When does menopause start? – Forbes Health

Menopause officially occurs when there is a cessation of ovarian hormone production, usually resulting in the absence of menstruation for a full calendar year. Once a person has officially entered menopause, they will no longer have periods and will no longer be able to get pregnant.

As hormones like estrogen, progesterone and testosterone begin to decline, many physiological, behavioral and psychosocial changes can take place, says Emily Anderson, a clinical nurse specialist in gerontology based in Minnesota. This transition period, known as perimenopause, typically results in “urogenital changes such as vaginal dryness and urinary incontinence, reduced bone density, vasomotor changes such as hot flashes and night sweats, decline cognitive and increased risk of ischemic heart disease,” says Andereson.

Perimenopause and menopause: what’s the difference?

Think of the years leading up to menopause as a time of transition, during which a person may experience certain changes in their body. It’s the perimenopause period, and it can last between four and eight years. Perimenopause usually begins with changes in the length of a person’s period and ends after 12 months of no period, signaling the onset of menopause.

“During this time, the ovaries begin to produce fewer hormones, which can lead to irregular menstrual cycles and symptoms of low estrogen,” Anderson says.

Although perimenopause and menopause can cause similar symptoms, the presence of even a late menstrual period during perimenopause is the main difference between them. “During perimenopause, fertility and conception are still possible, as the potential for ovulation remains,” says Anderson. “However, after a woman’s last menstrual period (signaling menopause), natural fertility and conception are no longer achievable.”

Perimenopause vs early menopause: what’s the difference?

Early menopause is menopause that occurs between the ages of 40 and 45. About 5% of people go through premature menopause naturally, and certain factors can cause this, such as smoking or certain medications or treatments, such as removal of the ovaries.

In early menopause, “menstrual cycles end prematurely due to ovarian or follicular dysfunction,” says Anderson. She notes that perimenopause may occur before early menopause, but that may not be the case. Some factors that can cause premature menopause include:

• Certain autoimmune diseases, such as thyroid disease or rheumatoid arthritis
• Certain genetic conditions, such as Turner syndrome
• Chronic fatigue syndrome
• Surgery to remove the ovaries
• Pelvic chemotherapy or radiotherapy
• Smoking
• A family history of early menopause

Although perimenopause may be the body’s way of preparing for menopause, early menopause occurs when menopause begins before the average age of onset.