How long does menopause last?

Menopause is a natural part of a woman's progression through her reproductive years. The early post-menopausal stage starts after the final menstrual period and lasts five to eight years. Late menopause starts after that stage ends and essentially lasts for the remaining years of a woman's life, according to the STRAW-10, Stages of Reproductive Aging Workshop criteria.

After a woman reaches the end of her fertile years, subtle changes occur in her menstrual flow, hormone levels, and symptoms develop that mark her entrance into perimenopause. Perimenopause usually occurs in a woman's forties or fifties but can also start as early as her thirties, which makes many women wonder how many years does menopause last?

Menopause occurs in three stages:

Perimenopause: This stage is also called the menopausal transition. Perimenopause can last eight to ten years before menopause, though the length of time can be variable. Perimenopause symptoms can be similar to those in menopause as hormones are in flux, less predictable and estrogen levels start to decrease. A woman may experience menstrual cycle irregularities, beginning with missed periods due to non-ovulatory cycles alternating with menstrual periods with heavy flow. Hot flashes and sleep disturbances may start. Breast tenderness, mood swings, or depression may occur. Vaginal dryness or increased urinary issues develop, and fertility and sex drive may also be affected.

Menopause: After 12 consecutive months of no menstrual cycles, a woman is considered to have officially reached menopause. However, she still needs to be examined to ensure that her periods have not stopped due to another medical reason, such as thyroid disease or even pregnancy. During menopause, her ovaries no longer release eggs nor produce hormones. If a woman has had her ovaries removed surgically, she will enter menopause immediately; otherwise, arriving at menopause is usually a gradual process. It is the final stage of the last several years and production of estrogen and progesterone dramatically declines.

Most women go through menopause between the ages of 45 and 55, while the average age is 51-52. If a woman goes through menopause before the age of 45, it is considered early menopause, and if she is under the age of 40, then it is called premature menopause.

The Menopause Rating Scale (MRS) lists the symptoms women experience that start in perimenopause and may increase or decrease during menopause.

  1. Hot flashes
  2. Heart discomfort or racing
  3. Sleep problems
  4. Mood changes or depression
  5. Irritability
  6. Anxiety
  7. Fatigue
  8. Sexual problems  
  9. Urinary problems
  10. Vaginal dryness due to decreased estrogen
  11. Musculoskeletal discomfort

Postmenopause: This is the period that begins right after that one-year mark of no menstrual cycles. Once a woman goes through menopause, she may feel she has made it through a tremendous journey, but the next question she often wants to know is, how long does post-menopause last?

A JAMA study found that menopausal vasomotor symptoms (VMS), which include hot flashes and night sweats, lasted a median total of 7.4 years. More than half of the women have symptoms that persisted for 4.5 years after their last menstrual period. In others, it lasted as long as ten years.

Increased risks of bone and cardiovascular problems occur during post-menopause. Women develop osteoporosis and are more likely to experience fractures. Without circulating estrogen, women have a greater risk of heart disease, cardiovascular disease, and stroke. There is an increase in heart attacks among women about ten years after menopause, according to the American Heart Association (AHA).

What affects the length of menopause?

Menopause can last several years, and while the length of each stage depends on many variables, some are not in a woman's control though there are some exceptions to the rule.

Genetics: Depending on when a woman's mother or sister went through menopause will influence when she will.

Smoking: Tobacco use is not only bad for your lungs but bad for your ovaries. Studies have shown that current smokers go through menopause earlier than average.

Obesity: While being overweight does not make a woman go through menopause sooner, in one Brazilian study, obese women suffered more severe hot flashes, interruptions with sleep, work, sexual activity, and leisure time.    

Ethnicity: Race has not been found to be a consistent predictor of when a woman will go through menopause. Findings that Japanese American women go through menopause later than Black women who reach menopause earlier may be influenced by socio-economics, lifestyle, and other health practices reported the AHA.

Premature or early menopause: Entering menopause in one's thirties or early forties is unexpected and can be very disappointing for those who intended to have children. Early menopause, between the ages of 40 and 45, affects about 7.3 % of women. Premature menopause, before age 40, affects about 2 % of women, according to the AHA.

Early menopause can be difficult to distinguish from primary ovarian insufficiency (POI). Women with POI can continue to ovulate infrequently. Women who go through early menopause may have had regular periods and then stop ovulating unexpectedly.

Chemotherapy and Radiation: Cancer treatments can damage ovaries even though necessary to save a woman's life.

Are there ways to make menopause last shorter? 

There is no method to shorten menopause; there are only techniques to make symptoms less intrusive on a woman's quality of life. Some interventions are lifestyle changes like an improved diet, weight reduction, quitting smoking, increasing exercise, and practicing stress reduction. A more committed choice involves taking hormone replacement therapy (HRT), which has risks and benefits that should be evaluated by your primary healthcare provider.

Why do some women hardly notice menopause symptoms while others have horrible experiences that last for a very long time?

Menopause is a personal experience. No two women go through menopause the same way or for the same number of years. It is important to focus on the fact that these changes are normal and natural. Most women experience them to some extent.

It is difficult to predict what it will be like for every woman. 

Some women's response depends on what they do to reduce the most common symptoms of menopause to keep them from escalating. For example, always dressing in layers so that a woman can remove an outer layer if she feels a hot flash coming on or setting up a fan at the bedside to turn on if needed in the middle of the night. 

For others, it is their attitude and involvement in other areas of their life that draws their attention away from the discomforts of menopause. They try to focus on the activities around them that make them feel happy.