What's happening, and when

What it is

Menopause is when periods stop for good because the ovaries stop making estrogen. It marks the end of the reproductive years, and it's confirmed once someone has gone 12 months without a period. The average age is 51.¹ It usually happens between 45 and 55, but it can come earlier.²

Perimenopause is the stretch of years before it. From the 30s and 40s, the estrogen the ovaries make starts to rise and fall unevenly.¹ That's why can feel unpredictable: hormones aren't simply falling, they're swinging.

Myth: Menopause is something that happens in your 50s.

Many of us only heard about as one event at the end. In fact estrogen starts to rise and fall unevenly in the 30s and 40s, years before periods stop.¹ Knowing that makes it easier to recognize what's happening.

Signs of perimenopause

The most common sign is a change in the cycle. Cycles may get longer or shorter, periods may be skipped, and bleeding may get lighter or heavier.¹ These changes are normal, but tell a doctor about them, because unusual bleeding can also be a sign of a problem.¹

Some people have few or no other symptoms; others have many, and they can be severe.¹ The next lesson covers them. Symptoms usually last 7 to 9 years, sometimes longer, and some, such as joint pain and vaginal dryness, can continue after .³

Early menopause

before 45 is called early menopause, and before 40, premature menopause.⁴ It's more likely if it runs in the family, and with an early first period, smoking or being underweight. Cancer treatment and surgery to remove the ovaries can also cause it.⁴ A later lesson covers it.

When to see a doctor

See a doctor if:³

you think you have symptoms and want to know your options
your bleeding pattern has changed and you're bleeding more, not less
you have a fast or pounding heartbeat
you've gone 12 months without a period and then have any bleeding, even spotting or brown discharge

How it compares in boys and men

Men don't go through . Their testosterone peaks around 18 and slowly declines from the 40s, rather than dropping over a few years.⁵

Recap

Menopause is confirmed after 12 months without a period. The average age is 51.
In perimenopause, estrogen rises and falls unevenly, and cycles get longer, shorter, heavier or lighter.
Symptoms usually last 7 to 9 years, and some continue after menopause.
Report big changes in bleeding, and any bleeding after 12 months without a period.
Men have no menopause, but testosterone slowly declines from the 40s.

Words to know 4

early menopause	Menopause before age 45.
menopause	When periods stop for good, confirmed after 12 months without one.
perimenopause	The years before menopause, when estrogen levels rise and fall unevenly and periods change.
postmenopause	The years after menopause.