Menopause is a huge transition in a woman’s life, yet it’s often shrouded in myth and mystery. One of the most unhelpful myths is how early menopause can start. Our State of Menopause Report revealed that 75% of women underestimated when menopause begins, leaving many unprepared for a transition that can profoundly impact their health, well-being, and careers.

The average age of natural menopause is 51, but menopause occurring between 45 and 55 is considered normal¹. Menopause is defined as the day 12 months after a woman’s last period. However, symptoms often start years earlier during perimenopause, when estrogen levels begin to decline.

Perimenopause lasts around seven years but can last up to ten². This means it’s completely normal for a woman in her mid-30s to be in perimenopause. Around 8% of women experience early or premature menopause, which can begin before age 40³.

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When Does Menopause Typically Start?

Why Knowing When Menopause Can Start Matters

Understanding when menopause can start—and recognising early and premature menopause—is key to protecting your long-term health. Our research uncovered a significant education gap among women entering perimenopause and menopause, leading to years of unnecessary suffering before seeking treatment.

Our State of Menopause survey found that 59% of women didn’t know what was happening when they first experienced symptoms, and 64% felt “completely unprepared” for how severe those symptoms would be.

While no two menopause journeys are the same, having a clear idea of what to expect can make a powerful difference. As Dr. Mary Claire Haver, author of The New Menopause, explains: “The paths we take may look different, but no one should ever feel lost.” Staying informed empowers women to take control of their health and navigate this transition with confidence⁴.

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What Is Early and Premature Menopause?

Early Menopause

Early menopause occurs when a woman has gone 12 months without a period between the ages of 40 and 45³. In these cases, perimenopause may begin as early as the early 30s.

An earlier onset can raise additional concerns around fertility and long-term health, as it extends the number of years a woman lives with low estrogen levels⁸. Symptoms may also feel more intense due to the sudden hormonal shifts.

Premature Menopause

Premature menopause occurs before age 40³. It may happen spontaneously or as a result of medical treatments such as chemotherapy, radiation, or surgery that affects the ovaries⁹.

Premature ovarian insufficiency (POI) is a related condition in which menstrual periods stop earlier than expected. Both premature and early menopause involve prolonged low estrogen levels, which can significantly affect overall health⁹.

Primary Ovarian Insufficiency (POI)

POI occurs when the ovaries lose normal function before age 40. Unlike premature menopause, POI isn’t always permanent. Women with POI may still have irregular periods or occasional ovulation, but they often experience menopause-like symptoms and reduced fertility⁹.

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Causes and Risk Factors for Early and Premature Menopause

What Causes Early and Premature Menopause?

“There’s no crystal ball that can predict exactly when you’ll begin perimenopause or reach menopause,” says Dr. Mary Claire Haver. However, several factors can influence timing, including genetics, autoimmune conditions, and medical treatments such as chemotherapy or radiation⁶. In many cases, the exact cause remains unknown⁸.

Genetic and Family History

Genetics play a major role in menopause timing. Women whose mothers or sisters experienced early or premature menopause are more likely to experience it themselves. Certain genetic mutations have also been linked to premature ovarian failure^4,8.

Autoimmune Diseases and Health Conditions

Autoimmune conditions—where the immune system attacks healthy tissue—can interfere with ovarian function. Conditions such as thyroid disease, rheumatoid arthritis, and lupus have been linked to POI and early menopause⁶.

Surgery and Cancer Treatments

Surgical procedures like oophorectomy (removal of the ovaries), as well as chemotherapy and radiation, can trigger early menopause by damaging ovarian tissue⁹.

Dr. Haver stresses that surgically induced menopause should be a last resort. “Surgically induced menopause is a big deal. It brings sudden and dramatic hormonal changes and significantly increases the risk of heart disease, stroke, cognitive decline, mood disorders, and osteoporosis”^4,8.

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Signs of Early Menopause

Symptoms of Early and Premature Menopause

Symptoms of early and premature menopause mirror those of natural menopause. These include hot flushes, night sweats, vaginal dryness, mood changes, and irregular periods.

However, because hormone levels drop more abruptly, symptoms may feel more severe and harder to manage than the gradual transition seen in typical menopause¹¹.

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Health and Well-Being Impact of Early Menopause

Long-Term Risks

Experiencing menopause earlier than average increases the risk of osteoporosis, cardiovascular disease, and cognitive decline. Women may need to take preventive steps earlier to protect bone, heart, and brain health¹².

Emotional and Psychological Impact

The emotional impact can be significant. Feelings of grief, anxiety, or depression are common, particularly when fertility is affected. Support from healthcare professionals, counselling, and shared experiences with others can make a meaningful difference.

Can I Still Get Pregnant After Early or Premature Menopause?

Fertility is reduced but not always eliminated. While natural pregnancy is rare, assisted reproductive options such as IVF with donor eggs may be available for some women¹¹.

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How Is Early Menopause Treated?

Take Control of Your Health

Early menopause is managed similarly to natural menopause. You don’t have to suffer in silence. Education and open conversations with your healthcare provider about symptoms, medical history, and treatment preferences are essential.

Treatment Options

Menopausal hormone therapy (MHT), also known as hormone replacement therapy, is an effective option for many women, particularly for managing hot flushes and protecting bone health. It isn’t suitable for everyone, so discussing benefits and risks with your provider is important.

Natural Solutions with Biolae

If prescription treatments aren’t right for you, Biolae offers natural, clinically tested solutions designed to address menopause symptoms at their source. These options may support hot flushes, night sweats, sleep disruption, mood imbalance, and brain fog—helping you take control in a way that aligns with your preferences and goals.