When does menopause typically start. What are the three stages of menopause. How do menopause symptoms differ by age. What are the signs of early or premature menopause. What health risks increase after menopause.

Understanding the Three Stages of Menopause

Menopause is a natural biological process that marks the end of a woman’s reproductive years. It occurs in three distinct stages, each with its own set of symptoms and changes. Let’s explore these stages in detail:

Perimenopause: The Transition Begins

Perimenopause, also known as pre-menopause, is the initial stage of the menopausal journey. This phase typically begins 4-8 years before menopause itself. During perimenopause:

• Estrogen and progesterone levels start to decline
• Women may experience irregular periods
• Mood swings and other early menopause symptoms may appear
• The body begins adapting to hormonal changes

When does perimenopause usually start? While it varies for each woman, many begin noticing changes in their 40s. However, some may experience symptoms as early as their mid-30s.

Menopause: The Definitive Moment

Menopause itself is a specific point in time, marking 12 consecutive months without a menstrual period. This stage signifies the end of a woman’s reproductive capability. Key points about menopause include:

• It typically occurs around age 51, but can happen earlier or later
• Ovaries stop releasing eggs
• Hormone production significantly decreases
• Pregnancy is no longer possible

Post-menopause: The New Normal

Post-menopause begins after 12 months have passed since the last menstrual period. This stage lasts for the remainder of a woman’s life. During post-menopause:

• Menopause symptoms may continue for 2-7 years or longer
• Symptoms often become milder or disappear over time
• Risk increases for certain health conditions like heart disease and osteoporosis
• Regular health check-ups become increasingly important

Factors Influencing the Onset of Menopause

The timing of menopause can vary significantly among women. Several factors contribute to when a woman experiences menopause:

Genetic Predisposition

Genetics plays a crucial role in determining when menopause begins. Women often experience menopause at an age similar to their mothers or close female relatives. While not an exact predictor, family history can provide a general idea of what to expect.

Medical Conditions and Treatments

Certain medical factors can influence the timing of menopause:

• Autoimmune diseases may be associated with early menopause
• Removal of ovaries (oophorectomy) causes immediate surgical menopause
• Cancer treatments like chemotherapy or radiation therapy can induce early menopause

Lifestyle Factors

While research is ongoing, some lifestyle factors may influence menopause timing:

• Smoking has been linked to earlier menopause
• Body mass index (BMI) may play a role, with lower BMI associated with earlier onset
• Certain environmental exposures may affect hormonal balance

Recognizing Menopause Symptoms at Different Ages

Menopause symptoms can vary widely among women and may appear at different ages. Understanding these age-related symptoms can help women better prepare for and manage the transition.

Symptoms in Your 30s and Early 40s

While less common, some women may experience early menopause symptoms in their 30s or early 40s. These may include:

• Irregular periods
• Changes in menstrual flow
• Occasional hot flashes
• Mood swings
• Sleep disturbances

What is considered premature or early menopause? Menopause occurring before age 40 is termed premature menopause, while menopause between ages 40-45 is considered early menopause. These conditions affect less than 10% of women.

Symptoms in Your Late 40s and Early 50s

This is the most common age range for perimenopause and menopause. Symptoms during this time may include:

• More frequent and intense hot flashes
• Night sweats
• Vaginal dryness
• Decreased libido
• Mood changes, including irritability or depression
• Weight gain, especially around the midsection
• Thinning hair and dry skin

Symptoms in Your Late 50s and Beyond

As women enter post-menopause, they may experience:

• Continuation of earlier symptoms, often with decreasing intensity
• Increased risk of osteoporosis
• Changes in skin elasticity
• Potential increase in cardiovascular risk

Managing Menopause Symptoms: Strategies for Every Stage

While menopause is a natural process, its symptoms can be challenging. Fortunately, there are numerous strategies to manage these symptoms effectively:

Lifestyle Modifications

Simple changes in daily habits can significantly impact menopause symptoms:

• Regular exercise to maintain bone density and manage weight
• Balanced diet rich in calcium and vitamin D
• Stress-reduction techniques like meditation or yoga
• Avoiding trigger foods that may worsen hot flashes (e.g., spicy foods, caffeine)
• Maintaining a cool sleeping environment

Medical Interventions

For more severe symptoms, medical treatments may be recommended:

• Hormone replacement therapy (HRT) for managing hot flashes and vaginal dryness
• Low-dose antidepressants for mood swings and hot flashes
• Vaginal estrogen for localized symptoms
• Osteoporosis medications to maintain bone health

Alternative Therapies

Some women find relief through alternative approaches:

• Acupuncture for hot flashes and mood swings
• Herbal supplements like black cohosh or evening primrose oil (consult a healthcare provider first)
• Cognitive behavioral therapy for managing mood changes and sleep issues

Health Considerations in Post-Menopause

As women enter post-menopause, certain health risks increase. Understanding and addressing these risks is crucial for maintaining long-term health and well-being.

Cardiovascular Health

The risk of heart disease increases after menopause due to declining estrogen levels. To maintain cardiovascular health:

• Monitor blood pressure and cholesterol levels regularly
• Engage in regular aerobic exercise
• Maintain a heart-healthy diet low in saturated fats and high in fruits, vegetables, and whole grains
• Quit smoking and limit alcohol consumption

Bone Health and Osteoporosis

Postmenopausal women are at higher risk for osteoporosis. To protect bone health:

• Ensure adequate calcium and vitamin D intake
• Participate in weight-bearing exercises
• Consider bone density screenings
• Discuss the need for osteoporosis medications with a healthcare provider

Urinary and Vaginal Health

Declining estrogen levels can affect urinary and vaginal health. To address these issues:

• Practice Kegel exercises to strengthen pelvic floor muscles
• Use vaginal moisturizers or lubricants for comfort
• Discuss vaginal estrogen therapy with a healthcare provider if symptoms are severe

When to Seek Medical Advice for Menopause Symptoms

While menopause is a natural process, certain symptoms or circumstances warrant medical attention. It’s important to consult a healthcare provider if:

• Menopause symptoms significantly impact quality of life
• Periods become very heavy, occur more frequently than every three weeks, or resume after a year without menstruation
• There’s spotting between periods or after sex
• Symptoms of depression or anxiety become severe
• There are concerns about the risk of osteoporosis or heart disease

How often should postmenopausal women have check-ups? It’s generally recommended to have annual wellness exams, including breast exams, pelvic exams, and relevant screenings based on age and risk factors.

Embracing the Menopause Journey: A Positive Perspective

While menopause brings challenges, it also offers opportunities for personal growth and renewed focus on health and well-being. Many women find this stage of life liberating and empowering. To make the most of this transition:

• Educate yourself about the changes your body is undergoing
• Communicate openly with your partner, family, and healthcare provider
• Explore new interests or hobbies
• Connect with other women going through similar experiences
• Focus on self-care and personal growth

What positive aspects can women look forward to after menopause? Many women report feeling more confident, experiencing a sense of freedom from menstrual cycles and contraception concerns, and having more time to focus on personal goals and aspirations.

Menopause is a significant milestone in a woman’s life, marking the end of reproductive years and the beginning of a new chapter. By understanding the stages, recognizing symptoms, and adopting proactive health strategies, women can navigate this transition with confidence and grace. Remember, every woman’s experience with menopause is unique, and there’s no one-size-fits-all approach. Embracing this natural process with a positive attitude and seeking support when needed can lead to a fulfilling and healthy post-menopausal life.

When does menopause start? Signs, stages and what to expect

Menopause is a normal part of aging. As normal as it may be, menopause can feel anything but. 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, and when it’s a good idea to talk with a women’s health specialist.

We’re here to help. Read on to learn about the three stages of menopause, the symptoms you may experience at different ages, and when to seek care for menopause symptoms.

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 beginning 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 menstrual 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 bear children (become pregnant). Every woman – except for those who’ve had their ovaries removed before puberty – will go through menopause.

At what age 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 postmenopausal 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. Talk with a women’s health specialist.

A specialist like an OB-GYN or certified nurse-midwife (CNM) 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:

Changes to your period

Period changes are usually the first signs of menopause. For example, your period may start to happen every 6-8 weeks. Or you may miss a couple months before it comes back again. You may also have a heavier flow or a lighter flow from time to time.

That said, it’s important to know you can still get pregnant during perimenopause. So, continue to use birth control in the lead up to menopause as you normally would. Also, if you’ve missed your period and you’re not sure whether perimenopause has started, consider taking a pregnancy test as a first step.

Mood changes

As your hormone levels change, you may find yourself feeling more irritable, anxious, sad or forgetful than usual. Your sex drive (libido) can also decrease or increase.

These changes are very typical as your body approaches menopause. So be kind to yourself, practice self-care and ask for help if you’re having trouble.

Sleeping problems (insomnia)

You may find it difficult to fall asleep, or you may wake up in the middle of the
. Sleep trouble can contribute to a persistent feeling of tiredness, which can also affect your mood.

The good news is that sleep issues like insomnia can be treated. Lifestyle changes such as cutting back on caffeine, limiting screen time before bed and exercise can be extremely helpful. There are over-the-counter medications and supplements like melatonin that can help – but ask your doctor for a recommendation before you start taking something. Sleep medicine is an option, too.

Ready to talk menopause? We’re here for you at any age and any stage.

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:

Hot flashes and chills

Hot flashes are sensations of heat that develop around your face, neck and chest, and may spread to other areas of your body. They usually last for just a few minutes.

Alongside the feeling of heat, your skin may redden, you may sweat, your heart rate might increase, and your mood may change. Afterward, you may feel chills.

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.

Weight gain

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, however. 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 dryness or sensitivity

Lower estrogen levels can also cause vaginal tissue to become dryer and thinner. This may result in discomfort or pain during sex.

Vaginal dryness or sensitivity usually happens after menopause, but it isn’t unusual to notice it earlier. A moisturizer or lubricant can often relieve these symptoms and help you feel more comfortable.

Pelvic floor muscle problems

Did you know that estrogen also helps support the sides of your bladder? Less estrogen can lead to weaker pelvic floor muscles. That’s why urinary incontinence and frequent urination can be common after menopause. Your doctor can help you identify the best treatment options to improve your symptoms, including lifestyle changes, pelvic floor therapy or medication.

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.

OB-GYNs and certified nurse-midwives, along with experienced nurse practitioners and other women’s health experts, can listen to your concerns and symptoms, and work with you to create a personalized care plan. Care options might include lifestyle changes, hormone replacement therapy (HRT), and supplements or medications.

Some menopause symptoms might be harder to talk about than others – but don’t wait. Women’s health specialists have heard it all, and they have the expertise needed to help you manage menopause symptoms. The sooner they know what’s bothering you, the sooner they can help you find the right way to manage your symptoms.

Ready to talk menopause? We’re here for you at any age and any stage.

Definition, Symptoms, Causes, Treatment, and Complications

Written by WebMD Editorial Contributors

Medically Reviewed by Poonam Sachdev on March 31, 2023

• What Is Menopause?
• Menopause Causes
• Menopause Symptoms
• What Happens During Menopause?
• What Conditions Cause Premature Menopause?
• What Doesn’t Cause Premature Menopause?
• How Long Do Symptoms of Menopause Last?
• Menopause Diagnosis
• Menopause Treatment
• Alternative and Complementary Menopause Treatments
• Menopause Complications
• More

Menopause is the end of your menstrual cycles. The term is sometimes used to describe the changes you go through just before or after you stop having your period, marking the end of your reproductive years. Menopause usually happens around age 50. 

Women are born with all of their eggs, which are stored in their ovaries. Their ovaries also make the hormones estrogen and progesterone, which control their period (menstruation) and the release of eggs (ovulation). Menopause happens when the ovaries no longer release an egg every month and menstruation stops.

Women are born with all of their eggs, which are stored in their ovaries. Their ovaries also make the hormones estrogen and progesterone, which control your period (menstruation) and the release of eggs (ovulation.) (Photo credit: Nerthuz/Dreamstime).

Menopause is a regular part of aging when it happens after the age of 40. But some women can go through menopause early. It can be the result of surgery, like if their ovaries are removed in a hysterectomy, or damage to their ovaries, such as from chemotherapy. If it happens before age 40, for any reason, it’s called premature menopause.

First signs of menopause

Most women nearing menopause will begin experiencing vasomotor symptoms (VMS). The most common is hot flashes. During a hot flash there is a sudden feeling of warmth that spreads over the upper body, often with blushing, a racing heart, and sweating. These flashes can range from mild in most women to severe in others.

You may also notice other symptoms of menopause such as:

• Uneven or missed periods
• Vaginal dryness
• Sore breasts
• Needing to pee more often
• Trouble sleeping
• Emotional changes
• Dry skin, eyes, or mouth

Symptoms of menopause

Other symptoms include:

• Fatigue
• Depression
• Crankiness
• Headaches
• Joint and muscle aches and pains
• Weight gain
• Hair loss
• Changes in libido (sex drive)

Natural menopause isn’t caused by any type of medical or surgical treatment. It’s slow and has three stages:

• Perimenopause. This phase usually begins several years before menopause, when your ovaries slowly make less estrogen. Perimenopause lasts until menopause, the point at which your ovaries stop releasing eggs. In the last 1 to 2 years of this stage, estrogen levels fall faster. Many women have menopause symptoms.
• Menopause. This is when it’s been a year since you had a period. Your ovaries have stopped releasing eggs and making most of their estrogen.
• Postmenopause. These are the years after menopause. Menopausal VMS such as hot flashes and night sweats usually ease. But health risks related to the loss of estrogen increase as you get older.

Your genes, some immune system disorders, or medical procedures can cause premature menopause. Other causes include:

• Premature ovarian failure (or primary ovarian insufficiency). When your ovaries prematurely stop releasing eggs, for unknown reasons, your levels of estrogen and progesterone change. When this happens before you’re 40, it’s called premature ovarian failure. Unlike premature menopause, premature ovarian failure isn’t always permanent.
• Induced menopause. This happens when your doctor takes out your ovaries for medical reasons, such as uterine cancer or endometriosis. It can also happen when radiation or chemotherapy damages your ovaries.

Some things you might think would influence menopause age, but don’t:

Hormonal birth control. Even if you’re using a birth control method that stops ovulation, it doesn’t stop your loss of follicles — the constant process of your ovary taking them from your resting pool of eggs. All of your follicles available that month die away, even if you’re not ovulating, so experts don’t think that birth control delays menopause.

Ethnicity. A study of premenopausal and early perimenopausal women found that race and ethnicity play no role in the age when you experience menopause. The Study of Women’s Health Across the Nation (SWAN) looked at women from different races from seven states and found they experienced menopause around the same age.

Menopause is different in each woman. In general, the symptoms of perimenopause last about 4 years.

You might suspect that you’re going into menopause. Or your doctor will say something, based on symptoms you’ve told them about.

You can keep track of your periods and chart them as they become uneven. The pattern will be another clue to your doctor that you’re perimenopausal or nearing menopause.

Your doctor might also test your blood for levels of:

• Follicle-stimulating hormone (FSH). This usually goes up as you near menopause.
• Estradiol. This tells your doctor how much estrogen your ovaries are making. This level will go down in menopause.
• Thyroid hormones. This shows problems with your thyroid gland, which can affect your period and cause symptoms that look like menopause.

Menopause is a natural process. Many symptoms will go away over time. But if they’re causing problems, treatments can help you feel better. Common ones include:

• Hormone replacement therapy (HRT). This is also called menopausal hormone therapy. You take medications to replace the hormones that your body isn’t making anymore. Certain drugs or combinations can help with hot flashes and vaginal symptoms, as well as making your bones stronger. But they can also put you at higher risk of health problems like heart disease or breast cancer, so you should take the lowest dose that works for the shortest time possible.
• Topical hormone therapy. This is an estrogen cream, insert, or gel that you put in your vagina to help with dryness.
• Nonhormone medications. The depression drug paroxetine (Brisdelle, Paxil) is FDA-approved to treat hot flashes. The nerve drug gabapentin (Gralise, Neuraptine, Neurontin) and the blood pressure drug clonidine (Catapres, Kapvay) might also ease them. Medicines called selective estrogen receptor modulators (SERMs) help your body use its estrogen to treat hot flashes and vaginal dryness.
• Medications for osteoporosis. You might take medicines or vitamin D supplements to help keep your bones strong.

Lifestyle changes

Lifestyle changes help many women deal with menopause symptoms. Try these steps:

• If you’re having a vasomotor symptom like hot flashes, drink cold water, sit or sleep near a fan, and dress in layers.
• Use an over-the-counter vaginal moisturizer or lubricant for dryness.
• Exercise regularly to sleep better and prevent conditions like heart disease, diabetes, and osteoporosis.
• Strengthen your pelvic floor muscles with Kegel exercises to prevent bladder leaks.
• Stay socially and mentally active to prevent memory problems.
• Don’t smoke. Tobacco might cause early menopause and increase hot flashes.
• Limit how much alcohol you drink, to lower your chance of getting breast cancer and help you sleep better.
• Eat a variety of foods and keep a healthy weight to help with hot flashes.
• Practice things like yoga, deep breathing, or massage to help you relax.

Menopause diet. What you eat might affect when you enter menopause, research suggests.

After tracking more than 35,000 British women for 4 years, researchers found that menopause tends to start earlier for those whose diets are heavy in refined carbs. In contrast, it seems to begin later for those who eat a lot of fish and legumes.

“In particular, a higher consumption of oily fish was found to delay the timing of natural menopause by approximately 3 years, and fresh legumes — such as peas and green beans — was linked to a later menopause by around a year,” said study author Yashvee Dunneram.

“On the other hand, a higher consumption of refined carbohydrates — such as pasta and rice — hastened the onset of menopause by 1.5 years,” said Dunneram.

“Refined carbs are one of the main culprits for insulin resistance. A high level of circulating insulin could interfere with sex hormone activity and boost estrogen levels, both of which might increase the number of menstrual cycles and deplete egg supply faster, thus causing an earlier menopause.”

As for those with a vegetarian diet, researchers found they experience menopause about a year earlier than meat eaters. The high-fiber and low-animal-fat content in some vegetarian meals has been linked to low estrogen levels.

But meat eaters who ate higher daily amounts of savory foods — such as potato chips, pretzels, and peanuts — experienced menopause about 2 years earlier than meat eaters who didn’t.

More research is needed to further understand the diet-menopause connection.

Some studies have found that soy products relieve hot flashes, but researchers are still looking into it. There aren’t many large studies on whether other supplements such as black cohosh or “bioidentical” hormones work for menopause symptoms. Talk to your doctor before starting any herbal or dietary supplements.

Yoga, tai chi, and acupuncture are safer ways to manage menopause symptoms.

The loss of estrogen linked with menopause is tied to the following health problems that become more common as women age.

After menopause, women are more likely to have:

• Bone loss (osteoporosis)
• Heart disease
• Bladder and bowels that don’t work like they should
• Higher risk of Alzheimer’s disease
• More wrinkles
• Poor muscle power and tone
• Weaker vision, such as from cataracts (clouding of the lens of the eye) and macular degeneration (breakdown of the tiny spot in the center of the retina that is the center of vision)

It can be tough to manage the sexual changes that come along with menopause, like vaginal dryness and a loss of sex drive. You might also find that you don’t enjoy sex as much and have trouble reaching orgasm. As long as it isn’t painful, regular sexual activity may help keep your vagina healthy by promoting blood flow.

Your ovaries have stopped sending out eggs once you’re in menopause, so you can’t get pregnant. But you can still get a sexually transmitted disease. Use safer sex practices if you’re not in a relationship with one person.

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[ii] United Nations, Department of Economic and Social Affairs, Population Division (2019). World Population Aging 2019: Highlights (ST/ESA/SER.A/430). https://www.un.org/en/development/desa/population/publications/pdf/ageing/WorldPopulationAgeing2019-Highlights.pdf

[iii] UNAIDS. The Gap Report 2014: People aged 50 years and older. Geneva, Switzerland. (2014). UNAIDS. https://www.unaids.org/sites/default/files/media_asset/12_Peopleaged50yearsandolder.pdf

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Key Facts

• Menopause is one of the stages in a woman’s life cycle that marks the end of reproductive age. After menopause, a woman cannot become pregnant except in rare cases when special fertility treatments are used.
• Most women experience menopause between the ages of 45 and 55 as a natural part of biological aging.
• Menopause occurs as a result of the decline in ovarian follicular function and a decrease in circulating estrogen levels.
• The menopausal transition can be gradual. It usually starts with changes in the menstrual cycle. “Perimenopause” means the period that begins with the onset of the first signs and ends one year after the last menstrual period.
• Perimenopause can last for several years, affecting physical, emotional, mental and social well-being.
• Symptoms of perimenopause can be alleviated with various non-hormonal and hormonal agents .
• Menopause may result from surgical or medical procedures.
  

How does menopause proceed?

For most women, menopause is associated with the cessation of monthly periods (also known as “periods”) due to the decline of ovarian follicular function. This means that the ovaries stop releasing eggs for fertilization.

The regularity and length of the menstrual cycle varies during a woman’s reproductive life, but the age of natural menopause for women worldwide is typically between 45 and 55 years of age.

Natural menopause is considered to occur after the absence of menses for 12 consecutive months without any other obvious physiological or pathological causes and in the absence of clinical intervention.

Some women experience menopause earlier (before age 40). This “premature menopause” may be due to certain chromosomal abnormalities, autoimmune disorders, or other unknown causes.

It is impossible to predict when a woman will go through menopause, although there are links between the age of menopause and several demographic, medical and genetic factors.

Menopause may also occur as a result of surgery to remove both ovaries or medical interventions that suppress ovarian function (eg, radiation therapy or chemotherapy).

Many women stop menstruating before menopause, such as those who have undergone certain surgeries (hysterectomy or surgical removal of the lining of the uterus) and those who take certain hormonal
contraceptives and other medicines that lead to infrequent or no periods. However, they may experience other changes associated with the menopausal transition.

Changes associated with menopause

Hormonal changes associated with menopause can affect physical, emotional, mental and social well-being. The symptoms experienced during and after the menopausal transition vary significantly from woman to woman. Some have symptoms
practically absent. Others may experience severe symptoms that can affect daily activities and quality of life. Some may experience symptoms for several years.

Symptoms associated with menopause include the following:

• hot flashes and night sweats. Hot flashes are sudden sensations of heat in the face, neck, and chest, often accompanied by reddening of the skin, sweating (sweating), rapid heart rate, and intense physical discomfort.
  which may last several minutes;
• changes in the regularity and course of the menstrual cycle, ending in the cessation of menstruation;
• vaginal dryness, pain during intercourse and urinary incontinence;
• difficulty sleeping/insomnia; and
• mood changes, depression and/or anxiety.

These changes may also affect the composition of body tissues and increase the risk of cardiovascular disease. The advantage of women over men in terms of the risk of developing cardiovascular diseases is gradually decreasing.
not with a significant drop in estrogen levels after menopause. Menopause can also lead to weakening of the pelvic floor structures, which increases the risk of pelvic organ prolapse. Loss of bone density during menopause is significant
a factor contributing to an increase in the incidence of osteoporosis and fractures.

There are a number of non-hormonal and hormonal agents that can help relieve menopausal symptoms. Symptoms that affect health and well-being should be discussed with a healthcare professional to determine available options
their relief, taking into account medical history, values ​​and preferences.

Pregnancy is still possible during perimenopause. To avoid unwanted pregnancy, it is recommended to use contraceptives for 12 consecutive months after the last menstrual period. Pregnancy after menopause without fertility treatment,
involving the use of donor eggs or previously frozen embryos is unlikely.

During perimenopause and after menopause, sexually transmitted infections (STIs), including HIV, can still be contracted through unprotected sex, including oral, anal, and vaginal sex. Thinning of the walls of the vagina after
menopause increases the chance of damage and ruptures, which increases the risk of HIV transmission through vaginal sex.

The importance of understanding menopause

It is very important to consider menopause as one of the life cycle stages. The state of health of a woman entering the perimenopausal period is largely determined by the previous state of health, reproductive history, lifestyle and factors
environment. Perimenopausal and postmenopausal symptoms can be devastating to personal and professional life, and the changes brought about by menopause impact a woman’s health as she ages. Therefore rendering
Perimenopausal health care plays an important role in promoting healthy aging and improving quality of life.

Menopause can be an important transitional period, both socially and biologically. Socially, how a woman experiences menopause can be influenced by gender norms, family and sociocultural factors, including how aging
women and the menopausal transition are accepted in her culture.

The global population of postmenopausal women is growing. In 2021, women aged 50 and over made up 26% of all women and girls in the world. This figure has increased from 22% 10 years earlier[i]. In addition, women’s life expectancy is longer
than in men. In 2019d. women aged 60 worldwide could expect to live an average of 21 more years[ii].

Menopause can be an important opportunity to reassess your health, lifestyle, and goals.

Menopause-related public health issues

Perimenopausal women need access to quality health care and to communities and systems that can support them. Unfortunately, awareness of and access to menopause services remains serious.
problem in most countries. Often, menopause-related issues are not discussed in families, communities, workplaces, and health care settings.

Women may not be aware that the symptoms they experience are associated with menopause and that there are counseling and treatment options available to help relieve discomfort. Women experiencing menopausal symptoms may feel uncomfortable
or shame that prevents them from drawing attention to their experiences and asking for support.

Health care providers may not be trained to recognize perimenopausal and postmenopausal symptoms and counsel patients about treatment options and health care after the menopausal transition. Currently in programs
The training of many medical professionals has given limited attention to the problem of menopause.

In many countries, the sexual well-being of menopausal women is neglected. This means that common gynecological effects of menopause, including vaginal dryness and pain during intercourse, may remain.
without attention. Similarly, older women may not consider themselves at risk of contracting sexually transmitted infections, including HIV[iii], and may not receive safe sex or testing advice from their doctors.

Many governments do not have the health policy and funding to include diagnostic, counseling and treatment services for menopause as part of routine services. Menopause services are
presents a particular challenge in the presence of other urgent and competing health financing priorities.

WHO activities

WHO believes that social, psychological and physical health support during the menopausal transition and after menopause should be an integral part of health care. WHO aims to improve understanding of menopause through
following events:

• raising awareness of menopause and its impact on women at the individual and community levels, as well as on the health and socioeconomic development of countries;
• advocacy for the inclusion of diagnostic, treatment and counseling services for menopausal symptoms in the universal health coverage package;
• Promoting the inclusion of menopause education and treatment options in pre-service training programs for health workers; and
• promoting a lifelong approach to health and well-being (including sexual health and well-being) by ensuring that women have access to relevant health information and services to promote healthy
  aging and a high quality of life before, during and after menopause.

Notes:

and self-identify as women), transgender men and some individuals who do not identify as either male or female are also going through menopause.

In this fact sheet, “women” are referred to according to available data, which usually does not specify gender identity. There is little data available on the experience of menopause among transsexuals and individuals with
gender identity. Transgender people and individuals with different gender identities have their own age-related health needs that clinicians should consider, including referral to specialized
services.

2) Although menopause is not a disease, in this fact sheet what women experience during perimenopause and postmenopause is
called symptoms because it can cause discomfort that affects quality of life.

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[i] United Nations, Department of Economic and Social Affairs. (2021) World Prospects 2021. https://population.un.org/wpp/Download/Standard/Population/

[ii] United Nations, Department of Economic and Social Affairs, Population Division (2019). World Population Aging 2019: Highlights (ST/ESA/SER.A/430). https://www.un.org/en/development/desa/population/publications/pdf/ageing/WorldPopulationAgeing2019-Highlights.pdf

[iii] UNAIDS. The Gap Report 2014: People aged 50 years and older. Geneva, Switzerland. (2014). UNAIDS. https://www.unaids.org/sites/default/files/media_asset/12_Peopleaged50yearsandolder.pdf

Women’s Health

Sexual and Reproductive Health and Research (English)

Aging

Sexual health

14 signs – harbingers of imminent menopause

Perimenopause – this is the name of this transitional period, when the reproductive function fades completely. This period can drag on for several years, pretty poisoning the life of a woman.

Menopause, also known as menopause, is a milestone in the life of every woman. It means that the reproductive phase of life is over. True, there are exceptions – even after the onset of menopause, a woman can still become pregnant, but this happens extremely rarely. And the so-called preparatory period precedes menopause – perimenopause.

What is it

Perimenopause begins a few years before menopause. The ovaries produce less and less estrogen and other hormones – more than 160 biologically active substances in total, the hormonal background changes. This usually happens after 40 years, but it also happens that ovarian function fades much earlier – about 30 years.

This transitional period lasts an average of 8-10 years, until the ovaries finally exhaust their resource – the ovarian reserve. It is laid genetically during prenatal development, and it cannot be influenced in any way.

And at the late stage of perimenopause, the amount of hormones produced by the ovaries drops to a minimum and they appear in a woman’s life – the symptoms of menopause. Officially, menopause occurs when 12 months have passed since the last menstruation. The active mechanism of aging starts.

Accelerated menopause

Menopause can come earlier than usual – this is influenced by many factors.

– The age of menopause is genetically programmed, but not only genetics is important.

Usually, a woman’s menopause occurs at about the same age at which it caught up with her mother and grandmother. However, there are other factors that provoke early menopause:

– Operations on the ovaries.

– Repeated unsuccessful IVF attempts with ovarian stimulation.

– Chemotherapy.

– Bad habits, in particular smoking.

Symptoms of perimenopause

There can be a lot of them, and they usually increase closer to the onset of menopause. Typical symptoms include the following:

Hot flashes – when waves of heat rush to the face, the heartbeat quickens, sweating increases;

– Soreness of the mammary glands;

– Premenstrual syndrome is more severe;

– Decreased sex drive;

– Constant fatigue;

– Irregular periods;

– Forgetfulness and difficulty concentrating;

– Pain in the muscles;

– Vaginal dryness, discomfort during sex;

– Urine leakage when coughing or sneezing, frequent urination;

– Mood swings;

– Sleep problems.

Completely eliminate these symptoms, unfortunately, is unlikely to succeed. But many can be stopped so that their impact on the quality of life is minimal. And one of the best ways to cope with them is physical activity. Which, by the way, also reduces the risk of osteoporosis, which after the onset of menopause becomes one of the main health problems.

“You should definitely visit a gynecologist: the doctor will conduct a gynecological examination, give a referral for a blood test for hormones and tumor markers. The main indicators of the approaching menopause are a reduced level of anti-Müllerian hormone and a high level of follicle-stimulating and luteinizing hormones. In addition, you will need to do an ultrasound of the pelvic organs, check the mammary glands and the condition of the cervix using colposcopy.

You can’t prescribe any medications on your own – doctors place a special emphasis on this. After all, only a doctor can choose the right means: someone will need vitamin complexes with phytoestrogens, and someone will need hormone replacement therapy.