle, and psychological support
- 6
A summary letter for your NHS GP and any other specialists involved in your care
- 7
Follow-up at 6 to 8 weeks to review your response to treatment and adjust as needed
- 8
Ongoing support until at least the average age of natural menopause (51)
Common Symptoms We Can Help With
- Hot flushes and night sweats before age 45
- Irregular or absent periods
- Mood changes, anxiety, or low mood
- Brain fog and memory issues
- Vaginal dryness or discomfort
- Reduced libido
- Joint pain and stiffness
- Difficulty conceiving
Treatment Options
- Body-identical oestrogen (patches, gels, or sprays)
- Micronised progesterone (Utrogestan)
- Testosterone where clinically appropriate
- Combined HRT or oestrogen-only after hysterectomy
- Non-hormonal alternatives for women who cannot take HRT
- Fertility-preservation advice and referral
- Bone-density monitoring and supplementation
- Psychological support and onward referral
Frequently Asked Questions
Q: How is early menopause diagnosed?
Early menopause is diagnosed when you have not had a period for 12 consecutive months (or 3 to 6 months with raised FSH on two blood tests taken 4 to 6 weeks apart) before the age of 45. POI is diagnosed before the age of 40. Your specialist will arrange the relevant blood tests and review your symptoms in detail.
Q: Will I need HRT if I have early menopause?
Most women with early menopause or POI are advised to take HRT until at least the average age of natural menopause (51), unless there is a medical reason not to. HRT in this age group protects long-term bone density, cardiovascular health, and cognitive function, and is generally considered safe.
Q: Can early menopause affect my fertility?
Early menopause and POI often reduce fertility, but spontaneous pregnancies are still possible in a small number of cases. If you are considering pregnancy, our specialists can refer you to a fertility clinic for individualised advice and discuss options such as egg donation if appropriate.
Q: How quickly can I be seen for an early menopause assessment?
We offer same-week appointments for women with suspected early menopause or POI, and we prioritise urgent cases. If you are under 40 and have been told to wait for a referral, please contact us directly — early treatment makes a real difference to long-term outcomes.
NHS Wait vs Private Care
- • Average wait: 12-18 weeks for referral
- • 10-minute GP appointment
- • Generic treatment protocols
- • Limited menopause expertise
- • Same-week appointments available
- • 60-minute specialist consultation
- • Personalised treatment plans
- • BMS-accredited menopause specialists
What Happens If You Do Nothing?
Untreated menopause symptoms rarely improve on their own. In fact, they often worsen over time:
- • Bone density loss accelerates — 20% in the first 5-7 years
- • Cardiovascular risk increases significantly
- • Mental health impact compounds — anxiety, depression, cognitive decline
- • Quality of life continues to deteriorate
- • Relationships and career can suffer
Limited Same-Week Appointments Available
Our BMS-accredited specialists are booking this week for new patients. Don't wait months for relief. Take control of your menopause journey today.
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