Emergency warning: If you have sudden heavy vaginal bleeding, severe depressive symptoms or thoughts of self-harm, chest pain, or difficulty breathing, seek emergency care immediately. Common signs that may suggest early menopause include menstrual irregularities or cessation of periods (especially before age 40), hot flashes and night sweats, vaginal dryness and pain during intercourse, reduced libido, sleep problems, mood changes and fertility difficulties. Evaluation typically includes history, exam and hormone tests such as FSH and estradiol; AMH, thyroid tests, pregnancy test and pelvic ultrasound may be requested when appropriate. Interpretation depends on clinical context and sometimes repeat testing. Discuss results and next steps with an obstetrics and gynaecology or endocrinology specialist. Follow-up for fertility planning and bone health may be recommended.