Symptoms of Early Menopause

Early menopause occurs when your menstrual cycle stops between the ages of 40 and 45. Menopause before age 40 is considered premature menopause or primary ovarian insufficiency. The average age of women who go through menopause, a complete year of no periods, is between 51 and 52 years old.

Premature menopause happens to about 1% of women under 40, while early menopause is seen in about 5% of women under 45.

As menopause gets nearer, your ovaries begin to produce less and less of the hormone estrogen, which causes your menstrual cycle to change. The symptoms you experience during menopause are a result of these fluctuating hormone levels.

There are some signs of early menopause to watch for. These symptoms are also associated with low estrogen levels, and are similar to those of premature menopause.

woman not feeling well

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Frequent Symptoms

The way you experience early menopause will differ based on what triggered it. For example, research has found that women who undergo medical menopause due to chemotherapy have longer menopausal transitions with worse symptoms than other women.

Women may start having irregular menstrual cycles for a few years before their last period. The symptoms of early menopause include many of the typical menopause symptoms, including:

  • Hot flashes
  • Night sweats and cold flashes
  • Vaginal dryness
  • Insomnia (difficulty sleeping)
  • Mood swings
  • Urinary urgency (a pressing need to pee more frequently)
  • More urinary tract infections
  • Dry skin, dry eyes, and dry mouth
  • Breast tenderness
  • Racing heart
  • Headaches
  • Joint and muscle aches and pains
  • Changes in libido (sex drive)
  • Difficulty concentrating, memory lapses (often temporary)
  • Weight gain (around the midriff)
  • Hair loss or thinning

Complications

Early menopause is linked to some serious health complications.

Neurological Diseases

Research has shown that a short time span between your first period and menopause may be associated with a higher risk of dementia. An evaluation of a diverse prospective cohort study of more than 15,754 women found that those who started menstruation at a later age or entered menopause early had a more than 20% greater risk of developing dementia.

Sexual Dysfunction

Early menopause means you may be faced with hormone-related sexual challenges earlier than expected. These may include vaginal changes like skin thinning and decreased lubrication, which can make tearing easier and penetration painful and anxiety-producing.

Mood Disorders

Not everyone who experiences early menopause will have a mood disorder. Some women will, however, have poorer mental health outcomes than others. Findings in this area are largely inconsistent, and long-term systematic investigations in early menopausal women are lacking. Nevertheless, early menopause means the end of fertility, which can be a highly emotional and unexpected loss for many.

In a cross-sectional clinic-based study of 174 women with chromosomal abnormalities and 100 women with Turner syndrome, researchers found that early menopause due to chromosomal irregularities increased the lifetime risk of depression, with depression onset typically occurring after ovarian function changes.

Heart Disease

Early menopause is associated with an increased risk of heart disease and stroke. This is likely at least in part due to lower estrogen levels, which are related to changes in cholesterol. This higher risk may also be because of cardiovascular risk factors earlier in life, such as smoking, which also increases the risk of early menopause.

More recently, a study found that for every one-year delay in menopause onset, the prevalence of coronary heart disease and stroke decreased by 3% and 5%, respectively.

Osteoporosis

Experts say the earlier in life you experience menopause, the worse its impact will be on your overall bone health. That’s because decreasing levels of estrogen inhibit your bone’s natural rebuilding abilities and make reformation less possible.

One cross-sectional study of 782 women who had never received bone mass–altering drugs found that those in early menopause had significantly lower spinal bone mineral density than women who underwent normal or late menopause.

When to See a Doctor

If you think your symptoms are related to early menopause, you should consult a doctor. Getting an accurate diagnosis can help with better symptom management.

You may also want to see your doctor in the following situations:

  • You have an infection, such as urinary tract infection or an infection in the vaginal lining due to a tear
  • Your moods are unpredictable and you are not sure how to cope
  • You are looking for solutions to hot flashes and night sweats and want to ask about hormonal or nonhormonal therapy risks and benefits
  • Hot flashes become fevers
  • Your symptoms are worsening or are causing problems in your family and social life 
  • Dry mouth or dry eyes are problematic, such as dry mouth making it harder to swallow or dry eyes making it uncomfortable or impossible to wear contact lenses
  • Joint and muscle pain is new or worsening and you want to ask if it’s related or if it is a symptom of another condition like arthritis or fibromyalgia
  • Hair loss is becoming more frequent and your mental health is suffering as a result
  • You would like a referral to a specialist
  • You are diagnosed with early menopause or menopause (12 months without periods) and then experience any bleeding or spotting again 

Take Bleeding Seriously

After you have been diagnosed with early menopause, watch for bleeding. There is an association between postmenopausal vaginal bleeding and endometrial cancer. A majority (90%) of women diagnosed with endometrial cancer reported bleeding before their cancer diagnosis. Any postmenopausal bleeding should therefore prompt an evaluation by your doctor.

Summary

Early menopause comes with many of the traditional menopause symptoms, such as hot flashes, night sweats, insomnia, and vaginal dryness. It's associated with a higher risk of complications like heart disease and osteoporosis. You should therefore consult your doctor if you suspect you are going through early menopause.

A Word From Verywell

Experiencing menopause at any age is a life-altering event, but experiencing menopause in your early 40s can feel particularly difficult. If you are feeling robbed of your 40s and as if menopause will never end, it may be time to talk to trusted family members or a mental health professional.

If you find that your physical symptoms are stopping you from living your life to the fullest, definitely reach out for mental health support. Connecting with others who can listen without judgment (and, better still, who have gone through this change at an earlier age) is extremely powerful. 

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9 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
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