This study examines the labour market trajectories of women experiencing early and surgical menopause over a 10-year period surrounding their final menstruation or surgery, representing for most women the menopause transition. We also investigate the potential mediating role of hormone therapy (HT) in early postmenopause (within 5 years of menopause onset or surgery) in these relationships. Using data from the English Longitudinal Study of Aging (ELSA), we employ sequence and cluster analysis, followed by mediation analysis. Our findings indicate that women with early menopause, compared to those who undergo menopause at 45 or older, are less likely to have flexible working arrangements (part-time work or self-employment) compared to full-time work during this sensitive period. However, they are equally likely to exit the labour market as to work full-time, indicating distinct experiences. Surgical menopause, compared to natural menopause, is associated with an increased risk of labour market exit, particularly for women aged 45 or older at the time of surgery, potentially due to higher comorbidities and increased age-related precarity. HT use appears to mitigate the risk of labour market exit for women with both early and surgical menopause, although other factors (e.g., health) may play a more significant role in this transition out of work. We advocate for further research on the impact of early and surgical menopause on women's labour market circumstances and for workplace policies that consider the diverse experiences of women with early and surgical menopause, including their increased risk of chronic conditions.