What is early menopause?

Menopause is the phase of a woman’s life that marks the end of menstrual periods. To be in menopause, you must be period-free for 12-consecutive months (unrelated to other conditions or medications). The average age of menopause is 51.

Early menopause typically occurs between ages 40-45. Women who have menopause earlier than age 40 enter menopause prematurely. Just like women who enter menopause after age 45, women between ages 40-45 will experience perimenopause and have similar symptoms. About 5% percent of women go through early menopause.

The cause of early menopause is not well known but it is likely related to genetics, past medical treatments, prior illness and infections, smoking, and other health conditions including autoimmune diseases.

What are the complications of early menopause?

Women are beginning to have children later in their childbearing years. The average age of first-time mothers is steadily increasing in countries like the U.S. and the U.K. Fertility complications of early menopause arise when women try to conceive later in life. Women who enter menopause in their early 40s are likely to begin perimenopause in their 30s, which can decrease the number of follicles, making getting pregnant more challenging. Early menopause can be challenging for women who wish to get pregnant later in their childbearing years.

Other complications stem from women missing valuable years of having higher estrogen levels. Low estrogen levels increase your risk for certain health conditions such as osteoporosis, cardiovascular disease, type 2 diabetes, earlier cognitive decline, and an overall lower life expectancy. If you have early menopause, you may also feel sad or depressed as this major life change can impact family plans and the way you feel about your body.

How do I know I am going through early menopause?

If you are experiencing symptoms of perimenopause such as irregular periods before age 45, make an appointment with your doctor. Be prepared for your doctor to take the following assessments:

A complete family and medical history
Review of your current symptoms, including last menstrual period. You can use the Caria app to track your symptoms daily.
Physical exam
Blood studies including thyroid function tests, autoantibody tests (to assess for autoimmune diseases), a follicle-stimulating hormone test (taken twice in a 2 month period), and a bone mineral density study.

How can I manage early menopause?

If you are diagnosed with early menopause, your doctor will likely talk to you about using hormone replacement therapy to increase your estrogen levels. In most healthy women, HRT can be an effective tool for reducing menopause symptoms and decreasing your risk for low-estrogen health conditions like osteoporosis.

Making lifestyle changes can also help reduce your risk for complications of early menopause. For example, maintaining a healthy weight through diet and exercise can help reduce your risk for osteoporosis, cardiovascular disease, and type 2 diabetes.

Community comments

Real experiences shared by the community, from the original discussion to today.

Laura6 years ago
Oh wow. Exactly, exactly the same!
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Mrs P6 years ago
I am 42 and have started peri-menopause this year. Everyone told me I was too early but my mum was 38 when she started so you definitely aren’t too early.
- Abby6 years ago
  Me too (I’m 42). I’m bucking the trend in my family, my mum was 52 when she started menopause.
Jodie6 years ago
I am 40 and think I am peri menopause. Tracking the symptoms x
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Sandra6 years ago
Please don’t take no for an answer, I was finally diagnosed with premature menopause at 29 after years of going back and forth to my GP. My cousin was diagnosed at 21 and despite me telling them of the family history they were reluctant to even test me. I’d urge you in the meantime to take soya as it does help (milk, yogurt etc) and the supplements are also helpful especially the ones from Tesco. Good luck
- Mandi6 years ago
  Thanks for the tip about Soya!
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Angie6 years ago
Hi Mandi, I’m 41 and starting experiencing some symptoms at 37, right after leaving (unsuccessful) fertility treatment. But, this year, my symptoms have gotten pretty intense. You’re not crazy, it’s not common but it happens. I don’t have early menopause in my family. I was diagnosed with infertility and premature ovarian failure at 34. Keep looking for a doc who has expertise in menopause, not all docs seem to be informed about it, and they can tell you more. If it’s at all helpful, I switched to the DASH plan a month ago and have seen big improvements in hot flashes, migraines, and energy levels.
- Mandi6 years ago
  Thank you for the support!! Can you tell me more about DASH?
- Angiereplying to Mandi6 years ago
  Absolutely, and sorry you’re experiencing this. It’s emotionally not easy too! DASH stands for the Dietary Approaches to Stop Hypertension. It’s been around for a long time and very similar to the Mediterranean diet - lots of fresh fruit and veggies, lean protein, lower-fat dairy, beans and nuts while limiting sweets and foods high in saturated fat. There are tons of free resources and eating plans online. I also cut out gluten and alcohol too because I noticed how much better I felt when cutting those out during fertility treatment.
- Mandireplying to Angie6 years ago
  Oh thank you! I'll definitely check it out. I'm sorry you've had a difficult journey too. but it's great you've found success with DASH! Thanks again for the advice
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Samantha6 years ago
I am 41 and for two years I have been battling an increase in PMS making myself log them daily to help prepare for those symptoms/cycle! Headaches, acne and mood swings being the worst. The only symptom I did not experience related to Peri-menopause was hot flashes. Then my menstrual cycle stopped and the hot flashes started! I am 5 months in (menstrual free) the acne has cleared up, mood swings less severe but the hot flashes and fatigue at the max!! I spoke to my dr and she said it is stress due to covid! Even though I said I am not stressed. I am on here to track and see if I don’t fit the ‘norm’ and I am going through it early.
- Mandi6 years ago
  I hear that about covid and stress all the time too. Yes things are stressful but I have a feeling not everything I'm experiencing is related! Thanks for sharing your experience
Cari6 years ago
Same I’m 43 and have been going through this for a couple of months
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Veronika6 years ago
My transition started around the same age (38) and i had my last real period at 45. At the time when my first symptom of hot flashes started i still had mirena and that was the reason i did not have my periods. Once i realized that my hot flashes are not going away i talked to my primary doctor and he ordered a bunch of tests. One of them was FSH and it turned out to be elevated. At that point he said i was in perimenopause and referred my to gyno who confirmed it. He removed Mirena and i got my somewhat normal periods back. It all stopped when i was 45. I am still getting very light spotting occasionally. You are not crazy! My Mom also had an early transition and it is very often Comes from the inheritance. You can ask your doctor for FSH test and that will tell you if your transition has started.
- Mandi6 years ago
  Thank you Veronika I will!
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Karina6 years ago
I started at 36yrs and two doctors didn’t believe me, they treated me for anxiety and panic disorder (which I had never had before) while my body was crashed and out of control, finally diagnosed at 39yrs and it’s been a cruel long process. No one knows your body like you do, trust your instincts! xo
- Mandi6 years ago
  Sorry you had a tough time too! Thanks for the support
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Claire6 years ago
I’m 35, think I am peri since birth of son two years ago. Heavy, gushing periods, low libido, exhausted, hair still falling out, dizziness and heart palpitations. Feel awful a lot of the month now and not just before period. Have been wondering if traumatic births or Caesarean sections can bring on symptoms of early peri menopause. It’s not low iron or thyroid but have lost confidence in my GP as always fobbed off
- Mandi6 years ago
  Sorry you're feeling all this Claire! I also lost confidence in my doctor. Hearing from you all has really helped
- Clairereplying to Mandi6 years ago
  Same here Mandi! I have been in contact with a doctor in a menopause clinic here in Ireland and am waiting on blood results (hormone panel), I will let you know if I find out any information from her next week. Every bit of information we can get helps steer us in the right direction
- MrsMJ6 years ago
  You sound like I did. I too had c sections, but your symptoms are just as mine were (posted above) after I had my DD. Maybe there is a link for “older” (another term from my GP - erm 34 not old!!!) mother’s and c sections? And yes, fobbed off too! You sound perimenopausal we definitely need to find confidence in knowing ourselves to go find a second opinion!
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Cat6 years ago
Hi Mandi, Just know that you are not alone. Similar to many of these posts, I now recognise that my symptoms started around age 40 with anxiety and panic attacks that just appeared having never experienced anything like that before. Doctors treated as mental health issues. Then came the brain fog and the extreme fatigue, low libido and intense bouts of frustration and irritation. I am now 47 and 2 years without a period. I am on HRT but experience greater relief from my symptoms by controlling my diet. No alcohol or caffeine and following Mediterranean diet as much as possible helps my sleep and energy levels massively. Other than that Caria has been the biggest help, just to be listened to by others who understand!
- Mandi6 years ago
  Thank you for the advice Cat. Another commenter also mentioned diet changes and I will try them! It does help knowing others understand...
- sam6 years ago
  hi, may i ask which hrt you take? i’ve been on gel after hysterectomy and oopherectomy at 35. i went hrt free for 4 yrs and felt great. started hrt estrogen gel and have had no end of side effects. it’s not too bad since adding progesterone in to stabilize the estrogen, however i have shed lots of hair over last 18 months since starting hrt, plus weight gain, and now exessive armpit groin sweat. i’m thinking of stopping hrt as for me it has not improved the watery discharge i wanted it to and seem to have a host of other issues. thanks sam
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Christie6 years ago
Hi Mandi, my periods stopped altogether at 39 so it does happen! I believe with hindsight, peri began around the age of 30 for me so took around a decade to completely tail off. If your mum went thru it early that’s often a huge factor in your likelihood of early menopause too. Mine was in her 30s too. Personally a lot of emotional things were the first sign but as I was so young menopause didn’t even enter my head. Only years later around 34 when it kind of became clear I couldn’t get pregnant again that we looked into it and realised. Then my periods slowly began going awol. Sounds to me like you know what’s going on so push for what you need to a) diagnose it and b) try treatments. Good luck
- Mandi6 years ago
  Thank you for sharing this!! So helpful to hear it isn't just me
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MrsMJ6 years ago
I totally understand this! I had my DD at 34 and after 18 months one day it was like someone turned the light off; my zingyness has gone, Periods irregular, extreme fatigue, aches, massive mood problems, palpitations, anxiety, Libido non existent, dryness everywhere (mouth, nose, and down below). My mum was 37 when she started menopause, so there was a possibility that these symptoms were “it”. My GP has been nigh on useless. He did send me for a hormone test and checked thyroid, both back fine – but if peri menopause it won’t necessarily capture. Gave me mirena IUD (this only masks a problem and makes it more “convenient” from a mans perspective – in fact this is why he gave it me because I mentioned hubby was complaining), given me ADs for anxiety (still on these buggers!), had a heart monitor for one night to check for any irregularities…this was first 3 years of keep going to him as he wouldn’t accept it could be menopausal/perimenopause. Last year started developing acne and after another “mention” of hubby’s inconvenience with dryness I was given something topics for acne and a HRT type pessary – which I don’t use as I read up after and decided they were too risky for me. I’m now 42 and after appointment after appointment of “I’m a man I don’t understand women’s things” and laughing and then “aches are part of life” I now have no faith in going to him. My most recent development has been loss of taste and smell and cholinergic urticaria (my pharmacist friend diagnosed this not my GP) which GP has said must’ve been COVID!! And my weird dizzy feeling must be my epilepsy?!?!! But mum had exactly the same; lost smell and taste and prickly heat and he just doesn’t want to know! So, in summary, your symptoms do seem to be perimenopausal in my experience. These ladies on here have done more to settle my worries in the short time I’ve had the app than my GP has done for 5 years. If you are able, go to another GP. My GP is partner at practice and they won’t allow you to see someone else unless an emergency, and we live rurally so I’m a bit stuck, although considering the options of travelling out of boundary. However if you don’t do it now you’ll feel as unconfident as I do – wondering if I go elsewhere another doctor will they think “it’s just life” and laugh too ? take care, you know your body better than anyone and go get help and persevere. Good luck and huge peri menopausal hugs to you ?
- Mandi6 years ago
  I'm so sorry to hear about your long and difficult journey. It makes me angry when I hear male doctors laugh at women like you and me. I wonder if they'd say it's just a part of life if men went through menopause too? I hope you're able to find a better doctor where you are. Sending you hugs back!
- MrsMJreplying to Mandi6 years ago
  Thanks, Mandi. Yes it’s appalling that the only times he has considered anything is when I’ve told him it’s inconveniencing hubby ? worries me that our GP’s are giving the same awful service and lack of advice to others. Peri menopause is real, the struggles are real - the brain fog, the skin changes, the changes in digestion and newly arrived allergies, the flu like aches, period changes, night sweats, intense dizziness and headaches...the list goes on! And all this whilst you’re trying to still be you! Yes if it were a male issue I’m sure it would be treated differently and certainly not laughed at ?? Wishing you well in finding some support and please do go get a second opinion.
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Shagufta6 years ago
Hi I had an early menopause when I was 24 years old.. My periods stopped completely then..After my second child was born my periods started being irregular..after doing tests doctors said I had an early menopause.. I have been living with this since then and was diagnosed with Cushings Disease in 2004 ..
- Mandi6 years ago
  It must've been so hard dealing with this in your 20s. Thank you for sharing with me and others. I hope you've find been able to find the right support
Joanna6 years ago
Mandy, I experienced the same thing. I started peri menopause in my forties; after I had my last child at 40 yrs old. I still have all my female organs so my doctor couldn’t understand that I was in Menopause The Hot flashes seemed to make it official ! I dislike Menopause so much because of the hair loss , moodiness and hot flashes; if all these changes could occur for a small amount of time and go away! Does Menopause stop causing these problems? Anybody know?
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Michelle6 years ago
I was 43 and in full blown menopause. Didn’t know it until I was 44 and went back to my gyno for my annual who had done blood tests and confirmed from year before. I just stopped having my period and then gradually the other symptoms set in. I went on HRT.
- sam6 years ago
  which hrt are u on ?
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Aimee6 years ago
You are most definitely not alone. I have battled with this for years and only recently started taking HRT. However I feel as though my symptoms are slowly creeping back.
- sam6 years ago
  which hrt are u on
Heather6 years ago
I'm 43, my grandma was 42, my mom was 42 when we all went through life change. You aren't crazy! Boy it's tough!

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