How Long Does Menopause Last: Expectations Vs. Reality

Content medically reviewed by Kaley Gadbois, PA-C

When does menopause start? If you're experiencing symptoms earlier than you might expect, you may be worried about menopause starting early. While it's a significant life change, menopause doesn't have to be a lonely or challenging experience. Learn about the stages and treatments available to help you embrace this transition with confidence and ease.

Menopause: An Overview

Menopause, which signals the end of your reproductive years, is a biological transition, not a disease or a medical condition. It’s defined by 12 consecutive months without a menstrual period. 

Significant hormonal changes are the root of menopause. When menstruation begins at puberty, girls produce estrogen and progesterone. As women mature into their 40s and 50s, these hormones decline in production until they reach a low, stable level.

"This  significant drop in hormone production leads to the end of menstrual periods," said Kaley Gadbois, PA-C, an OB/GYN at Essentia Health. "The hormone changes can also cause the uncomfortable symptoms commonly associated with menopause, like hot flashes, mood changes, and sleep disturbances."

When Does Menopause Start?

While the average age for menopause is 52, it can occur years earlier or later. The transition to menopause, called perimenopause, typically begins several years before the final menstrual period.

There are three stages associated with menopause: perimenopause, menopause, and postmenopause.

Perimenopause

Perimenopause, the transition to menopause, can last anywhere from a few months to a decade, with most experiencing perimenopause for three to four years. During this time, estrogen and progesterone levels fluctuate significantly. You can still become pregnant, although the chances are lower.Perimenopause is when you may start to experience menopause symptoms, such as –

• Decreased libido
• Difficulty concentrating
• Hot flashes, or sudden waves of feeling hot
• Irregular periods, including periods that are shorter, longer, or much heavier than usual
• Joint pain
• Memory problems
• Mood swings
• Night sweats
• Sleep disturbances
• Vaginal dryness
• Weight gain

You may not experience all these symptoms, or any symptoms at all. Severity can also vary from person to person.

Menopause

Once your menstrual period has stopped for 12 consecutive months, you’re officially in menopause. In this stage, egg production stops, and you can no longer become pregnant. However, some people still experience symptoms like night sweats, mood swings, and vaginal dryness.

Postmenopause

Postmenopause refers to the years after the 12-month mark of no menstruation. During this phase, hormone levels stabilize, although they remain lower than before. 

For many, postmenopause is a time of relief. Hot flashes have stopped or are less frequent, moods are better, and brain fog improves.

During postmenopause, the body produces significantly less estrogen. This decrease in estrogen levels can increase certain health risks, including osteoporosis (weakening of the bones) and cardiovascular disease. Maintaining a healthy lifestyle with regular exercise, a balanced diet, and regular medical checkups is crucial to minimize the risks associated with the postmenopause stage.   

Signs of Premature Menopause and What to Do About It

Premature menopause, defined as menopause that occurs before age 40, affects approximately 1% of women. Early menopause is when your periods stop before age 45.

The symptoms of premature and early menopause are similar to those of menopause, including hot flashes and night sweats, irregular periods, vaginal dryness, and mood swings.

What Causes Premature Menopause?

Sometimes there is no known cause for premature or early menopause, but certain factors, including smoking or a family history of premature menopause, can increase your risk.

Experiencing symptoms of menopause before age 45 can be concerning. If you think you’re entering premature or early menopause, talk to your doctor. A physical examination and blood test to check hormone levels can provide an accurate diagnosis and help you and your doctor determine the next steps.

Taking Care of Yourself During the Stages of Menopause

Menopause can be challenging to navigate. The change in hormone production leads to physical and emotional changes and increases your risk for certain conditions. Leading up to and after menopause, it’s important to care for your mental and physical health, which may include diet changes, stress management, and staying on top of recommended screenings. 

• Prioritize your mental health. Mood swings, anxiety, and depression can set in before, during, and after menopause. Increase activities that promote relaxation, like meditation, exercise, deep breathing, and indulging in a hobby.
• Eat a healthy diet. Low estrogen production is associated with physical changes like weight gain and increased cholesterol. Women lose bone density after menopause, so eating a nutrient-dense diet is essential during this transition. A balanced diet rich in fruits, vegetables, and whole grains allows you to get a variety of nutrients, such as vitamin D, that can help lower the risk of osteoporosis or bone loss.·
• Try to manage symptoms. If diet and lifestyle changes aren’t alleviating your menopause symptoms, hormone replacement therapy (HRT) may provide some relief. HRT replaces lost estrogen, progestin or a combination of both, and it can alleviate symptoms like hot flashes, vaginal dryness, and sleep disturbances.
• Stay current with checkups. Regular doctor visits help you stay on top of recommended screenings that can detect menopause-related health issues, such as osteoporosis.

“Each woman’s transition into menopause is different,” Gadbois said. “Some women notice menopause symptoms in their early 40s—years before they reach menopause. Other women first notice menopause symptoms in their 50s.”

Regardless of when symptoms begin, working with your OB/GYN, midwife, or primary care provider can help you manage symptoms and maintain well-being during the transition.