Early menopause is the permanent cessation of menstruation in females before the age of 40 years characterized by vasomotor instability (hot flashes/cold episodes), psychologic and emotional symptoms and profound changes in the lower genital tract.
The most severe forms present with absent pubertal development and primary amenorrhea termed primary ovarian failure (50% of these cases due to ovarian dysgenesis), whereas forms with post-pubertal onset are termed secondary ovarian failure and are characterized by disappearance of menstrual cycles associated with premature follicular depletion.1 
Q: What is ovarian failure?
A: Ovarian failure is dysfunction of the ovaries to continue developing its eggs until about 51 years of age and to produce female hormones which results in infertility. Ovarian failure is diagnosed by this criteria:
- High levels in the blood of follicle stimulating hormone secreted by the pituitary gland, and
- Low levels of estrogen secreted by the ovaries.
The hypothalamus located in the brain is continually monitoring blood levels of estrogen so that when levels are low, it stimulates the nearby pituitary, or master gland, to secrete follicle stimulating hormone (FSH). FSH in turn stimulates the ovaries in females to produce estrogen. In ovarian failure, the ovaries do not respond to FSH.
Some causes in the general population of women include cigarette smoking, viral infections, surgical removal of ovaries, chemotherapy, and autoimmune disorders such as celiac disease, Addison’s disease, hypoparathyroidism, diabetes mellitus, vitiligo, and pernicious anemia.
Who is Affected in the General Population? This heterogeneous disorder affects approximately 1% of women.2 
What Is Early Menopause in Celiac Disease?
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