At what age does menopause typically start?

From the Guidelines

Menopause typically begins between ages 45 and 55, with the average age being around 51 in the United States. However, it's essential to understand that menopause is not a sudden event but rather a gradual transition that occurs over several years. This transition period, called perimenopause, can start 8-10 years before menopause and is characterized by fluctuating hormone levels, irregular periods, and various symptoms like hot flashes, sleep disturbances, and mood changes. Menopause is officially diagnosed when a woman has gone 12 consecutive months without a menstrual period. Some women may experience early menopause before age 45 (premature menopause if before 40), which can occur naturally or be induced by medical treatments like chemotherapy, radiation, or surgical removal of the ovaries. Factors that can influence the timing of menopause include genetics, smoking (which can cause earlier onset), and certain medical conditions.

Key Points

• The median age of menopause in women in the United States is 51 years (range, 41 to 59 years) 1.
• Ovarian production of estrogen and progestin begins to decrease years before the complete cessation of menses 1.
• Understanding that this transition is normal and recognizing the symptoms can help women seek appropriate support and treatment options if needed.

Considerations

• The average woman in the United States who reaches menopause has a life expectancy of nearly 30 years 1.
• The probability that a menopausal woman will develop various chronic diseases over her lifetime has been estimated to be 46% for CHD, 20% for stroke, 15% for hip fracture, 10% for breast cancer, and 2.6% for endometrial cancer 1.
• Osteoporosis affects a large proportion of postmenopausal women in the United States, and the prevalence of osteoporosis increases steadily with age 1.

From the Research

Age of Menopause

• The average age of menopause in the UK is 51, as stated in the study 2.
• Menopause can occur at different ages, with early menopause defined as occurring before the age of 40, and late menopause occurring as late as 62 years of age 3.
• The median age of menopause is 51 years, according to the study 3.

Factors Influencing Menopause Age

• Genetic variants are known to contribute to approximately 50% of the variation in age at menopause 3.
• Genome-wide association studies have identified several genetic variants associated with menopause and premature ovarian insufficiency (POI) 3.
• Reproductive performance, age at menopause, and longevity are interlinked through common genetic factors involved in DNA repair and maintenance 3.

Menopause Symptoms and Treatment

• Menopause symptoms can be relieved with hormone replacement therapy (HRT), but the most common preparation increases the risk of breast cancer 4.
• Selective estrogen receptor modulators (SERMs) are alternative treatments for menopause symptoms, but may have adverse effects such as increased risk of venous thromboembolic events 5.
• Combination therapies, such as tissue selective estrogen complex (TSEC), have been developed to achieve a favorable clinical profile for menopausal management 5.