When Does Menopause Start—and When Will It Start for You?
Two women MDs and menopause experts share when can you expect your final period...and how to tell when you're "through" menopause.
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Hot flashes, night sweats, fatigue, brain fog, mood swings, vaginal dryness…our society spent ages focused on the uncertainties surrounding menopause because so many of the issues were under-researched and not well understood. Today it seems like finally, the conversation is changing because women have louder voices when it comes to our bodies…and, says Christiane Northrup, MD—a board-certified OB/GYN and bestselling author of Women’s Bodies, Women’s Wisdom who specializes in menopause—not everything about “the change” is bad…especially when you’re educated about what to expect.
So let’s begin with the basics: When does menopause start?
Knowledge truly makes all the difference between anxiety and anticipation, says Emily Hu, MD, a certified menopause practitioner and clinical professor at University of California San Francisco. “Knowing what to expect about menopause, including what will happen and approximately when it will happen, can help you go through this transition with more confidence and peace,” she suggests.
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What is menopause?
“Menopause” isn’t a process, it’s an event—your final period, as defined by going 12 consecutive months without menstruating—that marks the end of your reproductive years, says Dr. Northrup. (Meno coming from the Greek word for month, similar to “menstruation,” and -pause meaning to cease.) And it’s not usually a clear progression, with periods changing in duration, frequency, and intensity. For instance, you may go six months without menstruating only to be surprised with a heavy flow (probably when you’re swimming because life is like that). In that case, the menopause math starts over, she says.
When does menopause start?
Because of the unpredictability of these hormone changes, answering the question When does menopause start? can only be determined retroactively. “I advise women track their periods so they have an accurate picture of how long it’s been since their last period,” says Dr. Hu. This makes good sense, especially considering brain fog and forgetfulness are common symptoms during perimenopause! You can use a paper calendar, a notebook, or a period tracker app.
For instance, you may go six months without menstruating only to be surprised with a heavy flow. In that case, the menopause math starts over, she says.
“We use ‘perimenopause’ to describe everything leading up to that final period,” Dr. Northrup says, adding perimenopause can range from six to 13 years.
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What is the average age of menopause?
Dr. Northrup says most women can expect menopause to start between the ages of 45 and 55, with the average age being around 51 years old. However, menopause can occur earlier or later than this range, with some women experiencing it in their thirties or forties (known as premature menopause), or in their late 50s or early 60s (known as late menopause).
It likely won’t be a surprise, adds Dr. Hu. “The hormonal changes that precede menopause affect every system in the body, leading to the symptoms we typically associate with menopause,” she explains. “You won’t know the day of menopause in advance, but you’ll know it’s coming.”
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Does the age of your first period predict when menopause starts?
A frequently asked question is whether or not your age of menarche (or age that you got your first period) affects what age you experience menopause. As research has found, getting your period earlier than all your friends doesn’t mean you get stop having periods sooner than all your friends, according to a 2018 study involving more than 20,000 women published in Human Reproduction.
Researchers found that regardless of when a woman starts her period (generally ranging from nine to 17 years old), she is still most likely to have her last period between 50 and 52 years of age. This means that the earlier you menstruate, the more years of your life are spent in the “fertile window.” This may be good news for hopeful moms, as March 2022 data published by the New York Times stated that each year, greater than 100,000 Americans in their forties are giving birth.
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How to survive menopause
How a woman experiences perimenopause depends a lot on her expectation of the process—women who see it as a positive and natural life change report fewer disabling symptoms, says Dr. Northrup. She adds that practices which can improve your experience include eating a nutritious diet, exercising daily, staying busy with work you enjoy and find purpose in, maintaining close relationships, doing therapy, and taking time for regular self-care.
But no one is saying that it will be a cakewalk. Dr. Hu says it’s normal to experience negative symptoms during menopause, and these don’t mean you’re doing anything wrong. “The best thing you can do is talk with your doctor about perimenopause and menopause often,” says Dr. Hu. “We have lots of ways to help manage symptoms, including hormone therapy, medications, and lifestyle changes. This isn’t something you just have to grit your teeth and suffer through.”
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How can you tell if you are “in” or “through” menopause?
If you want a clear yes or no answer, blood tests can confirm that your hormone levels have stabilized and that your ovaries are no longer producing eggs. However, most of what women describe as “being in menopause” are the changes in their bodies now that they are no longer menstruating and have much lower levels of estrogen and progesterone, says Dr. Northrup. This often includes weight gain (particularly around the waist), dry skin, lower libido, and visible signs of aging. However, there are some real upsides to completing menopause, she adds.
“The worst symptoms of perimenopause, like night sweats and hot flashes, will likely have stopped and you’ll feel more stable emotionally,” she explains. “This is also a time where many women feel very creative, open, and in charge of their own lives, prioritizing self-care.” She adds: “This can actually be one of the best periods of your life!”
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Christine Northrup, MD, OB/GYN who specializes in menopause and author of Women's Bodies, Women's Wisdom
Emily Hu, MD, OB/GYN, certified menopause practitioner and clinical professor at University of California San Francisco.
Human Reproduction: "The relation of age at menarche with age at natural menopause: a population study of 336 788 women in Norway"