Premature Menopause and Longevity: How to Extend Your Lifespan

Many women enter their late 40s and early 50s bracing for the hot flashes, night sweats, and other not-so-pleasant symptoms that go along with menopause. But what if cancer treatment, an autoimmune disease, or a medical condition has thrust you into the change in your 30s, or even 20s? 

Going into menopause before age 40 is called premature menopause, and research shows it could set you up for some serious health risks—even early death (1). Before you panic that a premature end to your reproductive years might result in a premature end to you, there are actions you can take to mitigate these issues. Hormone replacement therapy (HRT) could lower the risks linked to premature menopause and ease those unwelcome symptoms in the process.

About the Experts

Polly Watson, MD, FACOG, is an OB-GYN and certified menopause practitioner. Her practice, Hormone Wellness MD, in Raleigh, NC, specializes in holistic women’s health.

Mache Seibel, MD, is a women’s wellness and menopause expert, National Menopause Foundation advisory board member, and editor of Hot Years magazine. He’s based in Boston, MA.

Early vs. Premature Menopause

While premature menopause and early menopause sound similar, it’s important to understand the difference. 

In the U.S., menopause means that you haven’t had a period for a full 12 months. For most women, that happens around the age of 52. Premature menopause is when that happens before the age of 40, and early menopause is when you stop your period before age 45, explains Polly Watson, MD.

About 5 out of 100 women go through early menopause, and 1 in 100 go into premature menopause (which doctors call premature ovarian insufficiency) (2). Around 1 in 1,000 women enter menopause super early—before age 30. 

The causes of early/premature menopause are the same; only the age when it occurs is different (3).

Some of the reasons why you might go into menopause early are (4):

• You had chemotherapy or radiation to your pelvis to treat cancer
• You had surgery to remove your ovaries
• You have an autoimmune disease like rheumatoid arthritis or thyroid disease
• You’ve been diagnosed with HIV or AIDS
• Your mom or another close relative started menopause early 
• You were born with a chromosome disease, like Turner syndrome

The Risks of Premature Menopause

Once you go into menopause, your body stops producing the hormone estrogen. That hormonal plunge causes symptoms like hot flashes, night sweats, and vaginal dryness earlier than usual, and is also linked to a long list of health problems, including heart disease, dementia, osteoporosis, depression, and sexual issues (5, 6).

Worst-case scenario, early menopause might contribute to an early demise. A 2024 study comparing 5,817 women who’d gone into menopause prematurely with 22,859 women without premature menopause found that women in premature menopause were more than twice as likely to die from heart disease or any cause and over four times as likely to die from cancer (7). 

This wasn’t the first study to link premature menopause to early death. A 2023 study that used data from the National Health and Nutrition Examination Survey showed that women who entered menopause before age 39 had a shorter-than-usual lifespan (8).

Why might premature menopause be detrimental to your health? The answer is likely a lack of hormones. When you’re in menopause, your ovaries go to sleep, and levels of estrogen and progesterone drop. “All of your systems are affected by these hormones,” says Watson.

Estrogen protects your heart by relaxing your blood vessels, boosting healthy high-density lipoprotein (HDL) cholesterol, and reducing unhealthy low-density lipoprotein (LDL) cholesterol (9).

This hormone also slows your body’s natural process of breaking down bone. That’s why half of postmenopausal women have osteoporosis, and most will get a fracture at some point (10). A broken bone might not seem like a life-threatening issue, but 22 percent of people who get a hip fracture die within a year (11). 

“Not treating women with declining estrogen levels, especially if that happens a decade-plus earlier than it’s ‘supposed to,’ is really setting those women up for osteoporotic fractures, which has a pretty abysmal mortality rate,” Watson adds.

MORE ON MENOPAUSE

7 Signs Perimenopause is Finally Ending

8 Signs You Might Need Menopause Hormone Therapy

How Hormone Therapy Can Help

That’s where HRT, also known as hormone therapy (HT), comes in. It replaces the hormones your body no longer produces, either through pills, a skin patch, spray, or gel.

Which hormones you take depends on whether you have a uterus, says Mache Seibel, MD. “If a woman has a uterus, meaning she didn’t have a hysterectomy, then she will require two hormones—estrogen and progesterone,” he says. Estrogen alone will keep building up the uterine lining. After menopause, the lining keeps growing, and its cells could eventually turn cancerous. If you had a hysterectomy, it’s safe to take estrogen only. 

Possible side effects

You may have heard that hormone therapy has been linked to a higher risk for breast cancer and blood clots, which can lead to heart attacks and strokes. While this is true, the increase in risk is incredibly small. Women who take estrogen-only HRT aren’t at higher risk for breast cancer, and the risk in those who take estrogen plus progesterone is only slightly higher than usual (12). 

As for blood clots, the risk can be avoided by using transdermal HRT via a patch, gel, or spray (13). According to Watson, getting hormones through the skin bypasses your liver, which plays a role in blood clot formation.

Other Treatments for Premature Menopause

HRT may not be the only treatment you need to manage the constellation of symptoms and health issues premature menopause creates. “In the absence of estrogen, you have to look at what I call the ‘sum of the woman’ and not some of the woman,” says Seibel. 

The drop in hormones can affect your skin, bladder, vagina, bones, mood, and more. Each body system should be managed separately, whether that’s with drugs like bisphosphonates to shore up your bones, moisturizers and lubricants to relieve vaginal dryness, or antidepressants to boost your mood.

Lifestyle Changes to Combat Premature Menopause

Changing your daily routine will also improve your wellness and longevity. That starts with clean eating. To protect your brain, heart, and bones for optimize longevity, Watson recommends eating plants, clean protein, and limiting sugar.

Here are some other tips from our experts to improve the quality and length of your life post-menopause:

• Ditch processed products and junk foods. Instead, eat whole foods with a good mix of protein, healthy fats, and complex carbs.
• Avoid alcohol, a toxin that’s been linked to several types of cancer, as well as stroke and heart disease (14).
• Prioritize sleep. Try to get at least 7 to 9 hours of restful slumber per night.
• Work out for at least 30 minutes, five days a week, mixing aerobic and weight training exercises.
• Manage stress with whatever technique works for you—yoga, meditation, deep breathing, etc.

The end of your reproductive years can also take a toll on you emotionally, especially when it arrives earlier than expected. Try to reframe it. “Menopause is always presented as an ending, this doom and gloom,” says Watson. She encourages women to see menopause not as a gateway to old age, but as a doorway to a new sense of autonomy.

And if you do feel discouraged by the early transition, seek out support—from your OB-GYN, a mental health provider, or your friends. “Talk to other women who are going through the same thing and create a posse,” suggests Seibel. “Everybody needs a posse.”