Premature menopause (ovarian failure) is defined as menopause before the age of forty years. It occurs in 1 per cent of women. About 10 per cent of women will reach the menopause before 46 years. When the menopause occurs early, the protection from ovarian hormones is lost and this results in increased risk of early heart disease and osteoporosis. Hormone replacement therapy should always be carefully considered. These women can also think of pregnancy with the help of egg or ovum donation programmes.