Premature and early menopause: protecting your health

Written by the Progyny Editorial Team. Reviewed by the Progyny Clinical Team - September 2026.

Menopause affects people in many ways, from physical symptoms to emotional wellness. It also raises certain health risks. And for women* with premature or early menopause, those risks are even greater. (*We'll use "women" to refer to sex at birth.)

If you entered menopause before age 45, it's essential to work with your healthcare provider to protect your future health and feel your best. Let's talk about special considerations you may have, and how to get the support you need.

What is premature and early menopause?

Menopause is official when you've stopped having a period for 12 months. In some cases, such as surgical removal of the ovaries, it may happen suddenly.

The average age for menopause is 51 or 52, and it's common to be a few years sooner or later. However, sometimes menopause can happen even earlier.

Premature menopause is menopause before 40. This happens naturally in about 1% of women.
Early menopause is menopause before 45. It occurs in about 5% of women.

Premature and early menopause are different from early perimenopause (the transition to menopause). Perimenopause may begin in your late 30s or early 40s and is not the same as full menopause at that early age.

Why might menopause happen early?

Premature or early menopause may be caused by:

Surgical removal of the ovaries
Chemotherapy or radiation
Autoimmune conditions
Genetic conditions such as Turner syndrome and fragile X syndrome

Often, however, the reason simply isn't known. Risk factors may include smoking and family history.

Health risks of early menopause

The hormone estrogen is crucial for our health. This is why menopause at an early age raises certain health risks. As we'll talk about, treatment (which often includes menopause hormone therapy) can significantly reduce your risk.

Osteoporosis

Estrogen plays a key role in helping bones stay strong and healthy. When estrogen drops in menopause, this may lead to osteopenia (a loss of bone density) and increased risk of osteoporosis (weak bones that fracture easily).

With early menopause, you lose the protective effects of estrogen sooner. And you have more years of being at-risk.

Heart disease

Estrogen's protective effects extend to our heart health. It helps improve cholesterol, fight inflammation, and improve blood flow. Unfortunately, early menopause raises the risk of heart attack and stroke.

Brain health

Many people may not realize that estrogen is also active in brain health. Early menopause may raise the risk for cognitive issues including dementia.

Fertility

After menopause, you can no longer become pregnant. For some, this can be devastating. A fertility specialist can talk with you about family-building options you may wish to consider. Emotional support is also available.

Emotional struggles

Premature or early menopause can be emotionally heavy. It may contribute to depression, anxiety, family-building concerns, altered self-image, and other struggles. If another serious condition caused early menopause, that adds to the emotional load.

If you feel any of these things, please know it is not in your mind - and you do not need to go through this alone.

Menopause symptoms

Early menopause can also lead to many symptoms of menopause itself. And those symptoms may be more severe.

You may have hot flashes, vaginal dryness, mood changes, insomnia, brain fog, and more. If menopause happened suddenly because of a medical reason, the sudden nature of the change may be difficult as well.

The role of menopause hormone therapy

You and your provider will work together to develop a plan of care and prevention that's right for you. For many people, menopause hormone therapy (MHT) is recommended until the average age of menopause, around 51 years.

MHT provides you with the protective estrogen that your body would have received during that time. MHT in premature and early menopause helps:

Lower the risk of osteoporosis
Lower the risk of heart attack and stroke
Improve vaginal dryness and other vaginal symptoms
Improve general quality of life and wellness

MHT isn't right for everyone. For example, it's not recommended if you have a history of breast cancer, heart attack, or stroke. Your provider will recommend other treatments and steps you can take to stay healthy.

Individual, holistic treatment is key

Your healthcare team can personalize a care plan for your symptoms, health history, and lifestyle. It's common to manage other risk factors as well, such as high blood pressure, high cholesterol, or high blood sugar.

Your team may also provide guidance on lifestyle changes. Healthy habits can have a sizeable benefit for your bones, heart, and brain health. These include:

Physical activity, especially weight-bearing and strengthening exercise
Balanced eating, such as the Mediterranean style of eating
Not smoking and limiting alcohol
Getting enough sleep and finding ways to cope with stress

Premature or early menopause may present challenges, but you have support at your side. For help navigating this journey, reach out to your Progyny Care Advocate. We can help you find a provider, lend support, and suggest resources.

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Disclaimer: The information provided by Progyny is for educational purposes only and is not medical advice. Always consult a qualified healthcare provider for medical guidance.