Menopause occurs after a person stops having their period for 12 consecutive months. It naturally happens for many people when they are between the ages of 40 and 58. In the United States, the average age for menopause to start is 52 years.
Before menopause, declining estrogen levels can cause people who menstruate to experience premenopausal symptoms. Menstrual changes, hot flashes, vaginal dryness, sleep problems, and other symptoms are the result of hormonal shifts that are taking place during this time, which is called perimenopause.
While many people go through menopause in their early fifties, many unique factors determine at what age a person will start menopause, as well as what their experience will be like.
When Does Menopause Start?
There is a range of what is considered “typical” in terms of when menopause can start, and the symptoms and stages that each person experiences will be different. Here is what you might be able to expect at different ages and stages.
In Your 30s
Perimenopause and menopause do not generally start when you are in your thirties. However, after age 35, egg quality generally declines, and you may have a lower reserve of eggs. Fertility begins to decrease around age 32, then more rapidly at age 37. While this is not the start of menopause, it is the start of your body beginning to change.
At birth, a person with ovaries has around one million egg cells. By puberty, they have 300,000 to 500,000. By age 37, approximately 25,000 remain. Of these egg cells, ovulation will release only 300 to 400 eggs during a person’s lifetime.
Symptoms of premature menopause are the same as those that occur during menopause.
Some people go through menopause in their thirties. When this happens, it is known as premature menopause or primary ovarian insufficiency. Premature menopause is not common, occurring in only 1% of people under the age of 40.
During premature menopause you may experience:
- Irregular menstrual cycles leading up to your last period
- Hot flashes
- Vaginal dryness
- Irritability
- Breast tenderness
- Headaches
- Difficulty concentrating
- Weight gain
Premature menopause may have a medical cause, but it can also be spontaneous with no known cause. Some factors that can lead to premature menopause include:
If you experience any of these symptoms, it’s essential to talk to your doctor. Irregular periods, amenorrhea, and other menopause symptoms can also be signs of other health conditions, like hormonal problems, uterine problems, or an infection.
- Hysterectomy or removal of the ovaries
- Smoking
- Cancer treatments
- Family history
- Chromosomal abnormalities
- Autoimmune diseases
- HIV/AIDS
- Mumps
In Your 40s
In your forties, your fertility continues to decline. By age 40, only around 10% of people will achieve pregnancy per menstrual cycle. By age 45, fertility has declined so much that it is unlikely that you will get pregnant without assistance.
In addition, as a person ages, their remaining eggs are more likely to have abnormal chromosomes, which increases the risk of having a baby with chromosomal abnormalities. It also makes having multiples more likely.
Perimenopause most often begins in a person’s forties and can last anywhere from a couple of years to 10 years. The average age of perimenopause onset is 45. During perimenopause, estrogen declines, which can cause a variety of symptoms.
Symptoms of perimenopause may include:
- Periods that are irregular, heavier, or lighter than usual
- Hot flashes
- Vaginal dryness
- Mood changes
- Insomnia
- Urinary tract infections
- Constipation
- Irritability
- Dry skin
- Breast tenderness
- Worsening of PMS
- Headaches
- Changes in libido
- Difficulty concentrating
- Weight gain
- Hair loss
In Your 50s
The average age of menopause for people in the United States is 52. Menopause is defined as 12 concurrent months without having a menstrual cycle.
Until you have gone 12 months without having a period, it is still possible that you could ovulate.
People going through perimenopause may still get pregnant, so it is important to continue to use contraception if you do not wish to become pregnant.
In the time leading up to menopause (perimenopause), you may have irregular periods or skip periods entirely. However, if your periods resume, you have not yet entered menopause.
Once you have not had a period for an entire year, you can assume that you are no longer ovulating, and therefore no longer be able to become pregnant. The symptoms of menopause are the same as perimenopause, except that you no longer have a period.
Some people find that symptoms like hot flashes ease as they enter postmenopause—the period following 12 months without a menstrual cycle. However, some symptoms can become more pronounced postmenopause.
Irregular periods, heavy periods, light periods, skipped periods
Might still become pregnant
Average age is 45
Periods have been absent for more than 12 months
No longer ovulating, no longer able to become pregnant
Average age is 52
Postmenopausal symptoms can include:
- Continued hot flashes
- Vaginal dryness
- Urinary incontinence and urgency
- Irritability and mood swings
- Insomnia
- Difficulty concentrating
- Depression
- Headaches
What Affects the Age You Start Menopause?
Certain factors may affect when you begin menopause. Your family history, medical conditions, and hormones all play a role in when menopause is likely to occur for you.
Genetic Factors
Family history and genetic factors play a role in when you may begin menopause and may also predict which symptoms you will experience.
Smoking may influence the age of menopause onset. Studies have found that smoking during the reproductive years was significantly associated with earlier menopause.
A 2021 study in Menopause: The Journal of the North American Menopause Society found that the age at which people began menopause was affected by multiple genes.
Removal of the Ovaries
If you have surgery to remove your ovaries (oophorectomy), you will experience menopause immediately because the organs that produce hormones and release eggs are no longer present.
Conditions like endometriosis, tumors, and cancer may require a person to have their ovaries removed.
Menopause that occurs from the absence of ovaries is known as surgical menopause.
People who have an oophorectomy will experience typical menopause symptoms; however, rather than having them come on gradually as they would with natural menopause, they will experience them all at once, which can be intense.
Hormone replacement therapies can be used to treat menopause symptoms. However, hormone therapy is not recommended for people being treated for breast cancer, as it may increase the risk of recurrence.
Cancer Treatment
Radiation to the pelvic area can cause the ovaries to stop working, leading to sudden menopause. People who receive smaller doses of radiation may find that their ovaries begin to function again with time.
Chemotherapy can also damage the ovaries. Menopause can occur immediately or months later. The risk of menopause depends on the type of chemotherapy a person receives and the dose that is given. Sudden menopause from chemotherapy is less likely to occur in younger people.
Treatment options after medical menopause include hormone therapy, vaginal estrogen, antidepressants, lubricants, and medicine for bone loss. Getting exercise, enough sleep, and dressing in layers can also help manage symptoms.
Primary Ovarian Insufficiency
Primary ovarian insufficiency (POI) occurs when the ovaries have stopped working prematurely. POI is not the same as premature menopause; people with POI may still get occasional periods and may even become pregnant.
Most of the time, the cause of POI is unknown. Possible contributing factors may include:
- Genetic disordersA low number of folliclesAutoimmune diseasesMetabolic disordersExposure to toxinsChemotherapy and radiation treatment
Symptoms of POI are similar to those of natural menopause. Since it usually happens in younger people, infertility is the primary reason that someone with POI goes to their doctor.
There is no way to restore the ovaries’ function, but there are ways to treat the symptoms of POI.
POI treatment may include:
- Hormone replacement therapyCalcium and vitamin D supplementsIn vitro fertilization (IVF)ExerciseTreatment of associated conditions
Testing
Menopause is usually detected due to age and symptoms. Tracking your menstrual cycle and symptoms can help you and your healthcare provider identify if you are in any stage of menopause. Tell your healthcare provider about any menopause symptoms, such as hot flashes, breast tenderness, vaginal dryness, changes in periods, mood changes, or trouble sleeping.
Hormone Levels
While laboratory tests are not usually necessary to diagnose menopause, your doctor may test the number of hormones in your blood. This is especially true if your periods stopped at an early age (before 40) or there is a medical reason to do so.
Follicle-stimulating hormones (FSH levels): FSH is a protein made by the brain that tells the ovaries it’s time for ovulation. When menopause begins, the ovaries start to shut down and don’t respond to the stimulation. This causes the brain to send more FSH into the body. Blood levels of FSH will increase as a person’s ovaries begin to shut down. These levels fluctuate, so these tests may need to be tracked over time.
Estradiol levels: Estradiol is the main form of estrogen found in a person before menopause. Generally, blood levels fall after menopause. However, there are exceptions for people who take certain medications.
Bone Density Testing
Bone density tests do not indicate menopause. However, they are used to monitor and screen postmenopausal people for osteoporosis, which weakens the bones.
A Word From Verywell
While the average age of menopause is 52, there is a vast range of what is considered “normal” for when menopause could begin. For some people, menopause starts in their forties or even earlier; for others, it occurs well into their fifties.
If you aren’t sure whether the symptoms that you are experiencing are related to menopause or perimenopause, talk to your doctor. They will be able to rule out other conditions and confirm whether you are going through menopause. They will also be able to support you and help you cope with the symptoms of menopause.
Frequently Asked Questions
- How early can menopause start?
- The average age of menopause in the United States is 52. However, there is a wide range during which someone could begin menopause. The typical range is from age 40 to 58, but it may begin even earlier. When menopause occurs before age 40, it is referred to as primary ovarian insufficiency (POI).
- How do you know when menopause has started?
- Menopause is defined as 12 consecutive months without having a menstrual cycle. If you are currently not having periods, but it has not yet been 12 full months, you might be in menopause, but you cannot be sure until you have gone a full year without having a period.Some cancer treatments like chemotherapy and radiation can also lead to medical menopause, which can be temporary or permanent.
- At what age do menopause symptoms stop?
- The age at which menopause symptoms stop depends on how old you were when menopause began. Even then, it’s difficult to know because every person is different.On average, the symptoms of perimenopause last for four years before menopause begins, but for some, they last longer.
The average age of menopause in the United States is 52. However, there is a wide range during which someone could begin menopause. The typical range is from age 40 to 58, but it may begin even earlier. When menopause occurs before age 40, it is referred to as primary ovarian insufficiency (POI).
Menopause is defined as 12 consecutive months without having a menstrual cycle. If you are currently not having periods, but it has not yet been 12 full months, you might be in menopause, but you cannot be sure until you have gone a full year without having a period.
The age at which menopause symptoms stop depends on how old you were when menopause began. Even then, it’s difficult to know because every person is different.
