What is Menopause?

Historically, the term “menopause” has carried a notorious reputation, conjuring thoughts of hot flashes, mood swings, and an end to menstruation. In reality, menopause is a normal, transitional stage of life, one that every woman will eventually go through in their own, unique way.

“Menopause is not a disease, but rather a natural life stage,” confirms Dr. Alyssa Dweck, Chief Medical Officer at Bonafide. “Menopause is a universal experience. Every person born with ovaries will eventually experience menopause.” 

Fortunately, the more we learn about menopause, the less we fear it. In this article, we turned to our resident expert to detail the basics, so you can be more informed. Here we discuss— what menopause is, when menopause starts, and what we can expect.

Here’s what they had to say.

What is the Menopause Transition? 

According to the National Institute on Aging, the menopause transition leading into menopause refers to the stage in a woman’s life when her menstrual periods permanently stop.¹ A woman officially reaches menopause after 12 consecutive months without menstruation (with no other cause).²

Marking the end of the reproductive years, women can no longer become pregnant once entering menopause. Biologically, this means the ovaries stop releasing eggs each month for fertilization.³ This change also brings on a significant shift and decline of reproductive hormones, with changes in estrogen and progesterone being hallmark.⁴ 

These hormonal shifts are at the heart of some of the most common menopause symptoms, which can include:⁵

• Hot flashes
• Vaginal dryness
• Night sweats
• Trouble sleeping
• Changes in mood
• Brain fog

When Does Menopause Start?

Understanding what menopause is begs another important question— when do women go through menopause? 

Most women can expect to experience hormonal shifts and associated symptoms during their 40s and 50s (with some experiencing symptoms as early as their mid to late 30s), with 51 being noted as the average age of menopause in the United States.⁶ 

Unfortunately, no one can predict when exactly menopause will start. Demographics, lifestyle, health status, and genetics all can play a role in age of menopause onset, in addition to other variables, like if someone is a smoker or undergoing cancer treatments, which can potentially alter the menopause timeline as well.^7,8 

Once menopause symptoms begin, women have many tools to find relief along the way, assures Dr. Dweck.

“At the current time, menopause is not preventable,” says Dr. Dweck. “The symptoms that occur during menopause are manageable, however.”

What Is the Earliest Age Someone Can Enter Menopause?

While most women enter menopause in their 50s, it’s possible to experience menopause and its symptoms, much earlier.⁹ 

• Early menopause refers to menopause before age 45. It occurs in about 5% of women.
• Premature menopause refers to menopause before age 40. It occurs in about 1% of women. 

Experiencing menopause in your 20s is incredibly rare, but not unheard of, with about a 0.1% occurrence rate among women. Additionally, it’s possible for women to transition through menopause early due do certain cancer treatments, surgeries, and medical conditions as well.¹⁰ 

If you’re experiencing menopause symptoms and are in this younger age range, it’s best to seek out advice from your healthcare provider who can explore the root cause.

What is Perimenopause?

You might hear the terms used interchangeably, but “menopause” and “perimenopause” are actually different stages of this transitional period. 

Scientifically speaking, perimenopause includes the years before official menopause, spanning an average timeframe of three to four years; although this stage may last a few months or extend up to a decade, it depends on the person.¹¹ It may help to think of “perimenopause” as the journey leading up to menopause (marked by at least 12 months of no periods) and then, finally, postmenopause. The perimenopause journey may be difficult and varied in length depending upon the individual (i.e. a few months, several years or even a decade), but ultimately every woman will end up at the same destination— with the permanent end of menstruation, in postmenopause.¹² 

“Menopause is also not contagious,” stresses Dr. Dweck. “This life stage is not an illness, and it is not temporary. This natural life transition occurs when ovulation ceases and ovaries stop the production of specific hormones including estrogen and progesterone.”

The ebb and flow of estrogen and progesterone during perimenopause varies among women. But it’s common for menopause symptoms to peak during this time frame, especially in the last one to two years of perimenopause as the drop in estrogen speeds up.¹³ 

What is Postmenopause?

“Postmenopause” refers to the period of time following menopause.¹⁴ Once a woman enters postmenopause, she’ll remain in this stage for the rest of her life. 

While it’s possible to still experience lingering menopause symptoms into postmenopause (as they can last up to 7.4 years), specifically those that are more common during the transition, they’re typically milder during this stage.¹⁵ Often, they go away entirely…cue a collective sigh of relief.

According to Dr. Dweck, “Menopause is typically a diagnosis made in hindsight. Menopause, by definition, is a clinical diagnosis – in other words, when one has had no menses for 12 consecutive months, after the age of 40, with no other explanation, menopause has likely occurred, and they are considered to be menopausal.  In some cases, blood hormone tests are used to support this diagnosis”

While as mentioned, menopause symptoms typically dissipate during this time, postmenopause can be a period of increased risk for other health issues like osteoporosis, weight fluctuations, stroke, and heart disease.¹⁶ With careful monitoring, however, it’s possible to prevent and/or manage many postmenopause-related health issues.¹⁷

Facts Over Fear— You Don’t Have to Face Menopause Alone

Menopause is a naturally occurring stage of life for women. And when it comes to facing the changes ahead, knowledge is power. 

It’s important to understand the reasons behind menopause, common and uncommon menopause symptoms, and everything in between. If you suspect you’re experiencing symptoms of perimenopause or menopause, don’t hesitate to reach out to a healthcare professional for guidance or join a community of support. 

Navigating perimenopause and menopause along with other women experiencing similar changes can make a world of difference in how you experience this life transition. 

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Resources

1. https://www.nia.nih.gov/health/menopause/what-menopause

2. https://www.who.int/news-room/fact-sheets/detail/menopause 

3. https://www.who.int/news-room/fact-sheets/detail/menopause

4. https://www.nia.nih.gov/health/menopause/what-menopause

5. https://www.mayoclinic.org/diseases-conditions/menopause/symptoms-causes/syc-20353397

6. https://www.mayoclinic.org/diseases-conditions/menopause/symptoms-causes/syc-20353397

7. https://www.nia.nih.gov/health/menopause/what-menopause

8. https://www.who.int/news-room/fact-sheets/detail/menopause

9. https://my.clevelandclinic.org/health/diseases/21138-premature-and-early-menopause

10. https://my.clevelandclinic.org/health/diseases/21138-premature-and-early-menopause

11. https://www.health.harvard.edu/womens-health/perimenopause-rocky-road-to-menopause

12. https://www.health.harvard.edu/womens-health/perimenopause-rocky-road-to-menopause 

13. https://www.webmd.com/menopause/guide-perimenopause

14. https://www.medicalnewstoday.com/articles/postmenopause#overview

15. https://my.clevelandclinic.org/health/diseases/21837-postmenopause

16. https://www.medicalnewstoday.com/articles/postmenopause#long-term-impact

17. https://www.aafp.org/pubs/afp/issues/2008/0901/p583.html