The short version
- Menopause is confirmed after a full year with no period or spotting.
- The transition usually begins between ages 45 and 55 and can last several years.
- Menopause-related symptoms typically last 2 to 8 years, and this varies a lot from woman to woman.
- Common symptoms include hot flashes, night sweats, poor sleep, joint discomfort, mood changes, forgetfulness and vaginal dryness.
- Bleeding after a year without periods always needs a medical check.
What counts as menopause
- Perimenopause, or the menopausal transition, is the time leading up to menopause. It usually starts between ages 45 and 55 and may last several years.1
- Menopause is confirmed only after a full year without a period or spotting. The US average age is 52.1
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The symptom list
| Area | Symptoms | Read more |
|---|---|---|
| Temperature | Hot flashes, night sweats | Hot flashes without hormones |
| Sleep | Trouble falling or staying asleep | Menopause sleep problems |
| Mood and mind | Moodiness, irritability, forgetfulness, difficulty concentrating | |
| Body | Joint and muscle discomfort, weight and fat shifting to the waist | Menopause belly fat |
| Periods | Irregular periods, changes in flow | |
| Vaginal and urinary | Vaginal dryness, pain during sex, bladder control problems | What hormone therapy is for |
Source: National Institute on Aging.1 Not every woman gets every symptom, and severity ranges from barely noticeable to severe.
How long do symptoms last?
Menopause-related symptoms can last 2 to 8 years, and the length varies from person to person.1 Body composition follows its own clock: in a large US study, fat gain and muscle loss sped up at the start of the transition and leveled off about two years after the final period.6
When to see a doctor
Changes in bleeding are expected, but some patterns need checking. See your doctor if:1
- your periods come very close together,
- you have heavy bleeding,
- you bleed or spot after sex or between periods,
- a period lasts more than a week,
- you bleed after a year with no periods.
Also talk to your doctor about any symptom that bothers you, including urinary problems. A yearly visit to review your plan is recommended.1
What helps
- Hormone therapy is the most effective treatment for hot flashes and vaginal symptoms and helps protect bone. It carries risks that depend on your age and health.2,4
- Treatments without hormones include cognitive behavioral therapy, clinical hypnosis and certain prescription medicines.5
- Sleep habits and CBT for insomnia help with broken nights.3
- Exercise and food do the most for weight, muscle and bone. See our workouts and recipes.
- Supplements are mostly unproven. See menopause supplements: what works.
Common questions
At what age does menopause start?
The menopausal transition most often begins between ages 45 and 55. The average age of menopause in the United States is 52.1
Can I still get pregnant during perimenopause?
Yes. If you want to avoid pregnancy, keep using birth control until 12 months after your last period.1
Is menopause a disease?
No. The National Institute on Aging describes it as a normal part of aging, not a disease or disorder. The symptoms can still be disruptive, and they are treatable.1
References
- National Institute on Aging. What is menopause? https://www.nia.nih.gov/health/menopause/what-menopause
- National Institute on Aging. Hot flashes: what can I do? https://www.nia.nih.gov/health/menopause/hot-flashes-what-can-i-do
- National Institute on Aging. Sleep problems and menopause: what can I do? https://www.nia.nih.gov/health/menopause/sleep-problems-and-menopause-what-can-i-do
- The 2022 hormone therapy position statement of The North American Menopause Society. Menopause. 2022;29(7):767-794. https://pubmed.ncbi.nlm.nih.gov/35797481/
- The 2023 nonhormone therapy position statement of The North American Menopause Society. Menopause. 2023;30(6):573-590. https://pubmed.ncbi.nlm.nih.gov/37252752/
- Greendale GA, Sternfeld B, Huang M, et al. Changes in body composition and weight during the menopause transition. JCI Insight. 2019;4(5):e124865. https://doi.org/10.1172/jci.insight.124865
Every health claim above links to its source. Before publication the article was read and approved by Claudia Muresian, health psychologist, fitness coach and healthy nutrition specialist. It is general information and cannot take your personal history into account, so use it to prepare for a conversation with your own clinician.
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