Elder woman

Menopause doesn’t happen overnight — and the symptoms vary from person to person. Many women will ask: “How will I know when I start menopause?”

Technically, you’re in menopause if you haven’t had a period for 12 straight months. Perimenopause is the time when your body begins to make the transition towards menopause.

Women start perimenopause at different ages. It’s a normal phase of life that usually occurs anywhere from a woman’s early forties to mid-fifties.

The symptoms of menopause can be confusing. Some women experience every symptom, others barely any. And while some symptoms may occur for months, others can last for years. Here are some of the most common early signs of menopause.

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What Are the Stages of Menopause?

  • Perimenopause typically occurs 3-5 years prior to the start of menopause. This stage occurs when your estrogen levels begin to drop and your body begins the transition towards menopause. You can still get pregnant during perimenopause.
  • Menopause is confirmed to have started after you’ve missed your period for 12 consecutive months. Though every woman is unique and will experience this transition differently, most women enter menopause when they are 51 or 52.
  • Postmenopause includes the time after menopause. Estrogen levels continue to decline during this stage, which can cause some menopausal symptoms to linger.

What Is the Normal Age for Perimenopause?

All women are different and will experience this transition at different times. Most women start to notice perimenopause symptoms in their 40s. But perimenopause can happen a little earlier or later, too. Perimenopause symptoms start about four years before your final period.

“Menopause, otherwise known as ‘the change,’ is a time in a woman’s life when she no longer gets her period,” said Patricia Katzenmoyer, CRNP, of UPMC Devine Mercy Women’s Health. “The natural transition into menopause can begin years prior, however. This is known as perimenopause and can begin as early as your 30s.”

First Signs of Menopause

Perimenopause and menopause can bring about a number of physical and emotional changes. Many women are surprised to learn that perimenopause can begin early in life.

Katzenmoyer says regular exercise, a healthy diet, and  limiting caffeine and alcohol can all help manage perimenopause symptoms.

  • Irregular periods
  • Hot flashes and night sweats
  • Insomnia
  • Mood swings
  • Loss of libido and sexual discomfort

Irregular Periods

Your periods may become lighter, heavier, or more sporadic in perimenopause, which is the phase leading up to menopause. This phase can last several years.

What to do: Continue to see your gynecologist on a regular basis. If you begin to have consistently heavy periods, your doctor may want to run tests to rule out infection or disease.

Hot Flashes and Night Sweats

One of the major symptoms of menopause, hot flashes can make your whole body uncomfortably warm for a minute or more. Your face flushes, you perspire, and it feels like your heart is racing. You may wake up hot and sweaty at night, even though your room is cool.

What to do: To reduce the discomfort of hot flashes, dress in layers during the day, and in light pajamas at night. Keep a cool bottle of water close at hand, and use an ice pack to cool your pillow at night.


One common symptom of menopause is waking in the middle of the night and not being able to get back to sleep. This can happen even if you’ve never had trouble sleeping before. Sudden insomnia is often combined with night sweats.

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What to do: Stick to good sleeping habits. Wake up and go to bed at the same time — even on weekends. Limit screen time before bed, and instead read or listen to soothing music. Avoid alcohol and caffeine (especially late in the day), and keep your bedroom cool and dark.

Mood Swings

Hormonal changes around menopause can intensify your moods. Symptoms of anxiety or depression may worsen during the onset of menopause.

What to do: Exercise, such as walking or yoga, can help you stay positive and feeling well. Eat a well-balanced diet with fruits and vegetables, whole grains, and lean protein. If feelings of depression or anxiety worsen, visit your primary care doctor.

Loss of Libido and Sexual Discomfort

Hormonal changes can negatively affect your sex drive. During menopause, vaginal dryness can make sex uncomfortable.

What to do: Talk to your gynecologist. Some local treatments can help with vaginal dryness. Over-the-counter products designed for vaginal use can also help make intercourse easier. Hand creams or lotions containing alcohol or perfumes are a no-no, as they can irritate tender skin.

When to See a Doctor to Manage Your Menopause Symptoms

Many women may feel uncomfortable discussing menopause with their doctor. Don’t ignore your symptoms. Your health care provider may recommend several preventive screening procedures when menopause begins. Consult your doctor if you experience vaginal bleeding after menopause.

As with any other major physical change, it’s important to speak with your doctor about the early signs of menopause. She can help you stay healthy and positive during this life transition, and possibly prescribe treatment if necessary.

If you’re still asking yourself, “How will I know when I start menopause?” visit the Midlife Health Center at UPMC Magee-Womens Hospital for more information.

Editor's Note: This article was originally published on , and was last reviewed on .

About UPMC Magee-Womens

Built upon our flagship, UPMC Magee-Womens Hospital in Pittsburgh, and its century-plus history of providing high-quality medical care for people at all stages of life, UPMC Magee-Womens is nationally renowned for its outstanding care for women and their families.

Our Magee-Womens network – from women’s imaging centers and specialty care to outpatient and hospital-based services – provides care throughout Pennsylvania, so the help you need is always close to home. More than 25,000 babies are born at our network hospitals each year, with 10,000 of those babies born at UPMC Magee in Pittsburgh, home to one of the largest NICUs in the country. The Department of Health and Human Services recognizes Magee in Pittsburgh as a National Center of Excellence in Women’s Health; U.S. News & World Report ranks Magee nationally in gynecology. The Magee-Womens Research Institute was the first and is the largest research institute in the U.S. devoted exclusively to women’s health and reproductive biology, with locations in Pittsburgh and Erie.