Menopause at 43: Early Transition — Symptoms, Health Impacts, and Management

Menopause before age 45 is classified as early menopause. At 43, it is within the early range (average 51). Causes include genetics, autoimmune disease, chemotherapy, ovarian surgery, or idiopathic.

Expected Symptoms

• Irregular periods → cessation
• Vasomotor: hot flashes, night sweats (often more severe in early menopause)
• Genitourinary: vaginal dryness, dyspareunia, urinary urgency
• Sleep disruption, mood lability, "brain fog"
• Metabolic: weight gain, insulin resistance
• Skeletal: accelerated bone loss (critical window)
• Cardiovascular: earlier loss of estrogen protection → higher lifetime CVD risk

Health Priorities

• Hormone Therapy (HT): Strongly recommended until at least average menopause age (51) for symptom relief and bone/CVD protection — unless contraindicated.
• Bone health: DEXA baseline; calcium/vitamin D; weight-bearing exercise; consider bisphosphonate if high risk.
• Cardiovascular: Aggressive risk factor modification (lipids, BP, glucose, smoking).
• Fertility: If desired, urgent referral to reproductive endocrinology (donor oocyte likely).
• Psychosocial: Counseling for identity, grief, sexual health.

Early menopause is a chronic condition requiring proactive, multidisciplinary care — not just symptom management.