When Does Menopause Start in Women? Understanding the Onset

Last updated 11.24.2023 | by Sabrina Johnson | 12 Minutes Read

This article has been reviewed and fact checked by Dr. Karen Pike, a senior physician administrator and board-certified emergency room doctor actively working in northern California. Read more at our medical disclaimer page.

The mean menopausal age for women in the United States is 51. Most women would experience it between 45 and 55. The majority of my friends went through menopause by the time they were 50. 

That’s how it is, though there are exceptions for early and premature menopause. That is a different thing, though. As I always say, menopause isn’t a one-day thing. You won’t wake up to menopause one fine morning. It happens eventually over some time, say, 4-5 years on average. 

It always urged me to know and understand the science behind menopause. What exactly happens to our body? Why do we experience so many symptoms? 

All these questions prompted me to research on this. What I came to understand is that the ovaries do not function as effectively as before when you reach your 40s. It releases fewer eggs. Simultaneously, the ovaries also do not make as much estrogen as they used to before. 

The estrogen goes through a rise-and-fall cycle until its numbers reduce drastically. If you’ve been wondering what’s causing the hot flashes, night sweats, and vaginal dryness, the answer is clear by now. It’s the hormones. 

There might be umpteen questions in your mind. Right? Like, what are the stages of menopause? How long do they last? What signs does your body go through then? It’s an unending list. I have tried my best to cover the answers to all your questions in this write-up. I have mentioned perimenopause and menopause alongside their duration. I have also highlighted the changes your body goes through then. Hope it will help.

The Onset of Menopause – The Transition Phase (Perimenopause)

The transition into menopause is long and happens over a considerable period. It prepares your body to enter menopause finally. No wonder perimenopause is alternately called around menopause.

Perimenopause has a similarity to puberty because both occur due to hormonal changes. The transition phase in both occurs over a long time.

The mean age for perimenopause is 40-44 years. Exceptions are there. Some women may enter into the perimenopause phase quite early, when in their 30s. While in some, it can begin quite late, in their mid-50s.

How Long Does the Transition Phase (Perimenopause) Last For?

On average, perimenopause, or the transition phase, doesn’t last for more than 4-5 years. But, it can last longer or for a short time as well. Some women experience perimenopause symptoms for 7-8 years before transitioning into menopause.

For those who experienced perimenopause in their 30s, the symptoms may last for 10-11 years. The same happened to a friend who got her first hot flash when she was 34. While in women who have had late perimenopause, the symptoms would last for just a few months. My sister began experiencing symptoms at 50 and went into menopause at 52. She just had a 2-year gap between the transition and the time she went into menopause.

If you have a 2-month gap between your periods or a little more than that, then it’s an indication that you are in late perimenopause. Menopause isn’t far away.

What Happens to Your Body in the Transition Phase?

Needless to say, all of the symptoms you experience or the changes your body goes through are due to the low estrogen levels.

The estrogen level of your body would transition from low to lower and lowest as the perimenopause phase progresses. The hormonal imbalance will be responsible for the various changes your body goes through during the transition to menopause.

  1. Irregular periods and inconsistent flow are one of the main signs of perimenopause. You might have very long or extremely short periods. The flow may vary as well, from very heavy to very light. Your next menstrual cycle can start seven days later or earlier than the previous one. If this is persistent, then it indicates that you are in the early perimenopause phase. When the gap between two periods is > 60 days, that means late perimenopause has set in.
  1. Because of the changing estrogen levels night sweats and hot flashes are quite common in perimenopause. Your sleep will surely be affected when you are sweaty, hot, and uncomfortable. The other day, I met a woman at the doctor’s office who said that she was going through repeated episodes of hot flashes- at least five days a week. That’s quite a number.
  1. Sleep disturbance is another grave concern faced by 40% of women on average in the perimenopause phase. Some studies have held night sweats responsible for insufficient sleep. This is something that bothered me immensely once I stepped into my mid-40s.
  1. Due to the fluctuating hormones, you may even experience vaginal dryness during the perimenopause stage. Besides the soreness and itchiness, you will also feel the need for increased urination.
  1. Don’t be surprised if you find yourself getting extremely cranky and irritated at the slightest instance. The hormones are to be blamed for making your mood go haywire. Plus, coping with physical problems is a tough thing indeed. When you aren’t able to sleep well at night because of the hot flashes, and night sweats, your mood goes for a toss.
  1. Breast pain in perimenopause is quite common mainly because of the fluctuating levels of the two hormones – estrogen and progesterone. It is mostly a burning sensation that you feel in your breasts or soreness. However, the nature of the pain varies from one woman to the other – it could be throbbing, stabbing, or sharp pain.

The list of changes your body goes through is endless. The ones mentioned above are some of the highlighting ones. Besides this, women may even have fertility problems, particularly when their periods keep getting irregular. So, when planning for a baby in your 40s, you’ve got to know that it wouldn’t be that easy. Then there are bone problems, fluctuating cholesterol levels, weight gain, etc. No, I don’t intend to scare you. All the changes I mentioned could happen due to the fluctuating and decreasing hormonal levels. But you won’t get all of these symptoms in a go. The severity and intensity differ from one woman to the other. A lot also depends on your lifestyle.

The End of Perimenopause and the Onset of Menopause

When you keep missing periods, and if the duration is for 12 months in a row, then it means that perimenopause has ended and menopause has begun.

What Happens to Your Body as Menopause Sets in?

When you enter into the menopause phase, it means the end of your menstrual cycle. You will not have your periods anymore since the ovary stops releasing eggs. They no longer produce estrogen in increased amounts like they would do before.

The symptoms of perimenopause will continue in menopause as well. However, in postmenopause, most of the symptoms would mellow down in severity. 

  1. Hot flashes don’t end the moment menopause begins. That’s a misconception. It’s a slow and gradual process taking anywhere between 6 and 24 months. However, new studies have a different set of data. As per them, hot flashes last for an average of 7 years and may prolong for 11 years as well.

It was also assessed through studies that women who were overweight, smoked or still smoked, or suffered from increased anxiety had hot flashes for a longer duration.

Ethnicity also played a role. Afro-American women experienced hot flashes for the longest time, more than 11 years. While Chinese and Japanese women experienced it for around 6 years.

  1. In most women, night sweats last for a couple of years after they’ve entered the menopause phase. The severity lessens with time. However, if you have night sweats too often, even after your menopause, it is better to consult a doctor. It might indicate an underlying medical condition.
  1. In menopause, the breast pain mostly goes away since the hormones do not fluctuate as much as they did before. However, if you’ve gone through hormone therapy in menopause, the breast pain will continue.  Do get in touch with a doctor if your breast pain persists and if you have a lump or nipple discharge.
  1. When the hormone fluctuations stop, your anxiety levels will also start decreasing. Yet, some women may continue to feel stressed after menopause. Practicing meditation may help in this regard.

Facts Associated with the Onset of Menopause

When you think of menopause, there must be umpteen questions coming to your mind. Like, if your mom’s early menopause means you too will follow suit. Or if too many kids can delay menopause, and so on. Let’s take a look at some of the interesting facts.

  1. How Do You Determine What Age You Will Reach Menopause?

Besides your physical fitness and overall well-being, genetic factors also play a significant role in determining your menopause age. If your mother, your sisters, or your close kin experienced their menopause too early or very late, you might also experience the same thing. A friend’s mother had menopause at 44, and she also followed suit.

  1. How Early is Too Early for Menopause?

Menopause before 40 is considered premature menopause. It occurs in approximately 1% of females who are less than 40 years of age. At the same time, 0.1% of the population aged 30 and below go through premature menopause.

Whereas women experiencing menopause between 40 and 44 years of age fall under the early menopause category. Around 5-7% of women go through early menopause.

Premature or early menopause may occur because of several reasons. These include surgery, chemotherapy or radiation, excessive smoking, and autoimmune diseases. Those who started their menstrual cycle before 11 years of age, or have a family history of early menopause, are even susceptible to premature or early menopause.

  1. Can Smoking Lead to Early Menopause?

A study showed that women who smoked were at risk of early menopause. However, the study did not deduce any relationship between early menopause, and passive smoking, or the consumption of coffee and alcohol.

  1. Can Having Too Many Children Lead to Delayed Menopause?

When you are pregnant, the ovulation and menstrual cycle pause. That’s why it is thought that too many pregnancies lead to delayed menopause. This is not a true claim, though.

A study conducted in Norway on 310147 women showed that women who had three childbirths were of the highest mean age during menopause – 51.36 years. Women who bore no children had the lowest mean age – 50.55 years.

  1. Does trauma affect the age of menopause?

Researchers found out that mothers who faced physical abuse in their childhood and whose child went through sexual abuse regularly reached menopausal age way too early by 8.78 years than mothers who didn’t face any trauma.  In fact, the reason for such occurrence has been attributed to chronic stress that impacts the hormone levels of the body. It even has a negative effect on the immune system. This is why massive stress and trauma make menopause occur early.

  1.  Does Early Menstruation Mean Early Menopause?

Well, if a woman has had her first menstruation at less than 11 years of age, then she could be at risk of premature or early menopause. Studies have also highlighted this aspect.

  1. Can the Length of the Menstrual Cycle Affect Menopause?

If a woman’s menstrual cycle occurs before 25 days, she could go through early menopause than women with regular cycles (26-34 days). This has been assessed through a study conducted on 634 women. They even had an increased frequency of menopause symptoms.

  1. Can You Save Yourself From Early Menopause If You Lead A Healthy Life?

Well, when you eat healthily and maintain a  proper lifestyle, you can save yourself from a lot of ailments. Yet, the connection between a healthy lifestyle and delayed menopause hasn’t been properly established.

However, a  British study that involved participants in the age group 40-65 years showed that consuming fresh legumes and oily fish helped to defer the onset of menopause by many years. Another study showed that having a diet rich in calcium and Vitamin D may save you from early menopause.


Q. What are the aftereffects of menopause?

Since estrogen levels are not as high as before, menopause could be the harbinger of several conditions in women. These include bone problems, cardiovascular disease, urinary tract infections, and so on. However, when you are careful about what you eat and your exercise regime, you’ll be able to manage most of the problems easily.

Q. How do you know that menopause has set in?

No periods for a year indicate that menopause has set in. Healthcare providers might advise urine or blood tests to check the levels of estradiol, luteinizing hormone, and follicle-stimulating hormone. This will help them to confirm menopause.


Once you’ve passed through this storm called menopause, the responsibility lies on you to take better care of yourself. Maintain a healthy lifestyle, and take care of your physical and psychological well-being. Besides this, get yourself checked regularly and screen yourself for cervical and breast cancer at regular intervals. Being cautious about your health will help you ward off several adversities.



  • Sabrina Johnson

    Meet Sabrina Johnson, a compassionate author and a seasoned expert in Obstetrics and Gynecology. She is a driving force behind Simply Menopause, where her extensive medical knowledge and empathetic nature come together to empower women in their menopausal journey. Sabrina offers culturally sensitive guidance and support through her approachable writing, making her a trusted friend on the path to menopause wellness.