When Does Menopause Start?
You're in menopause when you haven't had a period for 12 straight months and you aren't pregnant or sick. It's a normal part of aging.
It most often happens when you're in your 40s or 50s. The average age in the U.S. is 51. It can happen earlier if you've had surgery to remove your uterus or ovaries or are having certain treatments for cancer.
Are You Transitioning Into Menopause?
You may start to notice changes months or years before you're in menopause. Some of the first signs of the transition are often so-called vasomotor symptoms such as hot flashes or night sweats. You may also start to notice irregular periods. This time of transition into menopause is called perimenopause.
This phase typically starts when you're in your 40s, though the timing can vary.
When you're in perimenopause, it can be hard to predict when, or if, your next period may come. It's also harder to know how long your period will last or whether your flow will be heavy or light. It's more difficult to get pregnant during this phase. But it's still possible as long as you have periods.
You won't know exactly when menopause will hit. All you can do is pay attention to how you're feeling and notice changes. Keep in mind that symptoms can be very different from one person to another. You might have no symptoms at all.
Perimenopause is over when you've gone more than 12 months in a row without a period.
Symptoms of menopause include:
Your period may be considered irregular if the time between your menstrual cycle is longer or shorter, you skip a period, or your periods are lighter or heavier than usual. You could even skip a period. This is a classic sign of the transition into menopause.
Some chemotherapy drugs used to treat cancer can also make your periods irregular. Any bleeding, even just spotting, after menopause isn't normal. You should talk to your doctor if you have concerns about an irregular period.
Vaginal dryness. During menopause, the skin around your vagina may become drier. This can make sex hurt. Gels called personal lubricants can help.
Vasomotor symptoms (hot flashes or night sweats). Hot flashes can make you feel warm or hot suddenly for no apparent reason. Your skin may flush red and your heart may beat faster. Then you may feel suddenly cold.
Night sweats are hot flashes that happen during sleep. They can be so intense they wake you up. Like so many symptoms of menopause, hot flashes and night sweats can vary a lot from person to person. They can last 1 minute or 5 minutes. They can be mild or severe. You can have several an hour, one a week, or never have them.
These symptoms could go on for years or decades after you stop getting your periods—into the time called postmenopause. If you have hot flashes but aren't sure they're related to menopause, talk to your doctor. Some medical conditions and even medications can bring them on, too.
Mood swings. Lots of things can affect your mood and that includes the effect of changes in hormones that happen around menopause. If you've had anxiety or depression in the past, your symptoms may worsen during menopause. If you feel anxious or depressed for more than a few weeks, tell your doctor. Together, you can decide on a treatment to help you feel better.
Sleep problems. Waking up during the night or having trouble going to sleep can happen for lots of reasons, but if you don't typically have problems sleeping, it may be a sign you're approaching menopause. Sometimes it's caused by vasomotor symptoms like night sweats. If sleep problems hang on for a while and you can't pinpoint why you have trouble sleeping, it may be time to tell your doctor.
Body changes. You may also notice your hair and skin become drier and thinner. You could gain weight during menopause. Your body also might change so that you have more fat around the waist and more fat and less muscle in general. You may also find it a little harder to move, with stiff joints or joints that hurt. It's important to stay active. You may need to work harder to keep your strength and stay in shape.
Drop in sexual function. You might feel less interested in sex or have trouble getting aroused when you're in menopause. Or you could enjoy sex more and feel more free because you don't have to worry about things like getting pregnant.
Forgetfulness. Anyone can have minor memory lapses during middle age, such as not being able to think of a word or losing car keys. Usually, it's no big deal. Forgetfulness can occur during menopause but can stem from other factors like stress. If you're worried that you're forgetting too much, let your doctor know.
Peeing more often. A lack of control over peeing can be another symptom of this stage of life. Activities like coughing or lifting may cause you to lose pee or you may have a strong, instant need to pee that is followed by a loss. You may also get more frequent urinary tract infections.
Racial disparities in symptoms
Research has shown Black women have more serious menopause symptoms, like hot flashes, sleep problems, and depression, than White women. But they're less likely to get hormone therapy or other treatments. They also go through menopause an average of 8 years earlier. Some studies show Hispanic and Native Hawaiian women may begin menopause at an earlier age than White women. Researchers believe some of these differences are due to life stress, socioeconomic characteristics, and discrimination. More research is needed.
Impact of hormonal therapy
If you get gender-affirming care that includes hormonal therapy to raise estrogen and lower testosterone levels, you can also have menopause symptoms.
You won't go into actual menopause but could have symptoms if your hormonal therapy is interrupted. As you age, you may choose to lower your estrogen levels by stopping hormonal therapy. This will also cause symptoms.
If you were assigned female at birth and identify as male, you'll go through menopause unless you get hormonal therapy to raise testosterone levels or have had your ovaries removed. You can also enter menopause right after surgery to have your ovaries removed.
Early Menopause Symptoms
Menopause before age 45 is considered early menopause. It's called premature menopause when it happens before age 40. Premature and early menopause symptoms are similar to those of menopause that happens later. Causes and risk factors include:
Certain cancer treatments
A family history of early menopause
Starting your period before age 11.
Early or premature menopause sometimes has no cause. This is the case about half the time.
A condition called premature ovarian insufficiency can also cause periods to stop early with no medical cause. But unlike with early or premature menopause, your periods could come back and you might still be able to get pregnant.
When to Go to a Doctor
You may choose to see a doctor for menopause symptoms if they affect your daily life or concern you, like hot flashes that keep you from sleeping, mood changes, or body changes that affect your sex life.
Some people don't have symptoms that they feel are serious enough to require medical treatment. They may find ways to deal with their symptoms, such as changes in diet, exercise, and relaxation techniques.
Treatment is usually aimed at relieving symptoms. It might include:
Nonhormonal medications to stop hot flashes
Estrogen in a cream, ring, or tablet to ease vaginal dryness
You're in menopause when you've gone a year without having a period. Menopause and its symptoms are different for different people. If menopause symptoms bother you, talk to your doctor about treatment options including lifestyle changes and medication.
Menopause Symptoms FAQs
Can you get pregnant after menopause?
It is possible to get pregnant during the transition into menopause or perimenopause. The possibility does not go away until you enter menopause. See your doctor about contraception options if you don't want to get pregnant.
How long does menopause last?
You can have menopause symptoms for as many as 10 years.Most often, they last less than 5 years.
What are the signs of coming to the end of menopause?
Postmenopause is when you haven't had a period in 12 months. Typically, symptoms become milder and may go away after this. You remain in postmenopause for the rest of your life. This puts you at a higher risk for heart disease and osteoporosis. Lifestyle changes such as diet and exercise can reduce this risk.