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Early menopause and perimenopause: How to spot signs and take control

25 September 2025
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Feeling unusually tired? Noticing mood changes, disrupted sleep or periods that seem out of sync? These may be early signs of perimenopause or early menopause – natural life stages that can occur at different times for different women. 

When we think of menopause, we often think of hot flushes and missed periods. But the hormonal changes leading up to it may be associated with a variety of symptoms, both physical and emotional. Spotting these signs early can help you seek timely advice and support.  

Perimenopause vs early menopause - what’s the difference? 

Perimenopause is the gradual transition phase before menopause, often starting in your 30s or 40s, and lasting several years. During this time, your hormone levels (especially oestrogen and progesterone) fluctuate, which may be linked to different symptoms. 

Early menopause happens when your periods stop completely before the age of 45.  If it happens before 40, it’s called premature menopause. While perimenopause usually occurs gradually, early menopause can hit you suddenly, often triggered by medical reasons like surgery, health conditions or certain medical treatments.  

Signs and symptoms to look out for  

Whether you’re experiencing perimenopause or early menopause, many of the signs and symptoms overlap. Here’s what may occur: 

  • Irregular or missed periods 

  • Hot flushes or night sweats 

  • Mood swings, anxiety or low mood 

  • Trouble sleeping 

  • Brain fog or poor concentration 

  • Vaginal dryness or discomfort during sex 

  • Reduced libido 

  • Headaches 

  • Fatigue 

  • Joint or muscle pain 

It’s easy to put these down to stress or everyday life, but if these symptoms are showing up together, consider making an appointment with your GP.  

What causes early menopause?  

While perimenopause is a natural part of ageing, early menopause may occur due to a range of factors.  

It could run in the family, result from medical treatments like chemotherapy, surgery or certain health conditions, or be affected by lifestyle factors like smoking.  

Regardless of the cause, early menopause has been associated with an increased risk of health issues like osteoporosis and heart disease, so getting the right support early is key.  

Menopause and heart health  

As oestrogen levels drop during early menopause, there may be an increased risk of some heart conditions Oestrogen helps keep your blood vessels healthy and balances cholesterol – which may support heart and vascular health. To stay on top of your heart health get regular check-ups and screenings, eat heart-smart and stay active.   

How do you diagnose early menopause and perimenopause?  

If you’re under 45 and noticing changes in your menstrual cycle, or experiencing symptoms like those above, speak with your GP. They can chat with you about your medical history, symptoms and periods, and may run blood tests. Keeping a symptom diary can help track how you're feeling and make your care plan as unique as you are. 

How to make early menopause and perimenopause symptoms easier to manage 

Managing early menopause and perimenopause isn’t a one-size-fits-all deal – every woman’s experience is unique. But here are some tips that may help: 

  • Hormone Replacement Therapy (HRT): HRT may be prescribed to replace oestrogen and relieve certain symptoms. 

  • Lifestyle changes: Eating well, exercising regularly, managing stress and sticking to a good sleep routine may all contribute to supporting wellbeing. 

  • Mental health support: Mood swings, anxiety and stress are common, so speaking to a psychologist or trying mindfulness techniques may provide support. 

  • Vaginal oestrogen or moisturisers: These may be recommended by a healthcare professional to help ease dryness and discomfort. 

  • Calcium and vitamin D: Important if you're at risk for osteoporosis. 

nib can help you take control  

If your symptoms are affecting your day-to-day, or your period disappears before 45, it’s important to check in with your GP. Early support may reduce risks and help you manage symptoms more effectively.

Every small step you take to look after your health may support your wellbeing. Whether it’s improving sleep, managing stress or checking in with your doctor, these steps may help. As a nib member, you can book a telehealth appointment through our partner, hub.health, and speak with a qualified GP – all from the comfort of your couch. 

The information in this article is provided as general information only. It is not medical or professional advice and should not replace guidance from your doctor or another qualified health professional.