Whether you just had your first hot flash or you’ve been living with annoying symptoms for years, you probably have one question: When will menopause end?
The short answer is that menopause-like symptoms often last for several years, with perimenopause symptoms typically starting in your 40s. Perimenopause is often called the opening act, as these years are marked by all the classic symptoms that signal menopause is coming, like irregular periods, mood swings and hot flashes. But even when you officially reach menopause, these symptoms can continue into your post-menopause years.
The good news is that there are signs that can help you know that you’re finished with menopause. Learn what they are, post-menopause symptoms you can expect and how to stay comfortable as you make the transition.
The key sign that menopause is over: 12 months without a period
While that opening perimenopause act can last several years, menopause is a moment in time. For those who haven’t had a hysterectomy, menopause is “over” when you’ve gone 12 consecutive months without a period, which is typically around age 51.
Twelve consecutive months may seem like a long time, but it’s for good reason. As your hormones change in preparation for menopause, your periods may become increasingly irregular. Sometimes, that can mean shorter cycles. But as you get closer to menopause, longer cycles can become more common, so 12 months is long enough to rule out these irregular cycle lengths.
Perimenopause can last 4-8 years on average
Perimenopause symptoms usually begin about 8-10 years before menopause, though some women may start experiencing symptoms more than 10 years before menopause. The first sign you’re in perimenopause is usually irregular periods. This means that you may skip a period one month, start spotting between periods or notice other changes in your cycle.
Other symptoms, like mood swings and hot flashes, tend to occur gradually and increase over time. And just as perimenopause symptoms can vary for each person, so can how long they last. On average, you can expect to spend a few years in perimenopause.
When do menopause symptoms stop?
Most symptoms of menopause are due to decreased estrogen levels in your body, which naturally drop as you age and go through perimenopause, menopause and even post-menopause. So unfortunately, there’s no exact moment that menopause symptoms stop, and some women may always experience certain symptoms. But they do decline over time and eventually stop in most women (though probably not as soon as you’d like).
If you’ve had a hysterectomy, how do you know if menopause is over?
When you have a hysterectomy to remove your uterus, your periods stop. So, how can you tell if you’ve actually reached menopause? That often depends on whether your ovaries are also removed (oophorectomy) during your hysterectomy:
- If your ovaries are not removed, your hysterectomy shouldn’t affect your natural progression and transition into menopause. Specifically, you won’t begin experiencing menopause symptoms any earlier as a result. But since you won’t have the gradual ending of your period as a sign, you’ll need to rely on any changes in symptoms to know if you’re reaching menopause. (Keep reading to learn more about common signs of post-menopause.)
- If your ovaries are removed during your hysterectomy, you will begin experiencing perimenopause symptoms soon after surgery and may reach menopause earlier. That’s because the ovaries are the primary producers of estrogen, so removing them causes an immediate and permanent hormonal change.
Post-menopause symptoms to expect
Once you officially reach menopause, you may find that some familiar symptoms from perimenopause are stronger or less intense than others, and there may be some that you no longer notice at all.
Some of this variation may be due to genetics, but symptoms can be made worse by certain risk factors, such as smoking, drinking alcohol, being overweight, being inactive or having high stress.
Remember that while the symptoms you’re experiencing might be annoying or uncomfortable, they’re normal and even common. Also, there are self-care and lifestyle changes that can help manage your symptoms, and your doctor is there to support you with hormonal and nonhormonal treatments through every stage of menopause.
Hot flashes may continue, but will gradually decrease
Hot flashes tend to continue after menopause. On average, they last for around 1-6 years post-menopause, but a smaller number of women may have them for up to 15 years.
Vaginal and urinary discomfort can increase after menopause
Estrogen plays a big role in maintaining the health of the vagina and urinary tract. As estrogen levels decrease, women can experience an increase in urinary frequency or urges to use the restroom, as well as incontinence.
There are two types of incontinence: Stress incontinence and urge incontinence. Stress incontinence is the loss of bladder control when you laugh, cough, sneeze or lift things. Urge incontinence is the overwhelming urge to pee, which can result in loss of bladder control.
Decreasing estrogen also causes vaginal tissue to become thinner and drier. This can lead to itching and irritation, as well as pain during sex.
Urinary tract infections (UTIs) are also more common
The loss of estrogen also has an effect on the vagina’s pH, which helps control bacteria. This means that after menopause, it becomes easier to get UTIs.
Decreased libido is a normal response to other changes you’re experiencing
Some people find that they have less desire for sex during perimenopause and after menopause.
Sleep issues can continue in post-menopause
It may be harder to sleep well post-menopause for a variety of reasons. Symptoms like hot flashes and mood changes play a role, and may intensify any stress you’re feeling in other areas of your life. Also, Sleep disorders like sleep apnea and restless legs syndrome can become more of a factor post-menopause, so it’s important to stay on top of your symptoms.
Mood changes, both big and small, may happen
Menopause is associated with a variety of mood changes, including a higher risk of anxiety and depression, but the reason for this isn’t totally clear. Estrogen does have an effect on mood, but changes in how you’re feeling could also be a result of all the other changes you may be going through.
Navigating post-menopause with support and healthy lifestyle choices
Because the timeline of menopause is different for each person, it’s helpful to understand that even when you reach post-menopause, you’ll likely still experience symptoms. But the good news is that there are many options available to help make post-menopause more comfortable.
No matter if your symptoms are mild or severe, your primary care doctor or clinician, OB-GYN or midwife can assess your individual health needs and recommend personalized treatments, along with lifestyle changes to complement them. HealthPartners has many doctors and clinicians who are Menopause Society Certified Practitioners and can help you navigate this time of your life.
