Could Forever Chemicals Cause Earlier Menopause?
Losing estrogen sooner may accelerate aging across the heart, brain, and bones.
Women with higher blood levels of several common “forever chemicals” reached menopause about a year earlier than women with lower levels, according to a 2026 study of nearly 5,000 women.1
Forever chemicals (per- and polyfluoroalkyl substances, collectively called PFAS), are found in everything from tap water and nonstick cookware to some makeup, clothing, and cleaning products, and have already been linked to certain cancers and reproductive issues.
Because forever chemicals interfere with hormonal signaling, researchers suspect they may affect how ovarian follicles develop and produce estrogen and progesterone.2 The relationship between PFAS and earlier menopause may also run partly in reverse: Menstrual bleeding helps the body eliminate certain PFAS, so blood levels can rise after periods stop.
Still, the link deserves a closer look because it raises important questions about women’s long-term health. Entering menopause earlier means spending more years in a lower-estrogen state that increases risk of cardiovascular disease, cognitive decline, and osteoporosis.3 4 5 And PFAS exposure is independently linked to cardiovascular, cognitive, and bone problems, potentially compounding the health impact of earlier menopause.
“Entering menopause one year sooner may not sound like much, but menopause changes the hormonal environment of the entire body,” says Anastasia Jandes, M.D., a functional medicine physician and hormone management specialist. “If that shift begins sooner, changes affecting the heart, brain, and bones will begin sooner too.”
About the Expert
Anastasia Jandes, M.D., PharmD, IFMCP, is a practicing hormone management physician and consultant. Her current research and clinical practice interests are in the interplay between the environment, inflammation, and stress and their combined effect on the endocrine system’s ability to produce hormones.
How Earlier Menopause May Accelerate Aging
The drop in estrogen that occurs during menopause changes how women’s arteries function, how their body handles cholesterol, how quickly they lose bone, and how their brains use energy.6 7 8 9 If those changes occur a year sooner, the downstream effects could shape women’s health decades later, says Jandes.
Most women in the U.S. reach menopause around age 51 or 52. The new PFAS study examined whether that natural transition happened sooner. That’s different from early menopause, which happens before age 45, and primary ovarian insufficiency (POI), which involves loss of normal ovarian function before age 40.
But research in these younger groups helps explain why menopause timing matters. A 2026 position paper in the International Journal of Gynecology & Obstetrics is calling for POI and early menopause to be viewed not simply as reproductive conditions, but as forms of accelerated aging that can affect cardiovascular, bone, cognitive, metabolic, and sexual health.10
Much of the strongest long-term research comes from women who reached menopause before 40 or 45, so the new PFAS study can’t tell us exactly what a one-year shift means, says Jandes, “but the broader pattern suggests that menopause timing impacts health in critical ways.”
Estrogen loss raises cardiovascular risk. Estrogen helps blood vessels stay flexible and influences how the body manages cholesterol.11 12 As it declines during menopause, LDL (the “bad” cholesterol) tends to rise and blood vessels can stiffen. An analysis of 300,000 women found that those who reached menopause between 45–49 had a 12% higher risk of a cardiovascular event compared to those who reached it at 50 or 51.13 Human studies have separately found associations between PFAS and higher blood pressure, cholesterol, uric acid, and Blood Urea Nitrogen (BUN), which are all risk factors for heart disease or metabolic syndrome).14 15 16
Earlier menopause may affect cognitive health. Early menopause is associated with greater risk of cognitive decline and dementia, including Alzheimer’s disease.17 That’s likely because estrogen helps regulate blood flow, energy use, and communication between brain cells, including in areas involved in memory and executive function.18 Animal and laboratory studies suggest certain PFAS can enter brain tissue, promote inflammation, and interfere with cell signaling, though the evidence in humans is limited. 19 20
Estrogen loss affects bones. Estrogen helps maintain the balance between breaking down old bone and building new bone. As it declines the cells responsible for building new bone die off faster than they’re replaced, gradually increasing the risk for osteoporosis and fractures.21 22 Independent of menopause, PFAS exposure has also been associated with lower bone mineral density and osteoporosis in women.23 24
Reducing PFAS Exposure
You can’t completely avoid PFAS but exposure can be meaningfully reduced by focusing on the sources most relevant to where you live and work.
Find out what’s in your water. Contaminated drinking water can be the largest source in affected communities: At least 45% of U.S. tap water is believed to contain one or more PFAS.25 Check your local levels using the Environmental Working Group’s interactive map.
If there are high levels of PFAS in your area, install a filter with NSF/ANSI 53 or 58 certification, which means it’s certified to remove PFAS.26
Consider your environmental risk. Certain working or living conditions can affect your PFAS risk:
- Living near an industrial site, airport, landfill, firefighting facility, shipyard, medical finishing facility, or data center
- Being a firefighter, military personnel who works on jets, or certain other jobs.
“This is a difficult one because you may not be able to move or change jobs,” Jandes admits, “but if this affects you, pay extra attention to all the other steps you can take to avoid exposure.”
Check local fish advisories. PFAS can accumulate in freshwater fish. The EPA recommends that states monitor for 12 PFAS compounds in locally caught fish and issue consumption advisories accordingly.27 If your state health environmental protection department suggests your area is contaminated, limit local freshwater fish and instead choose commercially purchased seafood from grocery stores, which generally has significantly lower PFAS levels.28
Replace toxic cookware. Some nonstick cookware still uses a coating containing PFAS, which can leach into food when the coating is scratched or gets overheated.29 30 Jandes says when it’s time to replace your pots and pans, choose stainless steel, cast iron, carbon steel, or PFAS-free ceramic-coated options.
Scrutinize your cosmetics and personal care products. Some waterproof mascaras, long-wear foundations, and other cosmetics add PFAS for their water- and oil-resistant properties.31 Check ingredient lists for terms like “fluoro” or “perfluoro” to identify them.32 Also choose dental floss with natural wax rather than chemical coating (check the label for PTFE or Teflon or skip products labeled “smooth glide,”) Jandes says.
If You’re Worried About PFAS Exposure
If you develop persistent cycle changes or symptoms such as hot flashes, night sweats, or vaginal dryness — particularly before age 40 — see a clinician.
Perimenopause is diagnosed mainly based on symptoms, so come prepared to describe what you’re experiencing, when those changes began, and how intense they are. Your clinician will also review your menstrual history, family history, medications, and risk factors, and may also suggest blood work.
Blood work in association with perimenopause symptoms can add objective context, identify hormonal patterns, and help rule out other conditions with similar symptoms.
“I’m never hesitant to check labs in a symptomatic woman in her 30s,” Jandes says. “More often than not, it’s low progesterone, changing estrogen patterns, thyroid dysfunction, or another issue rather than perimenopause, but perimenopause can begin in the late 30s, so if you have classic hormone-based symptoms, see a specialist to complete hormone blood work.”
The Bottom Line
Higher PFAS levels are linked to menopause occurring about a year earlier, though cause and effect remain unclear. Reduce exposure where you can, and see a hormone specialist if you notice persistent cycle changes or symptoms especially before age 40.
Ning, Anhui, et al. (2026) Association between perfluoroalkyl and polyfluoroalkyl substances exposure and reproductive longevity for female in the United States: A population-based study
↑Ding, Ning, et al. (2020) Perfluoroalkyl and polyfluoroalkyl substances (PFAS) and their effects on the ovary
↑Fasero, Maria, et al. (2025) Cardiovascular Disease Risk in Women with Menopause
↑Khadilkar, Suvarna, et al. (2026) Cognition in menopausal women
↑Charde, Samruddhi H, et al. (2023) A Comprehensive Review on Postmenopausal Osteoporosis in Women
↑White, Richard E. (2002) Estrogen and vascular function
↑Palmisano, Brian T, et al. (2018) Estrogens in the Regulation of Liver Lipid Metabolism
↑Hara, Yuko, et al. (2015) Estrogen Effects on Cognitive and Synaptic Health Over the Lifecourse
↑Khosla, Sundeep, et al. (2012) Estrogen and the Skeleton
↑Benedetto, Chiara, et al. (2026) Hormone therapy (HT) in women with premature ovarian insufficiency or early menopause: Time to think of a new paradigm for healthy aging. A joint FIGO and IMS position paper
↑Beazer, Jack D, et al. (2021) Estradiol and HDL Function in Women – A Partnership for Life
↑Raj, Aditya, et al. (2023) The Impact of Menopause on Cardiovascular Aging: A Comprehensive Review of Androgen Influences
↑Zhu, Dongshan, et al. (2019) Age at natural menopause and risk of incident cardiovascular disease: a pooled analysis of individual patient data
↑Yang, Jingxuan, et al. (2023) The Association of Hypertension with Perfluoroalkyl and Polyfluoroalkyl Substances
↑Connolly, Jack C, et al. (2025) Per- and Polyfluoroalkyl Substances (PFAS) Enhance Cholesterol Accumulation and Dysregulate Inflammatory Responses in Macrophages
↑Chen, Yi-Ran, et al. (2024) Dissect the association between per- and polyfluoroalkyl substances (PFAS) and kidney function from the perspective of lipid molecules
↑Dobson, Annette J, et al. (2024) Menopause age and type and dementia risk: a pooled analysis of 233 802 women
↑Briceno Silva, Gabriela, et al. (2024) Influence of the Onset of Menopause on the Risk of Developing Alzheimer’s Disease
↑Gardener, Hannah, et al. (2025) The role of per- and polyfluoroalkyl substances in cognitive impairment and dementia
↑Brown-Leung, Josephine M, et al. (2022) Neurotransmission Targets of Per- and Polyfluoroalkyl Substance Neurotoxicity: Mechanisms and Potential Implications for Adverse Neurological Outcomes
↑Starrach, Teresa, et al. (2022) Perimenopausal Bone Loss Is Associated with Ovulatory Activity — Results of the PeKnO Study
↑Noirrit-Esclassan, Emmanuelle, et al. (2021) Critical Role of Estrogens on Bone Homeostasis in Both Male and Female: From Physiology to Medical Implications
↑Garmo, Laimar C, et al. (2025) Per- and polyfluorinated substances (PFAS) promote osteoclastogenesis and bone loss through PPARa activation
↑Khalil, Naila, et al. (2015) Association of Perfluoroalkyl Substances, Bone Mineral Density, and Osteoporosis in the U.S. Population in NHANES 2009-2010
↑Smalling, Kelly L, et al. (2023) Per- and polyfluoroalkyl substances (PFAS) in United States tapwater: Comparison of underserved private-well and public-supply exposures and associated health implications
↑U.S. EPA (2025) Identifying Drinking Water Filters Certified to Reduce PFAS
↑U.S. EPA (2024) EPA Releases New Science-Based Recommendations to Help More States, Tribes, and Territories Reduce Exposure to PFAS in Fish
↑Barbo, Nadia, et al. (2023) Locally caught freshwater fish across the United States are likely a significant source of exposure to PFOS and other perfluorinated compounds
↑Ecology Center (2020) PFAS and Other Chemical Hazards in Nonstick Cooking and Baking Pans
↑Consumer Reports (2022) You Can’t Always Trust Claims on Non-Toxic Cookware
↑Whitehead, Heather D, et al. (2021) Fluorinated Compounds in North American Cosmetics
↑U.S. FDA (2025) Per and Polyfluoroalkyl Substances (PFAS) in Cosmetics
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About the author
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About the reviewer
Natalie Kunsman, M.D., is a board certified physician specializing in functional, anti-aging, and regenerative medicine. She is a fellow of the American Academy of Anti-Aging medicine and the American Academy of Family Physicians.
