Late reproductive years
- Typical age
- late 30s to early 40s
- What's happening
- Cycles still regular; subtle changes in flow and PMS; fertility declining
When Does Menopause Start? It Could Be Sooner Than You Think
Menopause is twelve months after your last period. In the US, the average age is 51 and most women reach it between 45 and 55. Perimenopause starts years earlier, usually in the mid-40s and sometimes in the late 30s, and runs for four to eight years.
Typical age for each stage.
Age mapWhat's happening
Cycles still regular; subtle changes in flow and PMS; fertility declining
Late reproductive years
Typical agelate 30s to early 40s
What's happeningCycles still regular; subtle changes in flow and PMS; fertility declining
Early perimenopause
Typical agemid-40s (range late 30s to late 40s)
What's happeningCycles vary by a week or more; sleep and mood changes; first hot flashes for some
Late perimenopause
Typical agelate 40s to early 50s
What's happeningGaps of 60 days or more between periods; hot flashes and night sweats peak
Menopause
Typical age51 on average (45–55)
What's happeningTwelve months without a period
Postmenopause
Typical agefrom then on
What's happeningSymptoms ease for most women over a few years; bone and heart protection matter
Six things worth knowing.
- In the US the average age of menopause, the point twelve months after your last period, is 51, and most women reach it between 45 and 55.
- Perimenopause starts years earlier, usually in the mid-40s and sometimes in the late 30s, and runs for four to eight years.
- Symptoms typically start between 40 and 47. The first signs are usually changes in your cycle (shorter, then longer and less predictable), worse sleep, new anxiety or irritability, and sometimes hot flashes.
- Menopause is diagnosed by the calendar: twelve consecutive months without a period.
- Family history is the biggest factor in when menopause starts.
- Menopause before 45 is called early menopause and affects about one woman in twenty. Before 40 it is called premature menopause or primary ovarian insufficiency and affects about one in a hundred.
The stages, by age
Early perimenopause
- Typical age
- mid-40s (range late 30s to late 40s)
- What's happening
- Cycles vary by a week or more; sleep and mood changes; first hot flashes for some
Late perimenopause
- Typical age
- late 40s to early 50s
- What's happening
- Gaps of 60 days or more between periods; hot flashes and night sweats peak
Menopause
- Typical age
- 51 on average (45–55)
- What's happening
- Twelve months without a period
Postmenopause
- Typical age
- from then on
- What's happening
- Symptoms ease for most women over a few years; bone and heart protection matter
What age does menopause start?
The average is 51 and the usual range is 45 to 55; genetics is the strongest predictor, so your mother's or older sister's age at menopause is a reasonable guide to your own.
Menopause before 45 is "early" and affects about one woman in twenty; before 40 it is "premature" (primary ovarian insufficiency) and affects about one in a hundred.
When do menopause symptoms start?
Usually between 40 and 47. The most common first signs are:
Cycle changes
Periods come a few days closer together, then start to space out and become unpredictable; flow can become heavier for a while before it lightens.
Sleep
Waking up in the night and lying awake is often the earliest sign, before any hot flash.
Mood and anxiety
New anxiety, irritability or low mood in a woman who has never been anxious, often tied to the week before a period. See hormones and anxiety.
Hot flashes and night sweats
For some women these come first; for many they arrive later in the transition.
Brain fog, joint aches, weight settling around the middle, lower libido, vaginal dryness
Common, and often not recognised as hormonal for years.
See our guide to the top six symptoms of perimenopause.
How do you know menopause has started?
By the calendar. Menopause is twelve consecutive months without a period. Until then, you are in perimenopause, which a clinician diagnoses from your age, your cycle pattern and your symptoms.
Blood tests are less useful than most women expect. FSH, the hormone often tested, swings from week to week in perimenopause, so a single "normal" result rules nothing out and a single high one proves little.
Testing is reserved for cases where the timing is unusual, such as symptoms before 40 or after a hysterectomy, or where another cause is suspected.
Our guide to hormone tests covers when testing is useful.
What makes menopause start earlier?
Family history
the biggest factor.
Smoking
brings menopause forward by one to two years on average.
Surgery
removing both ovaries causes menopause immediately; a hysterectomy that leaves the ovaries can bring it a little earlier.
Chemotherapy or pelvic radiation
can trigger it at any age, sometimes temporarily.
Some autoimmune and genetic conditions
Body weight, diet and stress have smaller effects than the factors above.
Early and premature menopause
Menopause before 45, and especially before 40, means more years without estrogen, which raises the long-term risk of bone loss and heart disease.
Early menopause
Menopause before 45 is called early menopause and affects about one woman in twenty.
Premature menopause
Before 40 it is called premature menopause or primary ovarian insufficiency and affects about one in a hundred.
Guidelines generally recommend hormone therapy for these women until at least the average age of menopause, unless there's a specific reason not to.
What to do if the signs fit
If you are in your 40s and recognise the first signs, you don't need to wait for a diagnosis or a blood test to get help; perimenopause is treated on symptoms.
Golden Leaf Health's care team treats perimenopause and menopause by video. The first visit covers your symptoms, history and goals. Book a first visit if you'd like to talk it through.
Questions, answered plainly.
When does menopause start?
In the US the average age of menopause, the point twelve months after your last period, is 51, and most women reach it between 45 and 55. The symptoms, though, start earlier: perimenopause usually begins in the mid-40s and sometimes in the late 30s, and runs for four to eight years before periods stop.
What age do menopause symptoms start?
Typically between 40 and 47. The first signs are usually changes in your cycle (shorter, then longer and less predictable), worse sleep, new anxiety or irritability, and sometimes hot flashes. Many women have symptoms for several years before anyone connects them to perimenopause.
How do you know menopause has started?
Menopause is diagnosed by the calendar: twelve consecutive months without a period. Before that point you are in perimenopause, which is diagnosed from your age and symptoms. Hormone blood tests are not reliable for timing it because levels swing from week to week.
What is early menopause?
Menopause before 45 is called early menopause and affects about one woman in twenty. Before 40 it is called premature menopause or primary ovarian insufficiency and affects about one in a hundred. Both deserve a medical review and usually treatment, because the years without estrogen carry bone and heart risks.
Can menopause start in your 30s?
Perimenopause can begin in the late 30s, and menopause itself occurs before 40 in about one woman in a hundred. If your periods become irregular or stop in your 30s, see a clinician: the causes range from thyroid problems and pregnancy to primary ovarian insufficiency, and all of them need checking.
Find out where you are in the transition.
A video visit with a clinician who treats perimenopause and menopause, in 33 states.
