If you menstruate (have periods), menopause is when your menstrual cycle ends for 12 consecutive months. It is a natural stage of life that happens because your ovaries reduce or stop producing the hormones estrogen and progesterone. Estrogen and progesterone regulate female reproductive health, including fertility and pregnancy.
Here’s what to expect when entering menopause, how you can manage symptoms, and how it affects your overall health.
When does menopause begin, and how long does it last?
Menopause usually begins naturally, most often between the ages of 45 and 55. If you had an oophorectomy (surgery to remove the ovaries), or a hysterectomy with an oophorectomy, and are not taking hormones you may experience menopause symptoms sooner.
Menopause has different phases that may overlap. The entire process usually lasts about seven years but can take as long as 14 years. These phases include:
- Perimenopause. This is when hormone levels first start to change and hot flashes or other symptoms may begin. You may also have irregular periods during this phase. For some people, perimenopause begins as early as age 40.
- Menopause. This is when the ovaries slow their hormone production. You are officially in menopause 12 months after your final menstrual period. It occurs on average around age 51.
- Postmenopause. This phase follows menopause and lasts for the rest of your life. Your symptoms may continue during this phase.
The start of the menopausal transition and how long it lasts depends on many factors. These include genetics, the age it begins, your medical history or medications (such as chemotherapy drugs), and lifestyle habits (such as smoking). Race, ethnicity, and social factors such as stress and socioeconomic status may also impact your menopause experience.
Although fertility declines in perimenopause, it is still possible to become pregnant until you have gone 12 consecutive months without a period. If you do not want to become pregnant, birth control or other types of contraceptives (such as condoms) are still recommended until that point. You can still get sexually transmitted infections (STIs) throughout your life.
What are the symptoms of menopause?
Hormone changes during menopause can cause a range of symptoms. These symptoms vary by intensity and frequency, which makes it difficult to know whether the transition has begun. Common symptoms include:
- Hot flashes and night sweats (if they occur late in the evening)
- Trouble sleeping
- Mood swings, depression, or anxiety
- Difficulty concentrating or memory issues
- Abnormal uterine bleeding
- Vaginal pain or dryness
- Pain during, or loss of interest in, sex
- Headaches
- Body aches and pains
- Heart palpitations
- Incontinence
- Weight gain or muscle loss
Everyone’s experience is different—you may have many symptoms or hardly any. Communicate with your health care provider about any symptoms or concerns related to menopause. Some symptoms can be caused by other health conditions as well, so they may suggest some tests to rule out any other causes for the changes you're experiencing.
Tell your doctor if your periods happen very close together, last more than a week, are heavy, or return after a year of no bleeding.
Can menopause affect my health in other ways?
Yes. Hormone changes during menopause can increase the risk of heart disease and osteoporosis (a condition that weakens bones and makes them vulnerable to breaking), so it’s important to maintain healthy lifestyle habits.
You are also at greater risk for vaginal and urinary tract infections. Dyspareunia (pain during sexual intercourse) due to vaginal irritation from the lack of hormones can also have an emotional effect on you and your partner.
What can I do to manage my symptoms?
Menopause is a natural process, but there are many safe methods to relieve symptoms that disrupt your daily life.
Some tips from the National Institute on Aging for better sleep 💤 and managing hot flashes 🔥 include:
- Carry a portable fan 🔥 💤
- Avoid alcohol, spicy foods, and caffeine (especially close to bedtime) 🔥 💤
- Avoid smoking 🔥
- Maintain a healthy weight and exercise regularly, but avoid strenuous activity close to bedtime 🔥 💤
- Dress in layers that can be easily removed 🔥
- Keep your bedroom a cooler temperature 🔥 💤
- Drink small amounts of cold water before bed 🔥
- Adjust the number of layers of your bedding 🔥 💤
- Use mindfulness exercises such as meditation, yoga, or tai chi 🔥
- Follow regular sleep schedule and avoid naps in the late afternoon or evening 💤
- Take prescription or over-the-counter sleep medications such as melatonin 💤
Medications are also available to treat hot flashes and prevent bone loss that can occur throughout menopause. These medications may include menopausal hormone therapy. They could have health risks for certain people with risk factors such as high blood pressure or a history of certain cancers. Talk to your doctor about whether these are right for you.
Pain during sex may be treated with over-the-counter vaginal lubricants and moisturizers, or your doctor may prescribe medication.
Complementary health practices such as natural products or mind and body practices can help manage your menopausal symptoms. However, talk to your doctor before using natural products (such as black cohosh or soy isoflavones) as they may cause other side effects, including liver damage. MyMenoplan.org is a website that was developed with support from NIH.
MyMenoplan.org has a tool to find treatment options based on your specific symptoms.
Image credit: National Institute on Aging.
