Key takeaways

  • Perimenopause is a gradual process that may last several years, often beginning in your mid-40s.
  • Common symptoms during this period include hot flashes, difficulty sleeping, and vaginal dryness.
  • The onset of menopause occurs after 12 consecutive months without menstruation. It marks the transition to postmenopause.

Hormone levels naturally decline as you reach the end of your reproductive years.

Once you reach menopause, you will no longer ovulate or experience a menstrual period. This means you will no longer be able to become pregnant.

People in the United States generally experience natural menopause at around 51 years old.

Menopause is a gradual process. It usually takes about 2 and 8 years for symptoms to end, but menopause may last up to 15 years. There are three stages of menopause: perimenopause, menopause, and postmenopause.

Perimenopause

Perimenopause occurs before menopause. It usually begins in your mid-40s. During this stage, hormone levels begin to change, menstruation becomes irregular, and menstrual flow may be heavier or lighter. You may experience symptoms such as hot flashes and night sweats.

Perimenopause can last anywhere from a few months to several years.

Menopause

Menopause occurs when 12 or more months have passed since your last menstrual period. Hot flashes and other symptoms may continue. Although many people experience menopause in their early 50s, this transition can happen earlier in life.

Early menopause occurs at ages 40–45 years. Premature menopause occurs before age 40.

Postmenopause

Postmenopause refers to the years after menopause. During these years, menopause symptoms usually taper off, but other health conditions may begin, such as osteoporosis.

Everyone’s experience of menopause is unique. Some people experience severe and wide-ranging symptoms, while others may barely notice the change.

Common physical symptoms include:

Common mental and emotional symptoms include:

Physical changes during menopause can increase your risk of:

What are the early symptoms of menopause?

Early symptoms of menopause typically include irregular menstruation, but you may also start to notice hot flashes, mood changes, and other unusual symptoms.

Menopause is a natural process that results from changing levels of estrogen, progesterone, and other hormones as you age.

These changes are linked to a loss of active ovarian follicles. These structures produce and release eggs from the ovary wall.

For some people, menopause may start early as a result of:

If you’re experiencing unusual symptoms and aren’t sure if they’re related to menopause, it’s best to make an appointment with a healthcare professional, such as a primary care doctor or an obstetrician & gynecologist (OB-GYN).

They can order blood tests to confirm whether menopause is likely. The PicoAMH Elisa diagnostic test can help determine whether menopause has begun

Other blood tests can measure levels of FSH and estradiol, a form of estrogen. Blood levels that are consistently 30 mIU/mL or higher, combined with a lack of menstruation for 1 year, can usually confirm menopause.

Depending on your symptoms and overall history, your healthcare professional may order blood tests to rule out other underlying conditions.

This includes tests for:

If your symptoms are causing you distress or interfering with your quality of life, consider making an appointment with a healthcare professional.

They can answer any questions and recommend treatment based on your individual needs. Depending on your symptoms, you might find it helpful to use:

  • antidepressants and other oral medications to help manage hot flashes
  • topical hormone therapy to help prevent atrophic vaginitis, or vaginal atrophy
  • vaginal moisturizer to help relieve or prevent everyday dryness
  • vaginal lubricant during masturbation and sex to prevent discomfort

Certain lifestyle changes can help improve your overall well-being and aid in symptom management.

Personal care

Applying a daily moisturizer can help with dryness. It’s best to avoid excessive sun exposure and harsh cosmetics and cleansing products, too, as they may dry out your skin.

Dressing in loose, layered clothing that you can easily remove or put on can help manage hot flashes. Carrying a portable fan can help cool you down when you feel flushed.

Diet and nutrition

Getting a wide variety of essential nutrients in your food is important. Eating a balanced diet can boost your overall well-being.

If you aren’t able to increase your dietary intake of key vitamins or minerals, consult with a healthcare professional about potentiallly adding supplements to your routine.

A 2023 review of research suggests that omega-3 fatty acids may help improve hot flashes and night sweats. Calcium, vitamin D, and magnesium may help reduce the risk of osteoporosis.

Physical activity

Exercise can help strengthen your body, boost overall well-being, and manage weight.

Current guidelines recommend getting at least 150 minutes of moderate exercise and two sessions of resistance training per week.

Mental health

You might consider adopting mindfulness preactice, such as journaling, yoga, or meditation practice to help manage stress. Learning how to use box breathing or other breathing techniques can also help manage emotions as they arise throughout the day.

Joining a local support group or working with a counselor may also be beneficial.

Substance use

If you smoke, it might be a good time to cut back or kick the habit entirely. Taking measures to avoid exposure to secondhand smoke can also benefit your overall health.

Drinking alcohol can also have a negative impact on menopause symptoms. If you drink alcohol, try to limit alcohol consumption to no more than one drink per day.

Alternative remedies

Some people use black cohosh to improve symptoms such as hot flashes and night sweats. However, there is little evidence to support these claims, and more research is needed.

Some alternative remedies are believed to increase estrogen levels, but there’s not enough evidence to prove they are safe or effective. This includes:

Many people may experience symptoms of menopause for about 2 and 8 years, but menopause may last up to 15 years.

In the United States, the average age at which most people enter menopause is around 52. However, some may experience it before or after that time.

Menopause may cause a wide range of symptoms that impact your daily life. These can include hot flashes, night sweats, vaginal atropy, and vaginal dryness. If you experience symptoms of menopause, treatments are available to help manage them.

Menopause marks the natural end of fertility and occurs 12 months after your last menstrual period.

Symptoms of menopause may start several years earlier and include menstrual changes, hot flashes, night sweats, and flushing. Symptoms can continue for several years after menopause.

It’s worth seeking medical help if menopause symptoms are affecting your daily life, you have other symptoms not related to menopause, or you’re experiencing menopause symptoms and are younger than 45.