These days, celebrities like Gwyneth Paltrow and Michelle Obama are openly discussing perimenopause and menopause—and that’s a good thing. The more we talk about this once-taboo subject, the better prepared we’ll be to handle its inevitable symptoms, from hot flashes to mood swings and lower sex drive.

But one aspect that doesn’t get as much attention is early or premature menopause, which affects about 5% of women, according to the National Institutes of Health. Dr. Roger Lobo from Columbia University Fertility Center explains: “Early menopause happens when a woman goes through menopause before age 45. If it occurs before 40, it’s considered premature.”

### What Causes Early Menopause?
When menopause arrives unexpectedly, its effects on both physical and emotional health can be significant, says Dr. Alexandra Henríquez Linares, a specialist in gynecological and integrative medicine. Normally, the decline in estrogen and progesterone happens gradually between ages 45 and 55, but early menopause can be much more sudden.

While the exact cause isn’t always clear, several factors may play a role:

– Genetics – If your mother or grandmother experienced early menopause, you might too.
– Autoimmune diseases – Conditions like lupus or autoimmune hypothyroidism can contribute.
– Medical treatments – Surgeries, chemotherapy, or radiation therapy may accelerate menopause.
– Environmental toxins – Exposure to tobacco, heavy metals, pesticides, or industrial chemicals can disrupt hormones and reduce ovarian reserve.
– Viral infections – Rarely, illnesses like mumps in childhood may be a factor.

### Symptoms of Early Menopause
The symptoms are the same as natural menopause, says Dr. Lobo: missed periods, hot flashes, mood swings, trouble sleeping, and vaginal dryness. But because these changes can happen unexpectedly, many women don’t realize they’re entering menopause, delaying diagnosis and treatment.

Left untreated, early menopause increases health risks like heart disease, diabetes, bone loss, and even cognitive decline. “Memory issues are usually temporary,” says Lobo, “but untreated premature menopause has been linked to higher risks of dementia, Parkinson’s, and certain cancers.”

Dr. Henríquez highlights key symptoms to watch for:

– Irregular or missed periods for several months
– Hot flashes or night sweats
– Vaginal dryness and discomfort during sex
– Mood swings, anxiety, or unexplained sadness
– Trouble concentrating or “brain fog”
– Lower sex drive
– Unexplained fatigue

There’s also a subtler but important sign, notes Dr. Molly McBride, an OB-GYN and advisor at Lubify: “Some women describe it as NFLM—’not feeling like myself.’ Even if periods are still regular, cycle length and flow may change. This can start as early as 35 and last for years. Find a doctor who listens and offers treatment options.”

### Getting a Diagnosis
A gynecologist can confirm early menopause with a blood test to check hormone levels (like rising FSH and dropping estrogen). An ultrasound may also be used to examine ovarian follicles—small fluid sacs that hold eggs—which shrink as menopause approaches.

The key takeaway? If something feels off, don’t ignore it. Early diagnosis and treatment can make a big difference in managing symptoms and long-term health risks.Confirmed cases will be very few or non-existent,” she says.

### How to Manage Early Menopause
Treatment options for early menopause are similar to those for perimenopause and menopause. However, Dr. Lobo advises patients to consult their healthcare provider to determine the best approach for their needs. Hormone replacement therapy (HRT) is beneficial for most women unless contraindicated—such as in cases of estrogen-dependent breast cancer.

“In women with early menopause, HRT reduces the increased mortality risk associated with not using hormones,” he explains. “It’s particularly helpful for younger women in managing symptoms like vaginal dryness, mood swings, and poor sleep.”

For those concerned about fertility, Dr. Lobo recommends consulting a fertility specialist early to explore options like egg freezing or IVF. “By the time women enter perimenopause, egg freezing and IVF are usually no longer viable,” he adds.

Dr. Henríquez notes that HRT is highly effective for early menopause when tailored to the individual’s symptoms, medical history, and underlying causes. “The goal is to replace the hormones the ovaries no longer produce, using doses appropriate for the patient’s age,” she says. “This helps relieve symptoms like hot flashes, insomnia, and vaginal dryness while protecting bone, cardiovascular, and cognitive health.”

However, HRT isn’t always necessary or advisable. “For women with mild symptoms, certain hormone-dependent cancers, or blood clotting disorders, alternative treatments should be considered,” she explains. Dosage and administration methods must also be personalized based on symptoms and overall health. “An integrative approach aims for balance,” she adds.

### Healthy Habits for Early Menopause
Biologist and nutritionist María Pastor emphasizes that an integrative approach is key to managing menopause—whether early or not. She recommends an anti-inflammatory diet rich in omega-3s, with limited grains, cow’s dairy, processed foods, refined flours, and vegetable oils. Focus on antioxidant-rich foods like flaxseeds, sesame, fermented soy, cruciferous vegetables, tahini, and legumes.

“Don’t forget prebiotic fiber to support gut health, as a healthy colon microbiome can help reduce symptoms,” she advises. Avoid alcohol and simple sugars, and ensure each meal includes high-quality protein.

Both Pastor and Henríquez suggest certain supplements—though they stress that any regimen should be supervised by a professional. Recommended options include:
– Vitamin D
– Red clover (for hot flashes)
– Sea buckthorn (omega-7 for vaginal dryness)
– Phytoestrogens like black cohosh or soy isoflavones
– Probiotics
– Coenzyme Q10 or resveratrol
– Ashwagandha or Siberian ginseng

Stress management and emotional support are also crucial. “A diagnosis of early menopause can be emotionally challenging, especially for women hoping to conceive,” says Henríquez. “Mental health plays a vital role in hormonal balance.” She recommends therapy and strength training, which benefits bone health, mood, body composition, and insulin sensitivity.

Dr. McBride agrees, highlighting the importance of healthy daily habits. “Losing estrogen at a younger age has long-term health implications, so proactive care is essential.”She explains, “There are serious health risks, including heart disease, osteoporosis, depression, and dementia. Focus on staying active, eating healthy, and drinking less alcohol. Most importantly, treatment should be personalized—what works for one person may not work for another.”