Most people with female anatomy begin perimenopause between the ages of 45 and 55. After going 1 year without a period, you have reached menopause and enter postmenopause, which lasts the rest of your life.
Many people refer collectively to the stage of life when female reproduction comes to an end as “menopause.”
But this natural part of life has three stages associated with it: perimenopause, menopause, and postmenopause.
Healthline aims to bolster the discourse around menopause, which is why we recently asked Shilpa Amin, MD, CAQ, FAAFP, about distinguishing these stages from one another.
The onset of or transition into menopause is called “perimenopause“. Most people begin perimenopause between the ages of 45 and 55. The time of perimenopause may vary if you:
- have a family history of early menopause
- are or were a smoker
- have had gynecological surgery (hysterectomy or oophorectomy)
- have undergone cancer treatments
Perimenopause may last as little as a few months to up to 8 years — or 6 years on average. How long you’re in it may vary with:
- genetics
- race
- ethnicity
- culture
- lifestyle
- environment
Once your periods have stopped for 12 consecutive months (your ovaries no longer produce estrogen and cease releasing eggs), you have reached menopause.
The average age for reaching menopause in the U.S. is 52. Depending on your personal and family health history, you may reach menopause before or after this age.
While in perimenopause, you may observe heavy or light bleeding during periods or spotting between cycles. Your periods will be irregular and infrequent.
Perimenopause may also be associated with any combination, severity, and frequency of the following symptoms:
- hot flashes
- night sweats
- difficulty sleeping
- joint and muscle discomfort
- painful sex
- genitourinary syndrome of menopause
- vaginal dryness, burning, or itching
- mood changes
- forgetfulness
- irritability
- difficulty concentrating
Menstrual changes and symptoms correlate with fluctuations in the levels of the sex hormones estrogen and progesterone.
These hormones begin to decline once the menopausal transition starts and more rapidly decline closer to menopause.
You reach menopause after 12 consecutive months without a period. Then you enter postmenopause.
Menopause marks the end of your reproductive years. From this point on, you’re in postmenopause, which lasts the rest of your life.
Symptoms of perimenopause may continue during this time. The risk of the following health complications is higher:
- heart disease
- low bone density (osteopenia, osteoporosis)
- falls
- genitourinary infections
- mental health issues
- mood issues
What other changes can I expect during menopause?
Your metabolism also changes with this decline in hormones, which is associated with:
- changes in heart health
- weight gain, increased abdominal fat, and other body composition changes
- decreased bone density
You’ve officially reached menopause after going a full year without a period. The stage leading up to this moment is called “perimenopause,” and the stage that follows it is called “postmenopause.”
How long you’ll spend in perimenopause varies for everyone and is dependent upon many factors. Some people might also experience symptoms of perimenopause in postmenopause.
As you approach menopause, it’s more important than ever to take charge of your health. Speak with your doctor or a Menopause Society Certified Practitioner about how you can keep your bones, heart, and mind functioning at their best.