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If your periods stop before you are 40, you are said to have gone through an early (or premature) menopause.

The most common reason that women have an early menopause is if their ovaries are removed by surgery. You may have this operation if you get ovarian cancer or another disease that damages your ovaries. It is usually carried out along with a hysterectomy, an operation to remove your womb.

If you have surgery that removes only your womb (and not your ovaries) or if only one ovary is removed, you may get some symptoms of menopause, such as hot flashes, earlier than you would have normally. This might happen because removing your womb reduces the blood flow to the ovary or ovaries.

Some medical treatments may cause an early menopause if they affect your pelvic area (the part of your body where your ovaries sit). Radiation therapy is sometimes used to treat cancer, but it can damage your ovaries. This can make it difficult to get pregnant or can cause you to go through menopause early.

If your ovaries are removed by surgery, your body can't produce eggs or make the hormones estrogen or progesterone. You won't have periods or be able to get pregnant. Similarly, if your ovaries are damaged, the egg cells on the surface of the ovaries may be destroyed so they can't make enough of these hormones.

Some diseases can damage the ovaries. These diseases include mumps (although damage to the ovaries is rare) and autoimmune diseases such as rheumatoid arthritis. If you have an autoimmune disease, your immune system (which defends your body against illness) doesn't work properly and attacks your body's own organs and tissues.

Sometimes a women can have an early menopause without doctors being able to tell why.

In women who go through menopause naturally, hormone levels drop gradually. And even after a natural menopause, the ovaries may still be able to make some estrogen from other hormones called androgens. But if you have surgery to remove your ovaries, you will have a sudden drop in your hormone levels.¹ This means you may have more severe symptoms than women who go through menopause naturally.

If you go through menopause early, you may also be at a higher risk of having certain health problems, such as heart disease and osteoporosis (a disease that makes your bones fragile so that they break easily). To find out more, see Osteoporosis and Heart disease.

If you have an early menopause, you may wish to consider hormone replacement therapy (HRT). HRT can relieve symptoms like hot flashes, vaginal dryness and feeling low. And there is good evidence that it protects against osteoporosis and prevents fractures.²

However, you need to weigh the benefits of taking HRT against the risks. This treatment increases your chances of getting breast cancer, blood clots and strokes.² It's worth discussing other treatments with your doctor if you are mainly worried about bone loss during menopause.

For more details about treatments for symptoms of menopause, see What treatments work for menopause?

This information is for educational use only, and is not a substitute for prompt professional medical advice. Readers should always consult a physician or other professional for advice and treatment. ©BMJ Publishing Group Limited 2008. All rights reserved.