It’s the middle of the night, and you wake up sweating. You’ve also been getting hot flashes throughout the day, and you missed your last two periods—even though you’ve taken multiple pregnancy tests that came back negative. If you’re a menstruating person in your 30s or 40s, these symptoms may sound like menopause, which typically doesn’t happen until your late 40s or 50s. Could these actually be signs of early onset menopause instead?
While only a healthcare provider can truly answer this for you, menopause can come early (which is different from perimenopause or the stage right before menopause, BTW).
Here are nine things experts want you to know about why early menopause happens, if the treatment options are any different from regular menopause, and how it affects your overall health.
First, what is early onset menopause?
Before we dive in, let’s get a quick refresher on menopause: It’s a normal part of aging where menstruating people stop getting their period and, eventually, are no longer able to conceive. Along with your period ending, menopause can bring about other symptoms that affect day-to-day life.
Early onset menopause is when the transition arrives ahead of schedule. “Any menopause symptoms before 40 is considered premature menopause,” Michael Thomas, MD, an OB/GYN and the department chair of Obstetrics & Gynecology at the University of Cincinnati College of Medicine, tells Well+Good. He adds that when menopause happens in your early 40s, it’s considered menopause—but not premature.
It’s important to differentiate the two because it helps providers order proper tests (i.e., bloodwork that establishes menopause is causing symptoms) and provides you with the right treatment.
Another thing worth noting: Both early onset menopause and menopause are preceded by something called perimenopause. Studies say this phase usually lasts about four years1, but Dr. Thomas notes that sometimes, perimenopause might be shorter for those with early-onset menopause.
9 things to know about early onset menopause
1. Early menopause is a spectrum
The Office on Women’s Health notes the average age for menopause is 52. But that doesn’t mean every menstruating person will start it at this age. Our bodies all have their unique timelines, similar to how we accomplish career and life milestones at our own pace.
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More often, menopause is an ongoing process that can begin between the ages of 45 and 55. But if it starts earlier, it may be diagnosed as early or premature.
“Going through menopause is a continuum, like going through puberty but in reverse. With puberty, women gain ovarian function, and ovaries make estrogen. In menopause, women lose ovarian function, and ovaries stop making estrogen,” says Pamela Promecene, MD, an OB/GYN and professor at UT Health Houston.
2. The signs are similar to regular menopause
Turns out, the signs of early menopause in your 30s and 40s will look similar to signs of menopause at a later age. We’re talking about hot flashes, missed periods, and vaginal dryness, among other common symptoms. The only difference between early onset and “regular” menopause is the age when symptoms start.
Okay, there is one exception to this. And that is when you’re on the pill. If you’re on hormonal birth control, the signs of early menopause may be muted or nonexistent. This is because menopause symptoms happen from a lack of estrogen, which birth control pills provide plenty of (and therefore mute symptoms).
3. The most common cause is unknown
There are a lot of menopause myths surrounding what causes it to happen early—including stress, unhealthy diet, birth control, etc. But the truth is the cause of early onset menopause is often unknown. There may be some specific conditions to blame, however, including the following:
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Antepartum Depression: The Extremely Common Pregnancy Condition That No One Talks About
So it's time we talk about it.
Antepartum Depression: The Extremely Common Pregnancy Condition That No One Talks About
So it's time we talk about it.
Published Feb 6, 2025
Written by
Contributor
Photo: Getty Images / urbazon
Published Feb 6, 2025
Written by
Contributor
Pregnancy is often painted as a glowing, joyful time, but for many, it’s also a whirlwind of mood swings and hormonal shifts that can take a toll on mental health. Case in point: antepartum depression—a type of perinatal mood and anxiety disorder (PMAD) that develops during pregnancy. While most people have heard of postpartum depression (which happens after birth), antepartum depression deserves just as much attention.
therapist, maternal mental health advocate, and founding director of The Motherhood Center in NYC.
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In fact, 50 percent of PMADs, which include conditions like perinatal anxiety, obsessive-compulsive disorder (OCD), and post-traumatic stress disorder (PTSD), begin during pregnancy, with the other half surfacing postpartum, says Paige Bellenbaum, LCSW, a maternal mental health advocate, therapist, and founding director of The Motherhood Center in New York City.
Spotting the signs of antepartum depression is the first step to getting help and ensuring a healthier journey to parenthood for you and your baby.
Why does antepartum depression occur?
Antepartum (or prenatal) depression can happen at any point during pregnancy, from conception to birth, Bellenbaum says. It’s surprisingly common, affecting about 1 in 10 pregnant people, according to The American College of Obstetricians and Gynecologists (ACOG).
While its exact cause can vary, certain risk factors increase the likelihood of developing depression during pregnancy. These include, per Bellenbaum:
A personal or family history of mental health conditions
Stressful life events like financial struggles, relationship challenges, job loss, physical or sexual abuse, substance use, or unresolved grief
Social determinants of health, such as the environment where someone lives, works, and ages, which can influence overall well-being
Complications in pregnancy, childbirth, or breastfeeding
A prior experience with a perinatal mood or anxiety disorder (PMAD), which carries a 50 to 75 percent chance of recurrence
Unplanned or unwanted pregnancy
Carrying multiples (e.g., twins or triplets)
Undergoing infertility treatments
Studies1 show that despite its prevalence, depression during pregnancy is often underdiagnosed—both by healthcare providers and the pregnant person themselves. According to the Mayo Clinic, several factors contribute to this oversight:
Overlap of symptoms: Symptoms of depression, such as changes in sleep, energy, appetite, or sex drive, can closely resemble those of pregnancy. This makes it easy for both the pregnant person and their provider to dismiss mood-related concerns as “typical” pregnancy side effects.
Focus on physical health: Prenatal care often emphasizes physical well-being, like monitoring fetal development or managing physical symptoms, while mental health can take a backseat.
Stigma around mental health: In some communities, cultural beliefs or misconceptions about mental health may make you hesitant to bring up feelings of sadness, anxiety, or other mood changes out of fear of judgment or guilt, especially if societal expectations suggest pregnancy should always be a joyful time.
What depression symptoms are most common in pregnancy?
Feeling a little blue or having occasional mood swings during pregnancy is normal—but how do you know when it’s more serious? Depression can sometimes disguise itself as the typical ups and downs of pregnancy, but it’s important to spot the warning signs.
Talk to your OB/GYN if you experience any of these symptoms for at least two weeks, according to the American Pregnancy Association:
Persistent sadness or a depressed mood most of the day
Loss of interest in work or activities you usually enjoy
Feelings of guilt, hopelessness, or worthlessness
Trouble sleeping or sleeping too much
Changes in appetite, leading to unintentional weight loss or gain
Extreme fatigue or lack of energy
Difficulty concentrating, focusing, or making decisions
Restlessness or slowed movements noticeable to others
Thoughts of self-harm or suicide*
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Depression isn’t just “feeling down.” If these symptoms resonate with you, don’t hesitate to reach out for help—your mental health is just as important as your physical health.
*Editor’s note: If you or a loved one are experiencing a crisis, please know that immediate help is available. You can call or text the National Suicide Prevention Lifeline at 988 for free and confidential support 24/7. You can also check out the Suicide Prevention Resource Center for additional resources.
Can antepartum depression lead to other health complications?
Yes, antepartum depression can affect both the parent and baby, making it crucial to address it early. When depression during pregnancy goes untreated, it can affect self-care—leading to skipped prenatal checkups, poor nutrition, and lack of rest, according to ACOG. The ACOG and other studies2 also note that untreated depression during pregnancy has been linked to:
Poor fetal growth in the uterus
Premature labor
Low birth weight
Higher risk of postpartum depression
Additionally, antepartum depression can also lead to certain emotional challenges for the baby, such as crying more, having trouble being soothed, and experiencing behavioral concerns when they become older.
Many birthing parents with untreated depression during pregnancy struggle into the postpartum period. Bellenbaum has seen countless birthing parents overwhelmed by feelings of hopelessness, dread, and disconnect, only to find these symptoms worsening after birth. Early intervention is key, she says. The sooner depression is treated, the faster parents can return to their baseline, making it easier to care for themselves and their baby.
Coping strategies for antepartum depression
Dealing with antepartum depression can feel overwhelming, but there are effective ways to find relief and support. Here’s how:
1. Talk to a professional
Getting professional help is one of the best steps you can take. A perinatal therapist trained in treating PMADs can make a huge difference, Bellenbaum says. For acute symptoms, a specialized program like The Motherhood Center's Day Program provides high-quality, focused treatment to help you feel better faster, she says.
Looking for a mental health professional? These resources can help:
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Postpartum Support International(PSI): This organization offers a provider directory to find perinatal mental health professionals near you. They also have coordinators who can guide you to the right resources.
The Motherhood Center (NYC and virtual): Offers therapy, medication management, and support groups for those experiencing PMADs. Their team includes reproductive psychiatrists who can safely prescribe medication during pregnancy.
2. Join a support group
Connecting with others who are going through similar challenges can help you feel less alone. Both PSI and The Motherhood Center offer virtual support groups tailored to pregnant and postpartum individuals.
3. Consider medication
For some, medication like selective serotonin reuptake inhibitors (SSRIs) can be a safe and effective option, Bellenbaum says. Research suggests that certain SSRIs pose little to no risk to a developing fetus, she says. Untreated depression, on the other hand, can harm both you and your baby.
However, the ACOG warns that it’s important to weigh the risks of medication against the risks of untreated depression. Your healthcare team is a good resource to help you choose the right treatment for you and your baby.
How to support someone with antepartum depression
It truly takes a village—not just to raise a baby, but to support an expecting parent before the baby even arrives. Having a strong support system of partners, family, and friends can make all the difference. In fact, loved ones often notice signs of worsening depression before the person experiencing it does, according to ACOG.
When someone is struggling with antepartum depression, it can feel like drowning—desperately paddling just to keep their head above water, Bellenbaum says. “This is how I felt when it was happening to me,” she says. In that state, self-care can feel impossible, and it’s hard to recognize what’s really happening to you. This is where loved ones play a vital role in spotting the signs and helping access the right support.
Here’s how you can help someone with antepartum depression, per Bellnebaum:
Learn the signs and symptoms: Educate yourself about perinatal mood and anxiety disorders (PMADs). A great resource is The Motherhood Center's guide.
Offer reassurance: Let the birthing parent know they’re not alone, how they feel is valid, and that with the right support, they will feel better.
Help connect to care: Research perinatal mental health services that support expecting parents and assist in making an appointment to ensure your loved one gets the care they need.
Support isn’t just helpful—it’s essential. Together, you can create a safety net that empowers the birthing person to heal and prepare for the joys (and challenges) of parenthood.
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The bottom line
Antepartum depression is more common than you might think, but it often flies under the radar. Spotting the risk factors and recognizing how its symptoms can blend in with the usual ups and downs of pregnancy is crucial to getting the help you need.
The good news? You’re not alone, and there’s plenty of support out there. Whether it’s therapy, support groups, or medication, taking action can pave the way for a healthier, happier pregnancy—for both you and your baby.
“The most important thing to do is to get help as soon as possible. Don’t wait for it to pass; don’t white knuckle it,” Bellenbaum says. “The sooner you get the right kind of support, the sooner you can feel like yourself again and enjoy the journey of motherhood as you always wanted to.”
Chan, Justin et al. “Risks of untreated depression in pregnancy.” Canadian family physician Medecin de famille canadien vol. 60,3 (2014): 242-3. ↩︎
Jahan, Nasrin et al. “Untreated Depression During Pregnancy and Its Effect on Pregnancy Outcomes: A Systematic Review.” Cureus vol. 13,8 e17251. 17 Aug. 2021, doi:10.7759/cureus.17251 ↩︎
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Name a better feeling than crossing something off your to-do list. Not just metaphorically—literally taking a pen (or better yet, a just-out-of-the-box neon highlighter) and checking off tasks until every line has been crossed out. We’ll wait.
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Here’s an idea: What if you took that satisfaction and applied it to your health this year? According to Kelly Bristow, RDN, LD, registered dietitian nutritionist at Bayer, crafting a short and sweet 2025 wellness checklist is a great way to visualize your success and keep you on track.
In a recent survey conducted by One A Day®, the multivitamin and supplement brand from Bayer, 70 percent of women said they are focusing on self-care for their New Year’s goals. While nearly 9 in 10 women demonstrated a commitment to achieving their New Year’s goals, almost 50 percent said a lack of motivation has been their biggest barrier in the past.
That’s where the simple checklist comes in, Bristow says. “Lack of motivation can often be the result of doing too much too fast,” she says. “While it can feel good to just hit the ground running, keeping obtainable goals in reach can set you up for long-term success.” She finds that writing out wellness intentions in a tangible, visual way can provide a major sense of accomplishment.
So what’s on Bristow’s personal 2025 wellness checklist? Colorful eating, joyful movement, exploring a multivitamin habit, and a few more simple goals. Keep reading to find out why each one makes her top five, and get inspired to write your own list (with neon highlighters at the ready, of course).
1. Eat a colorful plate
This year, Bristow is filling her day with fruits and vegetables in every shade of the rainbow to ensure she’s maximizing her nutrient intake. “So often we focus on what we should be removing from our diet versus looking at what we can add to our day for better health,” she says. “The more color variety, the more variation in nutrition you will get.”
Once her big intention is set, Bristow’s all about breaking it down into smaller steps. “Do you have vegetables in your house? Are they washed, prepped, and ready to go? Do you enjoy the taste of them? Fresh, canned, frozen, and dried can all add color and nutrition to your day at different price points. A checklist can help you accomplish your goal more specifically.” And don’t forget to celebrate along the way, she says. “If your current intake of vegetables is zero, adding one small snacking pepper or a few cherry tomatoes to your lunch is already an improvement.”
2. Explore a daily multivitamin
Despite her best efforts to eat the rainbow (alongside a diverse diet), Bristow recommends exploring whether taking a multivitamin is right for you to fill in any nutritional gaps you may have in your diet. Multivitamins such as One A Day® Women’s Complete Multivitamin can help fill those nutritional gaps.*
A single tablet offers at least 100 percent daily value of 14 essentials nutrients such as vitamins B6 and B12, C, D, and E, as well as folic acid, biotin, and iron. It also includes calcium, magnesium, and zinc, Bristow says. “It is specially formulated with key nutrients to support bone health, immune health, skin health, healthy energy metabolism, and more.”†* And if you prefer a convenient gummy, you could try One A Day® Vitacraves® Women’s Gummies with nutrients to support the same key vital functions.†
Between sedentary jobs and access to technology, Americans are sitting more than they ever have, Bristow says. So she’s committing to more physical activity in 2025, and encouraging others to join her. “There are so many ways you can be active,” she says. “Find things you enjoy doing so you’ll be more likely to stick with it. Start small and try new things: a few short walks at different times of day, stretching or yoga, standing at your desk, or new hobbies like pickleball can make a big difference.”
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While any kind of fitness is great, Bristow has outdoor movement on her checklist. “Fresh air is underrated for what it can do for health and wellness,” she says. “Just 15 minutes outside can help reset—even on a brisk winter day.” And that time al fresco is made all the better when it’s spent in connection with others. For Bristow, a support system is essential when it comes to mapping out, working toward, and achieving her goals.
4. Schedule health checkups
Real talk: Sometimes making an appointment can feel like climbing Mount Everest. But if you write down your scheduling to-dos on your checklist, Bristow says, you’ll feel way more motivated to pick up the phone.
Join her in setting up routine doctor’s appointments with regular blood work to assess for heart and kidney disease and prostate cancer risk. “For women over 40, make your annual mammogram appointments to screen for breast cancer. Regular visits can help catch potential issues early and keep you on track for a healthy year.”
5. Restock the medicine cabinet
“When was the last time you checked the expiration dates on your medications? The new year can be a good time to take stock and make sure you have the essentials on hand like pain relievers, allergy meds, or cough and cold essentials,” Bristow says. “Expired medications may lose their effectiveness, and it’s better to be prepared than caught off-guard.”
Believe it or not, seasonal allergy season is right around the corner, Bristow says, so consider stocking up on allergy medications like non-drowsy Claritin®, pain relievers like Aleve® for everything from fever reduction to back and body aches, or Alka Seltzer Plus® for the next cold or flu.†
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Take a minute to draft your own wellness checklist, and then text a friend to share your top five for 2025. You might just inspire them to pull out their own paper, pens, and highlighters.
*Always talk to your doctor about adding supplements to your routine.
Hey wellness seeker! Friendly reminder that—like all of wellness—the supplements you take are personal. Well+Good always recommends checking in with your health-care provider before adding a new supplement to your routine.
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