Menopause typically occurs between the ages of 45 and 52. It is a biological process associated with the gradual depletion of the follicle reserve in the ovaries. However, since 2022, I have increasingly heard the same question from women aged 35–42 during consultations: “My cycle has changed, and I’m having hot flashes. Is this menopause?”
According to my clinical observations, since 2022 the number of consultations related to suspected early menopause has increased approximately three to four times. The reasons are clear – war, relocation, job loss, chronic anxiety, and insomnia.
Let’s be honest right away. Early menopause is real. It happens. Sometimes at 35–38. And it is not a fantasy or “self-suggestion.”
But there is another truth, equally important: stress can convincingly mimic menopause. It can disrupt the cycle, suppress ovulation, cause hot flashes – especially in the face and upper body – as well as anxiety and insomnia. If these conditions are confused, it can lead either to panic or to lost time.
As a gynecologist with 14 years of practice, I will say this clearly: based on how you feel, you cannot distinguish a “stress-related disruption” from a true decline in ovarian function. Only numbers can do that – lab tests and ultrasound.
In this article, I will explain everything in simple terms:
- what is considered early menopause and what is simply a stress response
- how doctors distinguish between the two
- whether stress can truly accelerate ovarian depletion
- which symptoms should raise concern
- and what you can do right now to avoid accelerating the process
No promises that “everything will recover.” No “come in and we’ll figure it out.” Just facts, logic, and a clear action plan.
What Is Actually Considered Early Menopause and Why It Is Often Confused With Other Conditions
Menopause is the permanent cessation of menstruation due to depletion of the ovarian reserve (the supply of follicles in the ovaries that determines the length of a woman’s reproductive period). The diagnosis is made retrospectively – if there have been no menstrual periods for 12 consecutive months and no other causes are identified.
How Doctors Distinguish Cycle Disruption From Menopause
If your cycle disappears due to stress, it does not equal menopause. I do not rely on complaints. I rely on indicators:
- FSH level (a hormone that shows how much strain the ovaries are under)
- estradiol (the key female hormone)
- AMH (a marker of egg reserve)
- the number of antral follicles on ultrasound
Example from practice:
a 37-year-old woman, hot flashes, three-month delay.
FSH – 8. This is normal.
AMH – 1.9. Preserved.
This is not menopause. This is a functional response.
If FSH is consistently above 25–30, AMH is close to zero, and only a few follicles are seen on ultrasound, this is no longer stress.
In practice, fear of early menopause often begins with a test result that has been incorrectly interpreted. Elevated FSH or reduced AMH, when assessed without considering age, cycle timing, and the overall clinical picture, frequently become a source of premature panic.
Premature Ovarian Insufficiency Is Not the Same as Early Menopause
It is important to distinguish these concepts.
Early menopause – cessation of menstruation before age 45.
Premature ovarian insufficiency – decline in ovarian function before age 40.
These are different categories.
According to global data, premature ovarian insufficiency occurs in about 1% of women. This is good news. It is not a widespread condition.
However, if it is present, it must be managed properly because it involves not only menstruation but also the risk of osteoporosis and cardiovascular changes.
Why It Is Important to Distinguish a Stress Response From Early Menopause
Because the prognosis is different.
With a stress response:
- the cycle may disappear
- ovulation may stop
- hot flashes may occur
But the indicators may recover. This is called functional hypothalamic amenorrhea. It is a reversible condition.
With diminished reserve:
- AMH is consistently low
- FSH increases
- follicles do not return
The difference is fundamental. Women often confuse these conditions and begin to panic. Panic is useless here. Diagnostics are required.
Why Menopause Can Occur Earlier Than Biological Age
Now to the key point.
The supply of eggs is formed before birth. New ones do not appear.
On average, by ages 37–38 the reserve declines sharply – this is physiology.
What can accelerate this process:
- genetics
- smoking (brings menopause closer by an average of 1–2 years)
- chemotherapy
- ovarian surgery
- severe autoimmune conditions
- chronic, pronounced stress
Yes, stress is a medically recognized factor. Not a myth. Not a fantasy.
Can Stress Bring Menopause Closer?
Directly “destroying” follicles within a few months – no.
But chronically elevated cortisol affects the regulation of the hypothalamus – pituitary – ovarian axis.
This can:
- suppress ovulation
- lower estrogen levels
- make deficiency symptoms appear earlier
If a woman already had a reduced reserve, stress can “shift” the onset by several years.
Can Stress Accelerate Irreversible Ovarian Depletion?
If the reserve is preserved – no.
If it is already critically low – stress is not the cause but an accelerator.
There is no mysticism here.
There is biology and predisposition.
Which Symptoms May Indicate Early Hormonal Changes
Symptoms do not prove a diagnosis, but they should not be ignored. If you are 35–42 and experience:
- hot flashes
- night sweats
- absence of menstruation for more than 3 months
- pronounced mucosal dryness
- a sharp decrease in libido
Do not Google for months.
Do not wait half a year.
The first step is to check AMH and FSH.
I also recommend reading my article about low AMH – this test is most often the first to indicate a decline in ovarian reserve.
Risk Factors: Who Should Be Especially Attentive
The risk is higher if there is:
- menopause in your mother before age 45
- ovarian surgery
- chemotherapy
- severe underweight
- prolonged chronic stress without recovery
A combination of factors increases the likelihood of accelerated reserve decline.
Can Early Menopause Be Slowed Down?
It is impossible to restore depleted follicles.
This is the honest answer.
But it is possible not to accelerate the process.
If the accelerating factor is stress, exhaustion, or significant weight deficiency, eliminating it may stabilize the situation.
This is not about “rejuvenating the ovaries.”
It is about not pushing the body toward faster depletion.
When to See a Doctor
It is important to emphasize: you should see a doctor not when “everything is already bad,” but when doubts arise.
Specifically:
- your cycle changes consistently before age 45
- hot flashes recur, with frequent night sweats and pronounced mucosal dryness
- menstruation is absent for more than 3 months
- there is a hereditary predisposition
The earlier the picture becomes clear, the less unnecessary anxiety there is.
Which Tests Are Truly Informative
Modern diagnostics allow for a fairly accurate assessment of a woman’s reproductive potential and help determine whether changes correspond to age norms. Typically, the evaluation includes several key indicators:
- Anti-Müllerian hormone (AMH) – one of the most informative markers reflecting the follicle reserve in the ovaries. It helps determine how well the ovarian reserve is preserved.
- Follicle-stimulating hormone (FSH) – an indicator that indirectly shows how much “strain” the ovaries are under. Elevated values may indicate declining activity. The test is performed on days 2–3 of the cycle.
- Estradiol – the primary female hormone affecting numerous processes in the body, from bone health to emotional balance.
- Pelvic ultrasound – allows visual assessment of ovarian structure and follicle count.
It is important to understand that there is no single “correct number” for these indicators. A doctor evaluates them together – taking into account age, cycle day, and clinical context.
No single test determines everything. The overall picture matters.
Clinical Example
A 34-year-old patient. Relocated from the Kherson region, spent a year searching for a job in Kyiv, chronic sleep deprivation. Complaints – cycle extended to 45–60 days, hot flashes, anxiety. The main fear was early menopause.
FSH – 11.
AMH – 1.4.
The reserve was moderately reduced but not critical.
The main issue was chronic overload.
After about 6 months, as life became more stable, sleep improved, and the workload decreased, the cycle returned to 30–32 days, and the hot flashes disappeared.
This was not a miracle. It was a functional response that proved reversible.
What a Woman Can Realistically Do Right Now
If this is stress-related strain:
- Normalize sleep – 7–8 hours, and try to fall asleep before 23:00.
- Avoid living in a state of chronic sleep deprivation.
- Maintain a stable weight and avoid strict diets.
- Test AMH and FSH instead of guessing.
- Reduce chronic tension – psychotherapy, physical activity, and anxiety management.
- Do not smoke.
Sometimes simple things truly work.
Yes, this may include a diet with sufficient fats, including avocado, fish, eggs, and other foods with normal caloric intake.
This is not “about avocado for the sake of avocado.”
It is about not accelerating a natural process.
Frequently Asked Questions About Early Menopause and Stress
Can menopause begin at 35?
Yes. Unfortunately, today this is no longer rare.
If my cycle stopped because of stress – is it already menopause?
Not necessarily. Hormone tests need to be evaluated.
Can the ovarian reserve be restored?
No. If it is depleted – it is depleted.
Can the process of early menopause be slowed?
Yes, if the accelerating factors are eliminated.
Does early menopause mean rapid aging?
No. With proper medical management, quality of life is preserved.
Conclusion
Stress does not burn out the ovaries overnight. But prolonged strain can accelerate processes that have already begun. The key is not to dramatize and not to ignore the situation.
The hormonal system is complex but not fragile. The body is often more resilient than it seems.
But it must be treated seriously.
Hormones are tested.
The overall picture is assessed.
And accurate conclusions are always based on test results, not assumptions or fear.
Clinical Guidelines and Sources
- European Society of Human Reproduction and Embryology (ESHRE). ESHRE Guideline on Premature Ovarian Insufficiency. 2024.
- Panay N., Anderson R.A., Davies M. et al. Evidence-based guideline: Premature Ovarian Insufficiency. Human Reproduction Open, 2024.
- Lumsden M.A., Davies M., Anderson R.A. et al. European Society of Endocrinology Clinical Practice Guideline: Management of Premature Ovarian Insufficiency. European Journal of Endocrinology, 2025.
