Cause

Menopause is a natural part of aging. As you age, the number and quality of your eggs decline, hormone levels fluctuate, and your menstrual cycle becomes less predictable until it finally stops completely.

Causes of early menopause

Certain lifestyle choices and medical treatments can cause or are linked to an earlier menopause, including:

• Smoking. On average, women who smoke reach menopause 1½ years earlier than those who don't. The longer you have smoked and the more you smoke, the stronger this effect is likely to be.¹
• Radiation therapy to or removal of the pituitary gland.
• Chemotherapy.
• Radiation therapy or other treatment to the abdomen or pelvis that damages the ovaries so that they no longer function.
• Genetic and autoimmune diseases.
• Removal of both ovaries (oophorectomy), which causes sudden menopause.
• A vegetarian diet.¹
• Low body fat (body mass index of 25 or less).

Symptoms

The first sign that you are nearing menopause is a change in your menstrual periods. They may become less frequent. And they may be lighter or heavier than you're used to.

Menopause symptoms range from mild (or none) to severe. They include:

• Hot flashes.
• Sleep disturbances (insomnia).
• Emotional changes, such as mood swings or irritability.
• A change in sexual interest or response.
• Problems with concentration and memory that are linked to sleep loss and fluctuating hormones (not a permanent sign of aging).
• Headaches.
• Rapid, irregular heartbeats (heart palpitations).
• Generalized itching.

These symptoms usually go away after 1 or 2 years. But some women have them for several years longer.

Other conditions can cause similar symptoms. Examples include pregnancy; a significant change in weight; depression; anxiety; disease; or uterine, thyroid, or pituitary problems.

Menopause caused by surgery, chemotherapy, or radiation therapy can cause more severe symptoms than usual. Preexisting conditions such as depression, anxiety, sleep problems, or irritability can also make symptoms worse.

Later symptoms

After you stop having menstrual periods, you may get other symptoms, including:

• Drying and thinning of the skin, caused by lower collagen production.
• Vaginal and urinary tract changes, such as:
  • Vaginal dryness, irritation, and itching.
  • An increased risk of vaginal and urinary tract infections (UTIs).
  • Pain during sex.