Menopause is a normal part of aging but as normal as it may be, menopause can feel anything but and many women struggle during this time. Which may leave you wondering… when can I expect all this to start and how does my age affect how I’ll go through the menopause.
Changes to your body and mood may have you flashing back to memories of puberty: Is this normal? What comes next? Do I need to do something?
Your experience with menopause will be unique to you – from when it starts to the types of menopause symptoms you’ll feel as you age but there are usually some signs to tell you where you’re at in the process.
Knowing what stage of menopause you’re in can help you know what to expect and how to best manage your symptoms. It can also help you understand what’s normal for you and your age, and when it’s a good idea to talk with your doctor.
WHAT ARE THE THREE STAGES OF MENOPAUSE?
There are three stages of menopause: perimenopause, menopause and post-menopause.
In everyday terms, those names can be translated to when changes begin, when your menstrual cycle stops, and your ‘new normal’ afterward. Here’s a closer look at what happens during each one.
PERIMENOPAUSE: THE BEGINING OF MENOPAUSE
Perimenopause – or pre-menopause – is a word that means “around menopause” and it’s when symptoms begin, leading up to menopause.
This stage typically starts about 4-8 years before menopause. The age at which perimenopause begins varies – some women notice it in their 40s, but others can experience it as early as their mid-30s.
When you enter perimenopause, you’ll probably start to notice some early menopause symptoms, like changes to your period or mood shifts. These changes happen because your body’s estrogen and progesterone levels are starting to naturally decline. As your ovaries produce lower amounts of these hormones, your body adapts.
It’s basically the reverse of what happened to your hormones as a teenager.
MENOPAUSE: THE END OF YOUR MENSTUAL CYCLE
Menopause refers to a specific point in time when your periods stop. You’re only in the menopause phase for one year, because when you’ve gone 12 consecutive months without a period, you enter post-menopause.
Reaching menopause means that you’re no longer able to fall pregnant. Every woman – except for those who’ve had their ovaries removed before puberty – will go through menopause.
AT WHAT AGES DOES MENOPAUSE START?
The average age for menopause is around 51. But some women experience menopause in their 40s – with a small percentage experiencing signs of menopause earlier. Some women may not reach menopause until their 60s.
There’s no way to know your exact menopause age until it happens, but genetics seems to play a strong role. You may get a general idea of when to expect menopause based on when your family members went through it, particularly your mother.
Genetics isn’t the only thing that can impact when menopause starts. Medical factors can also influence menopause timing. For example, if someone’s ovaries are removed, symptoms will begin to show immediately.
Certain medical conditions like autoimmune diseases have also been associated with early menopause. Women who’ve undergone treatments like radiation therapy or chemotherapy are also more likely to show symptoms earlier.
POST-MENOPAUSE: AFTER MENOPAUSE
Post-menopause simply means “after menopause” and you reach this point when it’s been 12 months since your last period.
Post-menopause signals the end of your reproductive years, and you’ll be in this stage for the rest of your life. While your ovaries are still making low levels of the hormones estrogen and progesterone, you are no longer ovulating (releasing eggs), so you can’t become pregnant.
You’ll continue to experience menopause symptoms for about 2-7 years after your final menstrual cycle (it can be longer for some people), but after that time, symptoms often get milder or completely go away.
Women in post-menopause are at a higher risk for certain health conditions like heart disease and osteoporosis. You and your primary care doctor can work together on a plan to prevent or manage those conditions.
MENOPAUSE SYMPTOMS BY AGE
Menopause symptoms evolve over time as your body slowly decreases the levels of reproductive hormones it’s making. Here’s a breakdown of menopause symptoms you may experience by age.
MENOPAUSE SYMPTOMS AT AGE 40
For the majority of women, menopause symptoms don’t start this early. If menopause happens before age 40, it’s called premature menopause. If it happens between ages 40-45, it’s known as early menopause. Fewer than 10% of women experience premature or early menopause.
But if you’re in your early 40s and are regularly experiencing symptoms such as changes to your period’s timing or flow, hot flashes, mood changes or sleep problems, don’t ignore them – speak with your doctor, who can work with you to determine whether your symptoms are related to menopause, or another reason such as hormonal disorders or other health conditions.
MENOPAUSE SYMPTOMS AT AGE 45
Around the age of 45, many women enter pre-menopause and start to notice the first signs that menopause is coming. For some women, the symptoms are mild and short-lasting. For others, menopause symptoms can be disruptive and long-lasting.
Some of the earliest signs of menopause may include:
The first sign of the menopause is usually a change in the normal pattern of your periods. You may start having either unusually light or heavy periods.
The frequency of your periods may also be affected. You may have one every two or three weeks, or you may not have one for months at a time. Eventually, you'll stop having periods altogether. These are all normal changes, but to make sure there isn’t a problem, see your doctor if:
• Your periods happen very close together.
• You have heavy bleeding.
• You have spotting.
• Your periods last more than a week.
• Your periods resume after no bleeding for more than a year.
Around midlife, some women start having trouble getting a good night’s sleep. Maybe you can’t fall asleep easily, or you wake too early. Night sweats might wake you up. And if you wake up during the night, you might have trouble falling back to sleep.
You might feel moodier or more irritable around the time of menopause. Scientists don’t know why this happens.
It’s possible that stress, family changes such as growing children or aging parents, a history of depression, or feeling tired could be causing these mood changes. Talk with your doctor or a mental health professional about what you’re experiencing. There are treatments available to help.
Your body seems different
Your waist could get larger. You could lose muscle and gain fat. Your skin could become thinner. You might have memory problems, and your joints and muscles could feel stiff and achy. Researchers are exploring such changes and how they relate to hormones and growing older.
In addition, for some women, symptoms may include aches and pains, headaches, and heart palpitations.
MENOPAUSE SYMPTOMS AT AGE 50
Most women will have their last period around the age of 50. After 12 months without a period, menopause is complete and post-menopause begins.
As menopause gets closer, your estrogen and progesterone levels start to decline more rapidly. As a result, your symptoms will likely become more intense.
Your periods will probably become more irregular until they finally stop. You may experience greater mood swings and an increase in insomnia. And you’ll likely start experiencing new symptoms that are common right around, or right after, reaching menopause, including:
Many women have hot flashes, which can last for many years after menopause.
They may be related to changing estrogen levels. A hot flash is a sudden feeling of heat in the upper part or all of your body. Your face and neck may become flushed. Red blotches may appear on your chest, back, and arms and heavy sweating and cold shivering can follow.
Hot flashes can be very mild or strong enough to wake you up (called night sweats). Most hot flashes last between 30 seconds and 10 minutes. They can happen several times an hour, a few times a day, or just once or twice a week.
Doctors aren’t sure why hot flashes happen, but there are ways to lessen their impact. Some tips include:
• Try to stay in cooler environments
• Dress lightly or wear layers you can remove
• Find effective ways to manage stress
• Monitor your diet (foods that are spicy, processed or fatty can trigger hot flashes)
• Reduce how much caffeine or alcohol you drink
Hot flashes can happen during pre-menopause, but they’re most often reported right around menopause and in the first few years of post-menopause.
Night sweats (hot flashes during the night)
When hot flashes occur at night, they’re called night sweats. Night sweats can prevent you from getting a good night’s sleep and make you more irritable the next day. Sleeping with fewer blankets, in lighter clothing and with a fan can be helpful to stay more comfortable.
Some people find that, even without changing their diet or lifestyle, they begin to gain weight during menopause.
This is because the drop in estrogen levels also lowers your ability to maintain muscle mass, which can slow down your metabolism. This means that during and after menopause, you won’t need as many calories to maintain your current weight.
MENOPAUSE SYMPTOMS AT AGE 55 AND ABOVE
Around age 55, most women have entered their post-menopausal years. After menopause, your body adjusts to the lower amount of estrogen and progesterone, and many women feel more productive, alert and free – now that they don’t have to worry about birth control or managing a period.
Post-menopausal years do bring some new symptoms with them. Some things to expect include:
Dryer or thinner skin and hair
Estrogen plays a role in collagen production. Collagen makes up your skin, hair, bones and many other tissues around your body. Because your estrogen levels are lower after menopause, your skin or hair may become dryer or thinner.
Vaginal Health and Sexuality
After menopause, the vagina may become drier, which can make sexual intercourse uncomfortable.
You may also find that your feelings about sex are changing. You could be less interested, or you could feel freer and sexier because after one full year without a period, you can no longer become pregnant.
A loss of bladder control is called incontinence. You may have a sudden urge to urinate, or urine may leak during exercise, sneezing, or laughing. The first step in treating incontinence is to see a doctor. Bladder infections also can occur in midlife.
WHEN SHOULD I SEE A DOCTOR FOR MENOPAUSE HELP?
The way you experience each stage of menopause will be unique. For example, maybe you don’t get hot flashes, but insomnia leaves you feeling tired and irritable. Or perhaps the first sign of change is vaginal dryness.
Menopause symptoms can often be managed by maintaining a healthy diet, exercising regularly and taking advantage of home remedies or over-the-counter medications.
But if your symptoms are intense enough to affect daily activities or keep you from doing the things you love, it may be time to seek advice and care for menopause symptoms.
Care options might include lifestyle changes, hormone replacement therapy (HRT), and supplements or medications. More and more women are also choosing a more holistic approach to managing their menopause.