Many women are caught off guard by the menopause, because the changes often begin years before periods actually stop. Knowing when menopause usually starts, and what the first signs look like, helps you recognise what is happening and get support sooner.
This guide explains the typical age of menopause, the early signs of perimenopause, what can make menopause start earlier, and when to see your GP.
When does menopause usually start?
In the UK, the average age of menopause is 51, and most women reach it between 45 and 55. Menopause itself is defined as the point when you have not had a period for 12 months in a row.
The lead-up, called perimenopause, usually begins in the mid-40s, although it can start in the late 30s. It lasts around four years on average, and this is when most symptoms first appear.
The first signs of perimenopause
- Changes to your periods: cycles becoming shorter or longer, heavier or lighter, or skipped
- Hot flushes and night sweats
- Poor sleep, often linked to night sweats
- Low mood, anxiety and irritability
- Brain fog and difficulty concentrating
- Joint aches and muscle stiffness
- Vaginal dryness and lower sex drive
- Headaches and heart palpitations in some women
Not every woman has every symptom, and some have very few. Changes in periods are often the first sign.
What can make menopause start earlier?
- Genes: women often reach menopause at a similar age to their mother
- Smoking: linked to menopause starting a year or two earlier
- Surgery to remove the ovaries, which brings on menopause straight away
- Cancer treatments such as chemotherapy or radiotherapy to the pelvis
- Some medical conditions, including some autoimmune conditions
Early menopause and premature ovarian insufficiency
Menopause before 45 is called early menopause. Menopause before 40 is called premature ovarian insufficiency and affects around 1 in 100 women. Both are important to discuss with your GP, because hormone treatment is usually recommended until the average age of menopause to protect bone and heart health.
How is perimenopause diagnosed?
For women over 45 with typical symptoms, NICE guidance says perimenopause and menopause can usually be diagnosed from symptoms alone, without blood tests, because hormone levels fluctuate from day to day. Blood tests may be used for women under 45, or when the picture is unclear.
Can you get pregnant during perimenopause?
Yes. You still need contraception until you have gone 12 months without a period if you are over 50, or two years if you are under 50.
When to see your GP
- Symptoms are affecting your sleep, work, mood or relationships
- Your periods stop or become very irregular before 45
- You have very heavy bleeding or bleeding between periods
- Any bleeding after menopause, which should always be checked promptly
- You would like to discuss HRT or other treatments
Frequently asked questions
What are the first signs of menopause starting?
Changes to your periods are often the first sign, followed by hot flushes, night sweats, poor sleep and mood changes.
Can menopause start at 40?
Yes. Perimenopause can begin in the late 30s or early 40s. Menopause before 45 is called early menopause and should be discussed with your GP.
How do I know if I am in perimenopause?
Irregular periods together with symptoms such as hot flushes, night sweats or mood changes in your 40s are typical. Your GP can confirm it.
Does menopause start suddenly?
Usually not. It is gradual over several years, except after surgery to remove the ovaries or some cancer treatments.
Menopause support in Chiswick
Omnia Lifestyle supports women through perimenopause and menopause alongside their GP, at our clinic in Chiswick, W4, close to Turnham Green station, on bus routes 94, E3 and 272. Limited parking is available on request when booking.
Read more about menopause symptoms, see how long menopause lasts and whether HRT causes weight gain, explore acupuncture, or book an appointment.
This article is general information, not medical advice. If you have bleeding after menopause or other concerns, see your GP.
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