We’re all much more aware of menopause these days – and rightly so. Talking about menopause and peri-menopause is far more mainstream even than a few years ago, and there’s never been more information and support for women in this stage of their lives.

But what about if you’re not quite ready for menopause? Most of us expect to start experiencing some symptoms in our forties and fifties – but some of us will enter menopause sooner than this, with 1% of the population becoming menopausal before the age of 40. So, how do we know if we’re at risk of early menopause – and is there anything we can do about it? 

We asked the experts for their advice. 

It’s helpful when thinking about the menopause to see it as a process which will take place over several years, rather than something that happens at a certain age.

‘The menopause isn’t a sudden condition that hits women once they reach 50, but a gradual change, called perimenopause, which can start 10 to 15 years before menopause itself, so symptoms can certainly start in your late 30s and early 40s,” says intimate health expert Dr Shirin Lakhani of Elite Aesthetics and speaker at Pause Live! 2023 consumer menopause education event.

“The average age of onset in the UK is 51 for menopause and 47.5 years for perimenopause, but research shows that 5% of the UK population will reach the menopause before the age of 45 and 1% will experience it earlier than their 40s.”

Medically speaking, early menopause is considered to be menopause before the age of 45, while before the age of 40, it’s referred to as premature menopause. 

Early menopause can occur naturally or as a result of other conditions or their treatment. 

“The cause of early menopause is often unknown but can be caused by a number of things such as autoimmune disease, certain infections and chromosome abnormalities,” says Dr Lakhani. “Experiencing an early menopause can be extremely distressing and, if permanent, can affect your ability to have children naturally.”

If early menopause starts naturally, it means that your ovaries have stopped producing enough oestrogen to trigger ovulation. This is known as primary ovarian failure or primary ovarian insufficiency (POI). The causes of this can be genetic or due to an auto-immune condition or other infection.

“Genetics plays a significant role in determining the age at which a woman may enter menopause,” explains Dr Babak Ashrafi, women’s health specialist at Superdrug Online Doctor. “If your mother or sisters experienced early or late menopause, you are likely to experience a similar pattern. However, there is no one-size-fits-all when it comes to your physical health so this should not be a precedent to live by.”

Early menopause can also be surgically induced, if the ovaries are removed as part of treatment for another condition such as cancer. 

‘There are many factors which can affect the age when menopause starts,” explains Dr Lakhani, “such as the age of the first menstrual period, the use of oral contraceptives, the number of pregnancies, BMI, smoking, drinking alcohol, exercise.

“High levels of stress can cause women to experience symptoms similar to the menopause. Although there are anecdotal reports of women experiencing menopause following a traumatic event, there is no clear medical evidence that it actually induces the menopause.’ 

The symptoms of early menopause are very similar to menopause in general. 

“If you’re concerned about your risk of early menopause, keep an eye out for signs such as hot flushes, mood changes, vaginal dryness and changes in menstrual patterns,” says Dr Ashrafi. “Speak to a health professional if you are concerned you are experiencing any of these signs.”

Symptoms to note are generally (but not limited to):

• Hot flushes and night sweats

• Difficulty concentrating

• Nausea

• Joint aches

• Memory loss

• Palpitations

• Reduced libido

• A change in the normal pattern of periods

• Difficulty sleeping

• Reduced muscle mass

• Recurrent urinary tract infections

In addition to the obvious impact on fertility, going through an early menopause can have other side effects for your overall health. 

“Due to the stark decrease in oestrogen in the initial stages of menopause, the primary risks associated with an early onset are osteoporosis and heart disease,” explains Dr Ashrafi. “Oestrogen plays a crucial role in bone resorption and formation which all contribute to a healthy bone density. With the reduction in this hormone, there are heightened chances of osteoporosis and with this, bone fractures.

“Oestrogen also has a protective effect on the cardiovascular system, helping to maintain healthy blood vessel function and lower cholesterol levels. Low oestrogen levels has been found to contribute to higher levels of heart disease in menopausal women. Early menopause can also lead to the premature onset of ageing-related changes, including reduced skin and breast tissue elasticity and hair thinning.”

If all of this makes for depressing reading, don’t despair – there are some (limited) ways that you can ease your transition into menopause, whenever it occurs. 

“Living a healthy lifestyle through a balanced diet and regular exercise can greatly reduce the physical and mental impacts associated with menopause,” advises Dr Ashrafi, “but there is no hard evidence that these choices will delay the process. The timing of menopause is primarily to do with your genetic make-up so is largely out of your hands. The most important thing is for women to be given evidence-based information, to be informed and to be supported so they can make their own decisions about their wellbeing.”

Images: Getty