Menopause Onset, Perimenopause, and Beyond

Menopause is a natural biological process that marks the end of a person’s reproductive years and happens when periods have stopped for 12 consecutive months with no other obvious cause. For most people, this transition occurs between the ages of about 45 and 55, with the average around age 51, although it can begin earlier or later for some individuals. The years leading up to menopause — known as perimenopause — can last several years and are characterized by fluctuating hormone levels, especially estrogen and progesterone, which cause changes in the menstrual cycle and a variety of symptoms. Common symptoms during perimenopause and menopause include irregular periods, hot flashes or hot flushes, night sweats, vaginal dryness, sleep disturbances, mood changes and memory or concentration issues. Because hormone production declines, other physical effects can also occur, such as weight changes, changes in libido, and risks to bone health such as osteoporosis. Some people may also experience emotional symptoms like irritability, anxiety or depression. The menopause transition is different for everyone. Perimenopause often begins with small changes in cycle length and gradually progresses to the point where menstruation stops completely. Once someone has gone a full year without a period, they have officially reached menopause. After this point, they enter postmenopause, where symptoms may continue but often lessen over time.