An early menopause can occur naturally or it can be induced by medication, radiotherapy or surgery. Around 10 percent of women have their menopause before the age of 45. Of these, less than two percent will have a true premature menopause, which means their periods will have stopped by the age of 40. Most experiences of true early menopause will have been induced and are the result of surgical or medical intervention. Induced menopause can take place at any age, but the younger the woman, the more traumatic and difficult it will be for her to come to tern-is with it. Surgical Menopause A surgical early menopause occurs when both ovaries are removed completely, and its effects start to be felt the day the ovaries are removed. The sudden drop in hormone levels, both estrogen and androgens, means a rapid adjustment is necessary by the whole body, and severe and distressing symptoms can occur. Most premature or early menopause is the result of this type of surgery, and it may be performed for a number of reasons. For example, tumors and cysts can destroy the ovaries, and whether these are cancerous or non-cancerous, they may need to be removed. Likewise, in cases of severe or chronic pelvic inflammatory disease, the ovaries may have been destroyed by infection and will have to be removed. In very severe cases of endometriosis, removal of the ovaries is sometimes an option, but symptoms may recur when hormone treatment is given afterwards. Hysterectomy Not long ago many gynecological surgeons used to recommend removing the ovaries when performing a hysterectomy. They justified this by saying that the ovaries were unnecessary if there was no longer a uterus to support a pregnancy, and that the ovaries should be removed to reduce the risk of future ovarian disease, ovarian cancer in particular. The