Menopause, marked by a year without your period, generally starts in your 40s. Menopause can take several years, and the transition period is called perimenopause. The average age of menopause is 51 years old.
Although menopausal timing differs for everyone, if you enter menopause earlier than is typical, your healthcare provider may diagnose you with premature or early menopause. Premature menopause is when you enter menopause before age 40, while early menopause is when you enter menopause between age 40 and 45.
Perimenopause refers to the transition into menopause, but it does overlap with the first twelve months of menopause (after you finish your last period). However, it is distinct from menopause, whether it is early, premature, or at a typical time.
Early or premature menopause can happen naturally, or it might occur due to medical treatment.
Medical interventions that can cause early or premature menopause include:
- Surgery to remove the ovaries or uterus
- Hormone therapy
- Chemotherapy or radiation to treat cancer
Other health conditions or risk factors that can cause premature or early menopause include:
- Family history of early or premature menopause
- Smoking
- Thyroid disease, rheumatoid arthritis, or other autoimmune conditions
- HIV or AIDS without proper treatment
- Missing or abnormal chromosomes
- Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS)
During the transition to menopause, your ovaries create less estrogen and progesterone. This can lead to the symptoms you may experience. Each person experiences a different variety and severity of menopause symptoms.
As you enter menopause, you may notice that your periods become irregular, shorter or longer, and lighter or heavier than before. A complete absence of your period for a year is the hallmark sign of menopause. If you notice any of the following symptoms related to your period, contact your healthcare provider:
- Periods that occur very close together
- Heavy bleeding
- Bleeding or spotting between your periods or after having sex
- Periods longer than a week
- Bleeding or spotting after missing your period for over a year
Other signs of menopause you might experience include:
- Hot flashes, or feeling hot on your face, neck, and chest, for 30 seconds to 10 minutes
- Difficulty falling or staying asleep
- Vaginal dryness
- Pain or discomfort during sex (caused by vaginal dryness)
- Reduced sex drive or changes in how you view sex
- Moodiness, anxiety, or irritability
- Trouble controlling your bladder or leaking during exercise, sneezing, or laughing
- Urinary tract infections, or UTIs
- Changes in your weight or body composition
- Changes in your skin, joints, or muscles
- Trouble with memory or focus
Over time, you may notice that your body feels different, or your healthcare provider might tell you that you are at risk of new health conditions. This could include:
- Reduced bone density, which can put you at risk for osteoporosis
- Higher cholesterol levels, which can lead to heart disease or stroke
