AS a teenager, the last thing on your mind is the menopause. It's something you associate with your mum or your gran. But for some women, the menopause, with its hot flushes, increased risk of osteoporosis and infertility, can happen much earlier.

Gemma Fawcett, a civil servant from South Shields, was just 19 when she experienced premature menopause. "I didn't know until I started trying for a baby. It was an absolutely massive shock." she says.

Gemma, who is now 23, met her fiance, John Armstrong, five years ago and they spent a year trying unsuccessfully for a child before Gemma consulted her GP.

She was referred to South Tyneside District Hospital, where doctors discovered that she wasn't producing a monthly egg. They recommended fertility drugs, but Gemma still didn't become pregnant.

After two years, she was transferred to fertility specialists at Newcastle's Centre for Life for further tests, and two months before her 21st birthday, she was told she was going through the menopause.

"I just couldn't believe it. It's a very strange feeling because you associate it with people around 50. It's not something that happens to young people and I didn't feel like me at first.

"I didn't think about the implications other than the fact I wasn't going to be able to have a baby. Now I've talked to my GP about it I know there's a higher risk of osteoporosis and cervical cancer but that didn't worry me at the time. It didn't even occur to me."

Looking back, she says she realises she had been having menopausal symptoms, including night sweats, hot flushes and mood swings, but she put it all down to stress from the fertility treatment. "We were so stressed out at the time, I was sure that was what was causing it. Besides, you're just not going to think about menopause at that age."

But Gemma is one of approximately 110,000 British women between the ages of 12 and 40 who are currently experiencing premature menopause.

Fayez Mustafa, a specialist in reproductive medicine at James Cook University Hospital, says: "It is a big problem in this country - about one in every 100 women under the age of 40 go through the premature menopause. Those figures are from the early 1990s so I'm sure it's much higher now. However, when you are talking about teenagers, it is quite rare.

"In the vast majority of cases, there is no apparent cause, although in women in their teens and 20s, there may be specific causes like being born with a genetic disorder. Girls may have had radiotherapy or chemotherapy or have a metabolic or auto immune disorder."

Some experts believe the number of cases may be increasing due to environmental toxins such as pesticides, while others put it down to severe physical or emotional stress.

Gemma still has no idea why she went through the menopause at such an early age. Her ovaries simply stopped producing eggs.

She says, rather philosophically: "I just have to accept that it's one of those things. I know it can be a genetic problem but noone in my family has had it. It seems to be one of those freak things."

Although premature menopause is a recognised medical condition, little research has been carried out into the subject.

Julie Fisher of The Daisy Network, a national support and advice group, says: "Because so little is known, people have to find their own way but it raises so many issues that a lot of women just end up feeling overwhelmed.

"There are all sorts of health issues. Deciding whether to go on HRT or try alternatives is a huge issue on its own as, of course, is infertility, and there are all kinds of psychological issues. Being diagnosed can be a devastating experience and it's certainly life-changing."

The network is staffed by volunteers, most of whom have been through the early menopause themselves. They provide support and advice for women and their families and raise awareness among members of the medical profession.

Symptoms of the early menopause include tiredness, joint pains, headaches, weight change, night sweats, vaginal dryness, mood changes, anxiety, irritability and depression. There are also more long-term health concerns.

Menopausal women are more susceptible to osteoporosis and heart disease. Hormone replacement therapy (HRT) can help, although the drug combinations offered to older women are often not suitable for younger ones.

Gemma has been taking HRT for the last two years. "It's absolutely brilliant. I feel 100 per cent better because it's helped with the hot flushes and mood swings. I know there was this scare recently about an increased risk of breast cancer but I think the pros outweigh the cons."

For Gemma, and dozens of young women in the same position, the most important issue is having children. Just one in 50 women diagnosed with premature menopause goes on to become pregnant. However, egg donation, where a woman can have an embryo from a donor egg and her partner's sperm implanted in her womb, means pregnancy isn't impossible.

Gemma and John are pinning their hopes on egg donation, although a shortage of donors means they may have a long wait. There are 65 couples waiting currently at the Centre for Life's Centre for Reproductive Medicine. Last year, there were 50 on the list but only 17 donors came forward.

Gemma says: "The waiting is hard but there is hope for women who have a premature menopause. I do think about it but I just get on with it and carry on with my everyday life."

* The Daisy Network

www.daisynetwork.org.uk.