How To Manage Menopause and Early Menopause

Time to Read: About 5 minutes

This information will help you understand and manage the health effects of menopause (MEH-nuh-pawz) and early menopause. Menopause is a permanent end of your monthly periods.

What is natural menopause?

The ovaries (OH-vuh-reez) are small glands that a female is born with. They hold eggs and make hormones, including estrogen (ES-truh-jin). These hormones help control your monthly menstrual cycle (period).

You’re born with about 1 million eggs, but you lose eggs as you get older. With the loss of eggs, your ovaries stop making estrogen. This causes your monthly periods to stop, and natural menopause starts.

Natural menopause happens as a normal part of aging. For most people in the United States, natural menopause starts at 51 years old.

Natural menopause can cause changes to your body, such as:

  • Hot flashes (feeling of intense heat not caused by an outside source).
  • Night sweats.
  • Trouble sleeping.
  • Mood swings (changes in your mood).
  • Changes to your vagina and vulva (the area outside your vagina). For example, your vagina and vulva can become drier and less elastic (stretchy).
  • A higher risk for osteopenia (OS-tee-oh-PEE-nee-uh) or osteoporosis (OS-tee-oh-puh-ROH-sis). Osteopenia causes a loss of bone density and makes your bones weaker. Osteoporosis causes a thinning of bones and makes them weak, brittle, and more likely to fracture (break).
  • A higher risk for heart disease.

For more information about these symptoms, read the “Managing Menopause Symptoms Without Hormones” section.

Cancer and Early Menopause

Some cancer treatments cause people to go through menopause at a young age. This is called premature or early menopause. It can also be called premature ovarian (oh-VAYR-ee-un) failure or primary ovarian insufficiency (IN-suh-FIH-shen-see).

Cancer treatments that can cause early menopause include:

  • Surgery to take out both of your ovaries.
  • Certain chemotherapy medications that can affect your ovaries and cause a loss of eggs.
  • Radiation therapy that can affect your ovaries and cause a loss of eggs.

Many people treated for cancer will not get menopause at a young age. But some may go through menopause earlier than they normally would. This is usually during or right after their cancer treatment.

Others may go through menopause years after their cancer treatment. It’s hard to know if or when someone will go through menopause earlier because of their cancer treatment.

If you’re younger than 40 years old, call your doctor if you have any symptoms of early menopause. This includes:

  • Irregular periods for 3 months or longer. An irregular period is when the number of days in between each of your periods keep changing. Your periods can come early, late, or not at all.
  • No periods for 3 months or longer.
  • Any symptoms of menopause. For a list of symptoms, see the “What is natural menopause?” section.

Menopause Symptoms While Taking Ovary Suppression Medications

Some people are given medications to suppress their ovaries. These medications (such as leuprolide) will stop your ovaries from making estrogen.

While you’re on the medication, you will have symptoms of menopause. This will go away when you stop the medication, unless you get other treatment that could cause early menopause.

Treatment for Symptoms of Menopause

Hormone Replacement Therapy (HRT) for Early Menopause

If you have early menopause, your doctor may recommend hormone replacement therapy (HRT). HRT replaces the hormones your body is no longer making in their usual amounts. This can prevent some of the health effects of early menopause.

HRT can help by:

  • Treating the symptoms of menopause.
  • Helping to prevent thinning of your bones.

HRT can be given in a few different ways. If you have a uterus (YOO-teh-rus), your doctor may prescribe the hormones estrogen and progestin (proh-JES-tin). If you’ve had a hysterectomy (a surgery to take out your uterus), your doctor may prescribe estrogen only. Your doctor will recommend what’s best for you.

Some people are worried about the health risks of taking HRT. But many of these risks are reported in older people who take HRT after they reach menopause naturally. There’s no proof these same risks happen in younger people who take HRT.

Not everyone can safely take HRT. It’s generally not recommended for people with:

  • Hormone-sensitive tumors (such as breast cancer).
  • A history of blood clots.
  • Heart or vascular disease (having a history of heart attacks, high blood pressure, or stroke).
  • Liver disease.
  • Abnormal or unusual bleeding from the vagina.

Talk with your doctor about whether HRT is safe for you. If you cannot take HRT, there are other ways to manage the effects of menopause and early menopause. Some of these are described in the next section.

Managing Menopause Symptoms Without Hormones

You can also manage your menopause symptoms without hormones by following the tips in this section.

Hot Flashes and Night Sweats

Hot flashes usually start as a warm feeling in your face, neck, chest, and back. It can also spread to your whole body.

Hot flashes can range from light warming and redness (flushing) to drenching sweats (being soaked in sweat). Some people have 1 or 2 hot flashes a day while others have as many as 3 an hour. They can come on suddenly during the day and can wake you up at night.

You can reduce hot flashes by avoiding smoking, caffeine, alcohol, and spicy food. For more information on how to manage hot flashes, read Managing Your Hot Flashes Without Hormones.

Trouble Sleeping

Sleeping well at night can make you feel better and give you more energy. Some people with menopause or early menopause can have problems sleeping, such as having trouble falling or staying asleep. For more information on how to manage trouble sleeping, read Improving Your Sleep at Home.

Mood Changes

Some people see changes in their mood after menopause. If you’re feeling anxious (nervous or worried) or depressed (unhappy), talk with your doctor. They can refer you to MSK’s Counseling Center.

Our counselors provide one-on-one counseling and counseling for couples, families, caregivers, and groups. They can also prescribe medications to help if you feel anxious or depressed. For more information, visit or call 646-888-0200.

Changes to the Vagina and Vulva

The vagina and vulva become drier and less elastic after menopause. People who cannot take HRT can manage these problems by using vaginal and vulvar moisturizers. They can also use vaginal lubricants to help decrease dryness and pain during sexual activity. Some people may also be able to use vaginal estrogen.

For more information on these products, read Improving Your Vulvovaginal Health.

If you want more support and information about these issues, talk with your doctor. They can refer you to MSK’s Female Sexual Medicine & Women's Health Program. You can also reach the program by calling 646-888-5076.

Bone Health

Bone mineral density is a measure of how dense your bones are. It tells you how strong your bones are. Osteopenia is when your bone mineral density is lower than normal. Having osteopenia can lead to osteoporosis, which makes your bones weak and more likely to fracture. Losing estrogen during menopause or early menopause can raise your risk for these conditions.

There are things you can do to lower the chance of osteopenia turning into osteoporosis. You can exercise and eat a diet rich in calcium and vitamin D. For more information on how to keep bones healthy, read Improving Your Bone Health.

If you don’t get enough calcium or vitamin D in your diet, talk with your doctor. They may recommend you take a calcium supplement, a vitamin D supplement, or both. For more information on calcium and vitamin D supplements and how to take them, read Calcium Supplements.

Heart Health

Losing estrogen during menopause or early menopause can affect your heart health. There are many ways to reduce your risk for heart disease.

  • Don’t smoke. If you need help quitting, ask your doctor about MSK’s Tobacco Treatment Program. For more information, call 212-610-0507.
  • Eat a heart-healthy diet and keep a healthy weight. For tips on how to do this, read Eat Your Way to Better Health.
  • Make exercise a part of your routine. Any exercise that raises your heart rate for 30 minutes, 5 days a week, is a good option.
  • If you have high blood pressure, diabetes, or high cholesterol, ask your doctor about how to treat it.

Menopause Resources

The North American Menopause Society

The Office on Women’s Health

Last Updated

Thursday, February 9, 2023

Tell us what you think

Tell us what you think

Your feedback will help us improve the educational information we provide. Your care team cannot see anything you write on this feedback form. Please do not use it to ask about your care. If you have questions about your care, contact your healthcare provider.

While we read all feedback, we cannot answer any questions. Please do not write your name or any personal information on this feedback form.

Questions Yes Somewhat No
Please do not write your name or any personal information.