What Are The Signs Of Early Menopause?

Medically reviewed by Arianna Williams, LPC, CCTP
Updated February 20, 2024by BetterHelp Editorial Team
Many people will experience menopause during their lifetime; however, what we commonly call "going through menopause" is often the symptoms of perimenopause - the stage before menopause happens.

Menopause is the point marking 12 months since the last time a person experiences menstruation. The average age for menopause is 51, but it's considered normal any time from the mid-40s through age 60. Early menopause is when a person stops menstruating before age 45.

Ahead, we'll review the causes of early menopause alongside the cognitive and physical symptoms that may accompany it. Finally, we'll discuss recommendations for coping with the symptoms of menopause. If you are experiencing challenges, know that you are not alone and there is help available.

Early menopause symptoms can be hard to manage

What causes early menopause?

Our bodies are a complex balance of different hormones. The hormone associated with gynecological reproductive system is estrogen. Estrogen levels constantly fluctuate throughout our lives, even before we are born. This hormone is responsible for developing breast tissue and mammary ducts, breast milk secretion, thickening the endometrial lining, and long bone development in puberty.  As we age, estrogen production begins to slow down, and the closer we get to menopause, the lower the levels become. Low estrogen levels may mean different body changes, which can signal the onset of menopause.

Early menopause happens when this estrogen drop occurs before age 45. (Menopause that happens before age 40 is called premature menopause.) The most common is surgery to remove the ovaries or uterus. When this happens, the primary control for estrogen production is no longer there, which means the body is not being directed to produce it. The same can occur if the ovaries become damaged or diseased. Polycystic ovarian syndrome (PCOS), for example, can cause the ovaries to function improperly, which may affect estrogen production. Over time, less estrogen is produced, triggering menopause.

Another reason that people may experience early menopause is genetic. While this is harder to understand, it can be easier to predict because other family members may have experienced it. In this case, early menopause is triggered by the same process as normal menopause; it just happens earlier.

Cognitive symptoms of menopause

The most recognized symptoms of menopause are physical. Some people may not even be aware that there are cognitive symptoms since they may be similar to those caused by the normal aging process.

Mood swings


Many people experience mood swings during their normal cycle due to the fluctuation of estrogen levels. These tend to coincide with the time before a period, and they might lessen as estrogen levels begin to rise again. When menopause approaches, mood swings may become more frequent and more severe. You may find yourself experiencing the same symptoms during different parts of your cycle.


Depression is also a side effect of menopause. Menopause can often mark the end of the childbearing years, which can be hard to cope with. Some people may accept this as part of the natural aging process while others might find it harder to process.


Another mental health symptom that people going through menopause may experience is a rise in anxiety. Menopause also affects the brain hormones related to stress. You may be more prone to panic attacks during perimenopause and after menopause. Panic attacks can cause symptoms such as shortness of breath, sweating, trembling, and heart palpitations.

Physical symptoms of menopause

Most perimenopausal symptoms are similar to those experienced during a menstrual cycle, but these symptoms may progressively worsen as one gets closer to menopause. Many physical changes, like cognitive ones, might be dismissed as normal aging by loved ones and doctors.

Weight gain

The fluctuation of estrogen may cause weight gain, especially around the waist. The metabolism slows, which could make this extra weight harder to lose. Weight gain is also commonly dismissed as a symptom because it can happen to anyone, even when they are not in perimenopause.

Hot flushes

The most common physical symptom of menopause is hot flushes or flashes. These are characterized by a sudden onset of sweating caused by a rapid rise in body temperature. They may pass after a few minutes and frequently occur at night. About 75% of perimenstrual people in North America experience hot flashes.

Atrophy and skin changes

As we age, our muscle tissue starts to break down. This atrophy happens all over the body, but for perimenopause, it may be especially pronounced in the pelvic region. This can mean a loss of bladder control and less tightness in the vaginal muscles. Other vaginal issues may include dryness or lack of libido. As far as your skin, you may see more wrinkles and less firmness, which is commonly dismissed as normal aging. There is also a loss of "glow" as the suppleness of pre-menopausal skin diminishes.

Irregular periods

Irregular periods may be the most obvious sign that you are entering perimenopause. Menopause is the moment menstruation stops, so a cycle disruption could be an indication that estrogen levels are being affected. However, since stress and other conditions can lead to skipped periods, it can be easy to dismiss. Many people may miss periods due to various factors, including a change in hormonal birth control methods or poor diet. 

Early menopause symptoms can be hard to manage


It may also be common to experience insomnia as part of menopause. Difficulty sleeping is another symptom that can be easily missed, though. Insomnia might be caused by factors other than hormonal changes such as stress, caffeine, or inactivity, for example. 

What to do

If you think you might be going through early menopause, it could be essential to contact your doctor.  While the actual diagnosis may be challenging to determine, a medical professional may be able to give you estrogen supplementation or recommend dietary changes or supplements to try to hold off the process. 

Your doctor can also prescribe lifestyle changes. A healthier lifestyle with good food and exercise can help alleviate the severity of some symptoms. Menopausal people are also at greater risk for heart disease. This could be another reason to change your lifestyle when experiencing perimenopause.

Therapy can help

Whether you’re experiencing symptoms of anxiety and depression as a result of early menopause or having problems coping with the changes it means for your life, talking to a therapist can help.

Online therapy has many benefits that can make treatment more convenient. You don’t have to worry about finding a nearby therapist with available appointments, commuting to an office, or being on a waiting list. When you sign up, you’ll be matched with a trained therapist, and you can attend sessions from the comfort of your home. This web-based setting might be more conducive to discussing sensitive topics such as menopause and aging. 

Research shows that online therapy can be effective. One study noted that the participants enrolled in online treatment saw “significant and clinically meaningful improvements in depression and anxiety scores” after 12 weeks. 


Early menopause has the same physical and cognitive symptoms as menopause but occurs before you are 45. The transition from perimenopause to postmenopause can be challenging to cope with. Symptoms can be severe, and many people find it hard to accept that they are getting older and transitioning to the next phase of their lives. If you’re having symptoms of early menopause and need someone to talk to, connect with a licensed BetterHelp therapist today.
Understand how menopause impacts the body and mind
The information on this page is not intended to be a substitution for diagnosis, treatment, or informed professional advice. You should not take any action or avoid taking any action without consulting with a qualified mental health professional. For more information, please read our terms of use.
Get the support you need from one of our therapistsGet started