It’s a perfectly reasonable question that is unfortunately really hard to answer. However, there are signs that can help a woman get an idea of where her body is in the journey and behaviors that can influence the onset of menopause, so read on ….

The average age for onset of menopause (12 months without a period) is 51 in the United States. But every woman’s experience of menopause is as unique as she is, so she may be fully menopausal in her late-40s or mid-50s, or still regular in her late-50s!

There are a lot of factors that impact when a woman begins the transition to her menopausal body, and we’ll look into what they are and how you can get a sense of what your body is doing.

How does a woman know she’s starting menopause?

For many women, the transitional period before menopause (called “perimenopause”) can start as early as her mid-30s. Many women start noticing symptoms in their early 40s.

Often the first sign a woman notices is an irregularity in her periods. Where once it was every 28 days, lasted for five, had a pretty consistent flow pattern, etc., now it’s a little more frequent, longer, and heavier, or a little less frequent, shorter, and lighter, or some combination of any of these.

Skipped months happen as well, but note: it is possible to get pregnant during perimenopause, so if you want to avoid pregnancy, use contraception until you’ve gone a full 12 months without a period.

Other early symptoms may include night sweats/hot flashes, vaginal dryness, interrupted sleep, and mood swings, according to the North American Menopause Society.

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How long does perimenopause last?

If you type this question into an Internet search engine, you’ll probably find several sources claiming the “average” for perimenopause is four years.

We haven’t really found that to be the case. It may be that women coming to genneve for help are suffering more and have been suffering longer, but we find perimenopause of eight to ten years is not unusual.

And unfortunately, the symptoms don’t necessarily end with the last period. Hot flashes, vaginal issues such as dryness and frequent urinary tract infections, incontinence, poor sleep and other symptoms can carry on for years after.

What causes menopause?

Menopause is a completely natural process that every woman eventually experiences. It happens when the body is running low on viable eggs.

Women are born with all their eggs already in place – somewhere between 1-3 million of them. As she matures and ages, eggs are lost to ovulation or die off normally. As her egg reserve gets low (perhaps as low as 10,000 or fewer at menopause), her body produces less estrogen, triggering the process known as perimenopause.

What age will I start menopause?

What most women are probably asking when they ask this question is, “At what age will I start perimenopause?” since that’s actually when noticeable symptoms arise for most of us.

It’s pretty much impossible to tell a woman when her menopause will occur – unless menopause is the result of a medical intervention such as breast cancer treatment or hysterectomy.

However, there are factors that may help her understand her body better. According to an article in the National Center for Biotechnology Information (NCBI), the following may have some impact on when a woman begins her menopause transition.

  1. Genetics. This is probably one of the biggest determining factors for menopause that occurs naturally (rather than as the result of surgery or other external factors). For many women, the age your mother or other female blood relatives (aunts, sisters) was at menopause is a reasonable indicator of the age you’ll be (ish). However, other factors may serve to alter a woman’s genetic start and end date.
  2. Age at first period. If you started menstruating early, you may also enter menopause earlier.
  3. Pregnancies. Women who have never been pregnant or never completed a pregnancy past 20 weeks may enter menopause sooner. Alternatively, women who have had multiple pregnancies past 20 weeks may delay menopause.
  4. Birth control, age at first pregnancy. Taking the Pill (or other oral birth control) may delay menopause, as can having a “later” first pregnancy.
  5. One ovary. A unilateral oophorectomy (one ovary removed, one remaining) may prompt earlier menopause.
  6. Lifestyle factors. Smoking, lower socioeconomic status, and less formal education may all play a role in causing a woman to enter menopause sooner.

While getting to the “not having periods” part of life may sound attractive, there are health risks associated with menopause, mainly because we lose the protective benefits of estrogen on our brains, bones, hearts, and more.

If you’re still unsure where you are in the menopause transition, the best way to learn more about your body is to talk with an experienced, menopause specialist ob/gyn. Describe your symptoms, share your period tracker, talk about lifestyle and behavior.

You probably don’t need to bother having hormone levels tested – they shift so much during perimenopause that a quick snapshot will only tell you where levels are now, which may not be where they are tomorrow or even an hour from now. If you’re on hormonal birth control, you will likely need to come off it – possibly for a few months – to see where your body truly is.

Yes, it can be hard to pinpoint where your body is in the menopause transition, but that doesn’t mean you’re being unreasonable to want to know! Your future health depends to a very real extent on decisions you make now, and the more information you have, the more informed your decisions can be.

So make an appointment with a menopause specialist. Find out beforehand what kinds of questions you should be ready to answer. If you need to find a menopause specialist, you can book an appointment with genneve’s telemedicine service or refer to NAMS’ Find a Menopause Practitioner.

The more women we speak with, the more we discover that so many of us were really not prepared for perimenopause: so many symptoms, often quite severe, and they started earlier than we expected! There’s a reason few of us have heard the word “perimenopause” – because we don’t discuss it. We’d like to challenge everyone reading this article to share it. Let’s open up the conversation so no woman is left frightened and confused by the natural course her body is taking. Come talk with us (and invite other women!) in our community forums, on our Facebook page, or in Midlife & Menopause Solutions, our closed Facebook group (open to anyone who is experiencing or will experience menopause.)


Shannon Perry

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