You’re in your mid-30s, juggling your career, relationships, and everyday responsibilities, when suddenly you’re waking up drenched in sweat, struggling to concentrate, or feeling anxious for no obvious reason. Stress might seem like the easiest explanation, but your hormones could be telling a different story.
For young Black women, menopause probably sounds like something to worry about decades from now. However, emerging research suggests early perimenopause deserves attention long before women reach their 50s.
A 2025 study published in npj Women’s Health, involving researchers from UVA Health and the Flo women’s health app, surveyed 4,432 American women ages 30 and older. Among participants ages 30 to 35, 55.4% reported moderate to severe symptoms associated with menopause. That percentage increased to 64.3% among women ages 36 to 40.
Importantly, those findings do not establish that most women in their 30s have perimenopause. The online survey measured self-reported symptoms that can have several causes, and the results were not specific to young Black women. Still, the research challenges assumptions about when women should begin discussing hormonal health.
“Physical and emotional symptoms associated with perimenopause are understudied and often dismissed by physicians,” said study coauthor Dr. Jennifer Payne in a UVA Health statement. “This research is important in order to more fully understand how common these symptoms are, their impact on women, and to raise awareness amongst physicians as well as the general public”
Perimenopause is the transition leading to menopause, when estrogen levels fluctuate, and menstrual cycles become less predictable. According to the American College of Obstetricians and Gynecologists, this transition typically begins in the 40s, although hormonal changes and symptoms can occur earlier.
Early perimenopause symptoms may include irregular periods, heavier bleeding, hot flashes, night sweats, sleep disturbances, vaginal dryness, headaches, and brain fog.
The emotional symptoms are equally important. The UVA Health and Flo study found that psychological complaints, including anxiety, depression, and irritability, peaked among participants ages 41 to 45, earlier than the peak for hot flashes and sweating.
For Black women, these findings raise additional concerns about recognizing symptoms and receiving appropriate care.
Research from the Study of Women’s Health Across the Nation found that Black women experienced hot flashes and night sweats for approximately 10 years, compared with 6.5 years among White women. Despite reporting a greater symptom burden, Black participants were about half as likely to use hormone therapy.
Although that research examined women transitioning through midlife rather than specifically Black women in their 30s, it highlights important disparities in symptom burden and treatment.
Another concern for younger Black women is that hormonal symptoms can overlap with other conditions.
According to ACOG’s guidance on uterine fibroids, fibroids develop more frequently and often at younger ages in Black women. They can cause heavy periods, pelvic discomfort, and anemia, making it particularly important not to assume menstrual changes automatically indicate perimenopause.
Thyroid disorders, pregnancy, depression, and other health conditions can also produce overlapping symptoms. Getting evaluated matters more than guessing.
“We had a significant number of women who are typically thought to be too young for perimenopause tell us that they have high levels of perimenopause-related symptoms,” said Flo’s director of science, Liudmila Zhaunova, PhD. “It’s important that we keep doing research to understand better what is happening with these women so that they can get the care they need”.
So what can young Black women do now?
Start paying attention to your menstrual cycle. Track changes in bleeding, missed periods, sleep patterns, mood, night sweats, and energy levels. Document when symptoms begin, how often they occur, and whether they’re interfering with work, relationships, or daily activities.
Understanding your family’s menopause history can also provide useful context, although it cannot predict exactly when your own transition will begin.
Next, schedule an appointment with an OB/GYN or primary care provider rather than waiting for symptoms to become unbearable.
According to ACOG’s hormone testing guidance, doctors can often assess perimenopause using menstrual history, symptoms, and age. Women younger than 45 who develop menstrual changes may require additional testing, especially those under 40, who should be evaluated for conditions such as primary ovarian insufficiency.
During your appointment, ask specific questions: Could I be experiencing early perimenopause? What other conditions could explain my symptoms? Should I be tested for thyroid disease, anemia, or ovarian insufficiency? Could this affect my fertility? What treatment options fit my medical history?
Treatment is not limited to waiting for menopause to arrive.
ACOG explains that hormone therapy can relieve hot flashes, night sweats, and vaginal dryness for appropriate patients. Some women still having periods may benefit from hormonal contraception, which can also address certain menstrual symptoms while preventing pregnancy.
Nonhormonal medications, including certain antidepressants and gabapentin, can help manage hot flashes. The FDA also approved fezolinetant for menopause related hot flashes, although it requires liver monitoring because of a rare risk of serious liver injury.
Regular exercise, strength training, balanced nutrition, and consistent sleep habits support long-term health, although they cannot prevent perimenopause.
Women struggling to get answers can also search for clinicians experienced in menopause care through The Menopause Society.
“This study is important because it plots a trajectory of perimenopausal symptoms that tells us what symptoms we can expect when and alerts us to the fact that women are experiencing perimenopausal symptoms earlier than we expected,” Payne said.
For young Black women, Menopause Awareness Month is an opportunity to start conversations that should not have to wait until 50. Recognizing potential symptoms, understanding treatment options, and advocating for appropriate medical care can help women protect their health while getting the answers they deserve.
