What Is the Average Age for Menopause to Start?

Menopause occurs after a person stops having their period for 12 consecutive months. It naturally happens for many people when they are between the ages of 40 and 58. In the United States, the average age for menopause to start is 52 years.

Before menopause, declining estrogen levels can cause people who menstruate to experience premenopausal symptoms. Menstrual changes, hot flashes, vaginal dryness, sleep problems, and other symptoms are the result of hormonal shifts that are taking place during this time, which is called perimenopause.

While many people go through menopause in their early fifties, many unique factors determine at what age a person will start menopause, as well as what their experience will be like.

When Does Menopause Start?

There is a range of what is considered “typical” in terms of when menopause can start, and the symptoms and stages that each person experiences will be different. Here is what you might be able to expect at different ages and stages.

In Your 30s

Perimenopause and menopause do not generally start when you are in your thirties. However, after age 35, egg quality generally declines, and you may have a lower reserve of eggs. Fertility begins to decrease around age 32, then more rapidly at age 37. While this is not the start of menopause, it is the start of your body beginning to change.

At birth, a person with ovaries has around one million egg cells. By puberty, they have 300,000 to 500,000. By age 37, approximately 25,000 remain. Of these egg cells, ovulation will release only 300 to 400 eggs during a person’s lifetime.

Symptoms of premature menopause are the same as those that occur during menopause.

During premature menopause you may experience:

• Irregular menstrual cycles leading up to your last period
• Hot flashes
• Vaginal dryness
• Irritability
• Breast tenderness
• Headaches
• Difficulty concentrating
• Weight gain

Premature menopause may have a medical cause, but it can also be spontaneous with no known cause. Some factors that can lead to premature menopause include:

• Hysterectomy or removal of the ovaries
• Smoking
• Cancer treatments
• Family history
• Chromosomal abnormalities
• Autoimmune diseases
• HIV/AIDS
• Mumps

In Your 40s

In your forties, your fertility continues to decline. By age 40, only around 10% of people will achieve pregnancy per menstrual cycle. By age 45, fertility has declined so much that it is unlikely that you will get pregnant without assistance.

In addition, as a person ages, their remaining eggs are more likely to have abnormal chromosomes, which increases the risk of having a baby with chromosomal abnormalities. It also makes having multiples more likely.

Perimenopause most often begins in a person’s forties and can last anywhere from a couple of years to 10 years. The average age of perimenopause onset is 45. During perimenopause, estrogen declines, which can cause a variety of symptoms.

Symptoms of perimenopause may include:

• Periods that are irregular, heavier, or lighter than usual
• Hot flashes
• Vaginal dryness
• Mood changes
• Insomnia
• Urinary tract infections
• Constipation
• Irritability
• Dry skin
• Breast tenderness
• Worsening of PMS
• Headaches
• Changes in libido
• Difficulty concentrating
• Weight gain
• Hair loss

In Your 50s

The average age of menopause for people in the United States is 52. Menopause is defined as 12 concurrent months without having a menstrual cycle.

In the time leading up to menopause (perimenopause), you may have irregular periods or skip periods entirely. However, if your periods resume, you have not yet entered menopause. 

Once you have not had a period for an entire year, you can assume that you are no longer ovulating, and therefore no longer be able to become pregnant. The symptoms of menopause are the same as perimenopause, except that you no longer have a period. 

Some people find that symptoms like hot flashes ease as they enter postmenopause—the period following 12 months without a menstrual cycle. However, some symptoms can become more pronounced postmenopause.

Postmenopausal symptoms can include:

• Continued hot flashes
• Vaginal dryness
• Urinary incontinence and urgency
• Irritability and mood swings
• Insomnia
• Difficulty concentrating
• Depression
• Headaches

What Affects the Age You Start Menopause?

Certain factors may affect when you begin menopause. Your family history, medical conditions, and hormones all play a role in when menopause is likely to occur for you.

Genetic Factors

Family history and genetic factors play a role in when you may begin menopause and may also predict which symptoms you will experience.

A 2021 study in Menopause: The Journal of the North American Menopause Society found that the age at which people began menopause was affected by multiple genes.

Removal of the Ovaries

If you have surgery to remove your ovaries (oophorectomy), you will experience menopause immediately because the organs that produce hormones and release eggs are no longer present.

Conditions like endometriosis, tumors, and cancer may require a person to have their ovaries removed.

People who have an oophorectomy will experience typical menopause symptoms; however, rather than having them come on gradually as they would with natural menopause, they will experience them all at once, which can be intense.

Hormone replacement therapies can be used to treat menopause symptoms. However, hormone therapy is not recommended for people being treated for breast cancer, as it may increase the risk of recurrence.

Cancer Treatment

Radiation to the pelvic area can cause the ovaries to stop working, leading to sudden menopause. People who receive smaller doses of radiation may find that their ovaries begin to function again with time.

Chemotherapy can also damage the ovaries. Menopause can occur immediately or months later. The risk of menopause depends on the type of chemotherapy a person receives and the dose that is given. Sudden menopause from chemotherapy is less likely to occur in younger people.

Treatment options after medical menopause include hormone therapy, vaginal estrogen, antidepressants, lubricants, and medicine for bone loss. Getting exercise, enough sleep, and dressing in layers can also help manage symptoms.

Primary Ovarian Insufficiency

Primary ovarian insufficiency (POI) occurs when the ovaries have stopped working prematurely. POI is not the same as premature menopause; people with POI may still get occasional periods and may even become pregnant.

Most of the time, the cause of POI is unknown. Possible contributing factors may include:

• Genetic disorders
• A low number of follicles
• Autoimmune diseases
• Metabolic disorders
• Exposure to toxins
• Chemotherapy and radiation treatment

Symptoms of POI are similar to those of natural menopause. Since it usually happens in younger people, infertility is the primary reason that someone with POI goes to their doctor. 

There is no way to restore the ovaries’ function, but there are ways to treat the symptoms of POI.

POI treatment may include:

• Hormone replacement therapy
• Calcium and vitamin D supplements
• In vitro fertilization (IVF)
• Exercise
• Treatment of associated conditions

Testing

Menopause is usually detected due to age and symptoms. Tracking your menstrual cycle and symptoms can help you and your healthcare provider identify if you are in any stage of menopause. Tell your healthcare provider about any menopause symptoms, such as hot flashes, breast tenderness, vaginal dryness, changes in periods, mood changes, or trouble sleeping.

Hormone Levels

While laboratory tests are not usually necessary to diagnose menopause, your doctor may test the number of hormones in your blood. This is especially true if your periods stopped at an early age (before 40) or there is a medical reason to do so.

Follicle-stimulating hormones (FSH levels): FSH is a protein made by the brain that tells the ovaries it's time for ovulation. When menopause begins, the ovaries start to shut down and don’t respond to the stimulation. This causes the brain to send more FSH into the body. Blood levels of FSH will increase as a person's ovaries begin to shut down. These levels fluctuate, so these tests may need to be tracked over time.

Estradiol levels: Estradiol is the main form of estrogen found in a person before menopause. Generally, blood levels fall after menopause. However, there are exceptions for people who take certain medications. 

Bone Density Testing

Bone density tests do not indicate menopause. However, they are used to monitor and screen postmenopausal people for osteoporosis, which weakens the bones.

Summary

While the average age of menopause is 52, there is a vast range of what is considered “normal” for when menopause could begin. For some people, menopause starts in their forties or even earlier; for others, it occurs well into their fifties. 

If you aren’t sure whether the symptoms that you are experiencing are related to menopause or perimenopause, talk to your doctor. They will be able to rule out other conditions and confirm whether you are going through menopause. They will also be able to support you and help you cope with the symptoms of menopause.