Menopause: How Long Does it Last?

How Long Does Menopause Last? 

Menopause is normal for a person assigned female at birth (AFAB) and usually occurs between the ages of 45 to 55.¹ Menopause starts once the menstrual cycle has not occurred for at least 12 months after the previous period marking the end of someone’s ability to naturally give birth. 

Every person experiencing menopause will suffer differently; as a result, how long an individual's symptoms persist can vary.

Nonetheless, the average length of time that symptoms persist is 4 years.²

However, some symptoms of menopause, such as hot flashes (a sudden feeling of warmth in the upper part of the body), can last up to 10 years after a person’s last period.³ A study conducted on 3302 menopausal people AFAB found that the median duration of menopausal symptoms (primarily hot flashes and night sweats) was 7.4 years.⁴

Why Does Menopause Occur?

Menopause occurs when there are no more eggs in a person’s ovaries. There are almost 1 to 3 million eggs present at the time of birth in the body of someone assigned female at birth. These eggs gradually shed off after every monthly cycle. 

When someone first starts to menstruate, almost 400,000 eggs are still present. During the beginning of menopause, less than 1000 eggs remain. The process in which eggs deplete is known as Atresia.⁵

Follicle-stimulating hormone (FSH) is the hormone responsible for transforming ovarian follicles into fully developed eggs ready to be fertilised.⁶ As menopause approaches, the ovaries dramatically reduce their production of a hormone called oestrogen, and the remaining eggs become more resistant to FSH. This means it becomes much harder for pregnancy to occur.  Oestrogen also affects many other parts of the body, including the heart, bone, blood vessels, breasts, urinary tract, and brain. Most of the symptoms associated with menopause are due to the loss of oestrogen.  

Stages of Perimenopause and Postmenopause

Perimenopause is the transition from the beginning of irregular menstrual periods to the last menstrual period. It usually commences from the mid-40s and about 1 to 4 years before menopause.⁷

Postmenopause is the time after menopause when a woman has not experienced a period for over a year.⁸

Premature Menopause (Early Menopause) sometimes occurs after a hysterectomy (surgical removal of the uterus) or oophorectomy (surgical removal of the ovaries).⁹ It can also be due to an autoimmune disorder, in which the immune system of the body attacks the body’s cells, or other medical treatments. 

What Are the Symptoms of Menopause?

Women in the phase of perimenopause may experience these symptoms:¹⁰

• Irregular periods
• Hot flashes
• Vaginal dryness
• Night sweats
• Chills
• Mood changes
• Weight gain and slowed metabolism
• Loss of breast fullness
• Sleep problems
• Thinning hair and dry skin

Signs and symptoms may vary accordingly.

What are the Hormonal Changes During Menopause?

Oestrogen

During perimenopause, levels fluctuate and become unpredictable. Eventually, production falls to a very low level, and this is the cause of many of the symptoms associated with menopause.

Progesterone

Production stops during menstrual cycles when no egg is released and is no longer present after the final menstrual period.

Testosterone

• Levels peak in a woman’s 20s and decline slowly afterwards. By menopause, the level is at half of its peak. 
• Ovaries continue to make testosterone even after oestrogen production stops
• Testosterone production from adrenal glands also declines with ageing but continues after menopause.

How Long Does Perimenopause (the transitioning period) Last on Average?

The symptoms of the perimenopausal phase can last up to an average of 4 years.¹¹ These symptoms gradually diminish. 

How Long Does the Menopause Last on Average?

Menopause symptoms will disappear for most women four to five years after their last cycle.¹² However, symptoms can occasionally resurface many years later in a milder form. 

Some people will experience an abrupt cessation of their monthly cycle. In these cases, there are often very few symptoms during perimenopause; subsequently,  the onset of symptoms once menopause does begin can be rapid and intense. However, most people AFAB experience a gradual shift from irregular cycles to no cycles instead, and this can last for several years. 

How Long do Hot Flushes Last on Average?

Hot flashes are one of the most common menopause symptoms that people AFAB can experience years after all other symptoms have subsided. There is no definitive duration of hot flushes; yet, most people AFAB will experience hot flushes from 6 months to 2 years.¹³

How Long Does Vaginal Dryness Last?

Vaginal Dryness could last an average of 10 years even after the cessation of menstrual periods. 

How Long Do the Other Symptoms Last?

Other symptoms such as sweating and mood swings could last long till 10-12 years. 

What treatments are there for Menopause, and will they work?

If menopause is disrupting your life, there are several different treatment options to consider. 

Non Hormonal therapy

There are several non-hormonal treatments that can alleviate some of the symptoms.¹⁴ 

Vaginal oestrogen can relieve vaginal dryness without hot flashes. It is a lower dose of oestrogen that is available in the form of tablets, creams or rings and can be placed in the vagina. Deep breathing exercises, meditation and yoga are also great ways to decrease the stress level of menopause. 

Consult your doctor before taking plant-based oestrogens and herbal products like black cohosh for hot flashes, as their effectiveness is not proven. Additionally, women with a history of breast cancer should avoid them because of the concern that they may increase the risk of recurrence. 

Hormonal Therapy

Hormonal Replacement Therapy (HRT) is a combination of oestrogen and progesterone that can be prescribed for people who still have their uterus with moderate to severe symptoms of menopause.¹⁵ For those who have gone through hysterectomy and oophorectomy (surgical removal of their uterus and ovaries), oestrogen is usually the prescribed treatment. Oestrogen is the most effective treatment for vaginal dryness, hot flashes, and mood fluctuations.¹⁶ The treatment with oestrogen starts before the age of 60 and usually is recommended for 5 years. Oestrogen also comes in the form of hormonal patches, creams, gels, and vaginal rings and are alternatives to traditional pills. 

The following people are usually not suitable candidates for hormonal replacement therapy:

• those with a history of or are at an elevated risk of uterine (endometrial) or breast cancer, heart conditions (such as stroke or high blood pressure) or liver disease
• those who are pregnant 

Lifestyle changes

To maintain overall good health and to reduce the symptoms of menopause, a healthy diet and regular exercise program are recommended. Avoiding drinking alcohol, smoking cigarettes and unhealthy eating habits are helpful interventions. Wearing loose clothing rather than tight-fitted ones may also help relieve menopausal symptoms. 

Summary

Menopause is normal for a person assigned female at birth (AFAB) and usually occurs between the ages of 45 to 55. Every individual is different; whilst most people AFAB symptoms last four years, they can last up to 10 years. The most common symptoms of menopause are hot flashes, irregular periods, vaginal dryness, chills, mood changes etc. If menopause symptoms are disrupting your life, there are several different treatment options available. Such as non-hormonal treatment: yoga, meditation; hormonal replacement therapy: pills, patches, creams; and lifestyle changes: a healthy diet and regular exercise.