Perimenopause

15 Signs of Menopause at Every Age: From 40 to 50

Clara Siegmund

Taking note of the signs and symptoms of perimenopause and menopause can help you understand what’s happening in your body. As your body changes, here are signs you may experience at every age.

Modified On:

Published:

May 8, 2024

Est. Read Time:

black and white image of an outstretched hand over a body of water

No items found.

Menopause marks the end of your reproductive years and the next biological stage of your life. But this stage doesn’t just come on suddenly. Your body transitions into menopause over time, during a phase known as perimenopause.

Biological shifts and changes in hormone production (namely estrogen and progesterone) drive the transition through perimenopause and into menopause. For many, these changes can bring lots of uncomfortable, distressing, and even painful perimenopause symptoms.

While these symptoms vary from one person to the next, having a general idea of what to expect—and when to expect it—can help you understand what’s happening in your body. So, what are signs of menopause at 40, and are they different from symptoms of menopause at 50? Here’s a look at the signs and symptoms of menopause at every age, from the start of perimenopause all the way to menopause.

When does menopause happen?

Menopause is the end of your reproductive years. After menopause, you no longer ovulate, your menstrual cycles and period have stopped, and you can no longer get pregnant.

Menopause is officially diagnosed once you’ve gone 12 consecutive months without a period. The diagnosis is retroactive, since you can’t be sure right away whether or not a period was your last.

If you get another period, you’re still in perimenopause and the 12-month countdown to official menopause restarts—no matter how long it’s been since the period before. You may even go 60 days or more between periods in late perimenopause!

Perimenopause can begin anytime in your late 30s to mid 40s. Perimenopause lasts seven years on average, but duration varies from person to person and may take anything from a few months to a decade or more.

Menopause follows perimenopause, generally occurring in your 40s or 50s. In the US, the median age of natural menopause (meaning menopause that’s not medically induced) is 51.

Each menopause experience is different. Various changes and symptoms may be triggered at different moments. Factors like age at the start of perimenopause, race and ethnicity, overall health, and lifestyle differences can all influence your perimenopause and menopause timeline.

If you’re wondering where you are in the menopausal transition, certain signs and symptoms can give you insight into what’s happening in your body.

What are signs of menopause?

Millions of people experience symptoms during perimenopause and menopause. In fact, around 85% of women report having symptoms, many of which are present throughout both stages.

This symptom overlap is partly why perimenopause and menopause are often confused with one another. We commonly refer to the entire transitional period as “menopause,” and people who say they’re menopausal may really be perimenopausal.

>>MORE: Perimenopause vs. Menopause: What’s the Difference?

Each transitional period is unique (you don’t automatically start hot flashes at age 43, for example!), but outlining approximate age ranges and signs of menopause at every age is possible.

Here’s a general timeline of the physical, mental, and emotional signs and symptoms of menopause that you may experience as you move through perimenopause and into menopause.

Signs of menopause at 40 to 45

For most people ages 40 to 45, official menopause hasn’t yet occurred. Instead, signs of menopause at 40 are usually perimenopause symptoms, or the initial stage of the menopausal transition. If you haven’t experienced any signs of menopause at 40 to 45, don’t worry—it just means you may not have begun your transition yet.

So, what signs of the menopause transition should you look out for in your early 40s?

Changes in your period and menstrual cycle

There are many changes in your period and cycle you might start to experience, including:

Your period may become heavier or lighter
Your cycles may shorten or lengthen
You may skip periods and go long stretches of time without bleeding
You may experience spotting

In short, your cycle and period become irregular in perimenopause.

Decreasing fertility

Fertility begins declining more quickly during perimenopause before it ends at menopause. Whether you’re trying to conceive or you want to avoid pregnancy, tracking your ovulation during perimenopause can help.

Vasomotor symptoms

Vasomotor symptoms, commonly known as hot flashes and night sweats (nighttime hot flashes) are sudden and intense feelings of heat in the face, neck, chest, and upper back, sometimes accompanied by heart palpitations and chills after the heat. Up to 80% of people experience hot flashes, making them one of the most common symptoms of the menopausal transition.

Vaginal symptoms

As estrogen decreases, vaginal atrophy can occur. Vaginal walls may become thinner and vaginal lubrication may decrease, leading to symptoms like dryness, irritation, itching, burning, discomfort or pain during sex, overactive bladder, and recurrent urinary tract infections.

Changes in libido

Many people experience a decrease in sex drive during perimenopause related to factors like hormonal changes, vaginal symptoms, and emotional symptoms. It’s also possible, though rarer, to have an increase in libido during perimenopause.

Mood changes and depression

While you may be familiar with mood changes as a premenstrual symptom, mood swings during perimenopause are common, too. Lots of people report feeling angry, irritable, anxious, and even depressed as hormone levels (estrogen in particular) drop.

Sleep disturbances

Night sweats, emotional symptoms, and changing life circumstances can all make it harder to get quality sleep. You may toss and turn at night, and feel tired during the day.

Headaches and migraine

Hormonal changes, particularly the fluctuations and decrease in estrogen, can lead to an uptick in frequency and severity of headaches and migraine. Some may even develop migraine for the first time during perimenopause.

Brain fog

Cognition can be impacted during perimenopause, commonly known as brain fog. You may have difficulty concentrating, and feel forgetful and mentally cloudy.

Weight gain

A combination of factors—including hormones, slower metabolism, aging, and lifestyle habits— can all lead to weight gain during perimenopause, particularly in the abdomen.

Joint pain

Hormonal changes, particularly in estrogen, can cause joint stiffness, discomfort, inflammation, reduced flexibility, and general soreness. Joint pain is common, affecting 71% of perimenopausal people.

While rare, it’s not unheard of to reach menopause in your early 40s. About 5% of people experience what’s called “early menopause,” or menopause that occurs between the ages of 40 and 45. Menopause symptoms tend to be more severe for people who go through early menopause.

Signs of menopause at 45 to 50

Most people reach official menopause—meaning they’ve gone 12 consecutive months without a period—between the ages of 45 and 56.

That means that between 45 and 50, lots of people will enter late perimenopause and transition past official menopause. So, what are the signs of menopause at 45 to 50? It all depends on when exactly you officially reach menopause, but, for example, menopause symptoms at age 47 are likely similar to the symptoms of menopause at 50.

Some signs and symptoms may worsen as official menopause approaches, peaking in intensity in the months leading up to or following the final period. Others may appear for the first time.

After your hormones have stabilized into their new, lower, postmenopausal levels, though, you may find that many menopause symptoms start to go away.

Vasomotor symptoms

Hot flashes and night sweats may worsen the closer you get to menopause, and intensity peaks in the 12 months following the final period. Vasomotor symptoms gradually resolve after menopause, but can last for another 10 years.

Vaginal symptoms

With your body’s estrogen production at its lowest after official menopause, vaginal, sexual, and urinary symptoms related to vaginal atrophy may worsen.

Changes in libido

More severe vaginal symptoms can make sex more unappealing or even painful, which may make you less interested in intimacy. Others may feel sexier after official menopause and the end of pregnancy risk, which can drive desire.

Mood changes and depression

You may continue to experience emotional symptoms related to hormonal changes, your changing body, and, for some, adjusting to the end of fertility. This can be a challenging period, and you may feel menopause depression as a result of the transition, other symptoms, or hormones.

Sleep disturbances

Trouble sleeping can continue into menopause, and may worsen. Studies have shown that sleep disturbances are even more common postmenopause than during perimenopause.

>>MORE: Menopause Insomnia: Causes, Symptoms, and Treatment

Headaches and migraine

headaches and migraine can increase in frequency and intensity as estrogen reaches its lowest point, but after official menopause you may get a reprise. Studies have shown that postmenopausal people may be less susceptible to headaches and migraine.

Brain fog

Symptoms of brain fog may start to improve after you reach menopause.

Weight gain

As hormones stabilize after menopause, weight gain tends to slow or even plateau, particularly when you also maintain a healthy diet and exercise regularly.

Joint pain

Some people may experience a decrease in joint pain after menopause, but for many, joint pain continues. Studies show that postmenopausal women can be at higher risk of moderate to severe musculoskeletal pain compared to premenopausal ones.

Changes in skin

The closer you get to menopause—and the older you get—the more your skin changes. Skin may become drier or thinner, and may start to lose its elasticity.

Hair changes

As you approach menopause, you may experience hair loss or thinning on your head. You may also notice more hair growth on your face and body.

Bone loss

Menopause increases the risk of bone loss and osteoporosis. As estrogen declines, bone loss speeds up—up to 20% of bone loss happens around this time, and rates of osteoporosis are higher in postmenopausal people.

Heart disease

The risk of heart disease increases following menopause. Consider talking with your doctor about how to manage this risk.

How to treat menopause symptoms at any age

If your perimenopause and menopause symptoms impact your quality of life, at any age, there are lots of treatment options, whether you’re looking for natural or medical interventions.

Options include:

Lifestyle and diet changes
Vitamins
Certain natural remedies
Over-the-counter and prescription medications
Hormone replacement therapy (HRT), including estrogen replacement therapy and combined HRT

These methods can all help you manage perimenopause and menopause symptoms and find relief.

>>MORE: Perimenopause Treatment: 9 Ways to Find Relief (And How to Know It’s Working)

Signs of menopause at every age: the bottom line

Taking note of signs of perimenopause and menopause can help you understand what’s happening in your body and which stage of your life you’re in.

While perimenopause and menopause have many symptoms in common, some signs are particular to one stage are the other.

If you’re struggling with perimenopause and menopause, talk to your doctor openly about any and all symptoms you experience—at any age. Together, you can create the right treatment plan, medical or otherwise, to help you adjust to your changing body and improve your quality of life.

About the author

Clara Siegmund is a writer, editor, and translator (French to English) from Brooklyn, New York. She has a BA in English and French Studies from Wesleyan University and an MA in Translation from the Sorbonne. She is passionate about literature, reproductive justice, and using language to make information accessible.‍

Sources

Avis N E, et al. (2018). Vasomotor Symptoms Across the Menopause Transition: Differences Among Women.
Endocrine Society. (2022). Menopause and Bone Loss.
Gava G, et al. (2019). Cognition, Mood and Sleep in Menopausal Transition: The Role of Menopause Hormone Therapy.
Grant M D, et al. (2015). Menopausal Symptoms: Comparative Effectiveness of Therapies.
Greendale G A, et al. (2019). Changes in body composition and weight during the menopause transition.
Jehan S, et al. (2015). Sleep Disorders in Postmenopausal Women.
Lu C, et al. (2020). Musculoskeletal Pain during the Menopausal Transition: A Systematic Review and Meta-Analysis.
Martin V T, et al. (2016). Perimenopause and Menopause Are Associated With High Frequency Headache in Women With Migraine: Results of the American Migraine Prevalence and Prevention Study.
NIH, National Institute on Aging. (2021). What Is Menopause?
OASH, Office on Women’s Health. (2022). Early or premature menopause.
Peacock K & Ketvertis K M. (2022). Menopause.‍
Prabakaran S, et al. (2021). Cardiovascular risk in menopausal women and our evolving understanding of menopausal hormone therapy: risks, benefits, and current guidelines for use.

‍

perimenopause-periods

Should I still see my gynecologist if my periods are just "weird" but not painful?

Yes. Annual visits remain important during perimenopause. Your provider can help determine if your "weird" periods are typical perimenopause changes or something requiring attention. They can also discuss management options to improve your quality of life.

perimenopause-periods

How long do irregular periods last before menopause?

Irregular perimenopause periods typically last 4 to 8 years before your final period, though this varies greatly. Some women experience irregularity for just a few months, while others have irregular periods for over a decade before reaching menopause.

perimenopause-periods

Is it normal to have two periods in one month during perimenopause?

Yes, this can happen, especially in early perimenopause when cycles shorten. You might have a 21 day cycle, meaning you could have a period at the beginning and end of the same calendar month. Track these patterns to distinguish between short cycles and abnormal bleeding.

perimenopause-periods

Why are my periods suddenly so heavy in my 40s?

Heavy perimenopause periods often result from estrogen dominance. When progesterone drops but estrogen remains high, your uterine lining builds up more than usual, causing heavier bleeding when it sheds. This is common in perimenopause but should be evaluated if it affects your daily life.

perimenopause-periods

Can I still get pregnant if my periods are irregular during perimenopause?

Yes. As long as you're having periods, even irregular ones, you may still be ovulating. Pregnancy is possible until you've gone 12 full months without any period. If you don't want to become pregnant, continue using contraception throughout perimenopause.

perimenopause-and-weight-gain

Can you prevent perimenopause weight gain completely?

While you may not prevent all weight changes during perimenopause, you can minimize gain through proactive strategies. Starting strength training before perimenopause, maintaining consistent sleep habits, and managing stress can help your body adapt to hormonal changes more smoothly. Remember, some body changes during this transition are normal and healthy.

perimenopause-and-weight-gain

At what age does perimenopause weight gain typically start?

Perimenopause weight gain can begin in your late 30s or early 40s, often coinciding with the first hormonal changes. Many women notice gradual changes starting 5 to 10 years before their final period. The timing varies greatly based on genetics, lifestyle, and overall health.

perimenopause-and-weight-gain

Does everyone gain the same amount during perimenopause?

No. Perimenopause weight gain varies significantly. Some women gain 5 pounds, others 20 or more, and some maintain their weight. Factors include genetics, starting weight, activity level, stress, sleep quality, and how dramatically hormones fluctuate. Your experience is unique to your body.

Is perimenopause weight gain different from regular aging weight gain?

Yes. While metabolism naturally slows with age, perimenopause weight gain has distinct characteristics. The hormonal shifts cause fat redistribution to the midsection, even if overall weight doesn't change dramatically. This abdominal weight gain pattern is specifically linked to declining estrogen and progesterone, not just aging.

perimenopause-and-weight-gain

Will the weight come off after menopause?

Perimenopause weight gain often stabilizes after menopause when hormones level out, but the weight doesn't automatically disappear. The metabolic and body composition changes that occur during perimenopause tend to persist. However, with consistent healthy habits, weight management becomes more predictable post menopause than during the fluctuating perimenopause years.

https://www.oova.life/blog/progesterone-supplementation-guide

Can I take progesterone if I'm breastfeeding?

Yes, progesterone is generally safe while breastfeeding and doesn't significantly affect milk supply. However, always discuss with your healthcare provider before starting any hormone supplementation while nursing.

https://www.oova.life/blog/progesterone-supplementation-guide

Is it safe to take progesterone throughout pregnancy?

Yes, when prescribed by your healthcare provider. Progesterone supplementation in early pregnancy is safe and can reduce miscarriage risk in women with low progesterone or a history of pregnancy loss. Most providers continue supplementation through the first trimester (weeks 10-12) when the placenta takes over.

https://www.oova.life/blog/progesterone-supplementation-guide

Can progesterone supplementation cause weight gain?

Progesterone can cause temporary water retention and bloating, which may show up as a few pounds on the scale, but it doesn't cause true fat weight gain. Most women don't experience significant weight changes from progesterone supplementation.

https://www.oova.life/blog/progesterone-supplementation-guide

Can I switch from pills to suppositories or vice versa?

Yes, but only under your doctor's guidance. The dosing and timing may need adjustment when switching between forms since they're absorbed differently. Never switch on your own, especially if you're pregnant or undergoing fertility treatment.

https://www.oova.life/blog/progesterone-supplementation-guide

Will progesterone supplementation delay my period?

Yes, progesterone keeps the uterine lining intact, so if you're not pregnant and continue taking progesterone, your period will be delayed. Once you stop taking it, your period should start within 2-10 days. If you are pregnant, progesterone helps maintain the pregnancy and you won't get a period.

https://www.oova.life/blog/progesterone-supplementation-guide

Should I take progesterone pills orally or vaginally?

For fertility and pregnancy support, vaginal progesterone is usually preferred because it delivers higher concentrations directly to the uterus. For perimenopause or general hormone balance, oral progesterone often works well and is more convenient. Your doctor will recommend the best route based on your specific needs.

https://www.oova.life/blog/progesterone-supplementation-guide

When should I start taking progesterone after ovulation?

Typically, progesterone supplementation for luteal phase support starts 2-3 days after ovulation (confirmed by LH surge or temperature rise). Your doctor will give you specific timing based on your protocol. Some women start immediately after a positive ovulation test.

https://www.oova.life/blog/progesterone-supplementation-guide

What's better: progesterone cream or pills?

Pills (oral micronized progesterone) are generally more effective and reliable than creams because absorption from creams is inconsistent. For medical conditions like fertility issues, low progesterone, or HRT, prescription pills or suppositories are strongly recommended over over-the-counter creams.

https://www.oova.life/blog/low-vs-high-progesterone-symptoms

How can I tell if I have low or high progesterone?

The only definitive way to know is through hormone testing via blood tests or at-home urine tests that measure progesterone metabolites. However, symptom patterns can provide clues: anxiety and irregular periods suggest low progesterone, while bloating and extreme fatigue suggest high progesterone.

https://www.oova.life/blog/low-vs-high-progesterone-symptoms

When during my cycle should I test progesterone levels?

Test progesterone levels during the luteal phase, typically 7 days after ovulation or around day 21 of a 28-day cycle. This is when progesterone should be at its peak, making it easier to identify if levels are too low or too high.

https://www.oova.life/blog/low-vs-high-progesterone-symptoms

What are the main differences between low and high progesterone symptoms?

Low progesterone typically causes irregular or heavy periods, anxiety, hot flashes, and sleep issues. High progesterone causes bloating, fatigue, intense breast tenderness, and depression-like mood changes. Low progesterone symptoms persist throughout your cycle, while high progesterone symptoms are most intense during the luteal phase.

https://www.oova.life/blog/low-vs-high-progesterone-symptoms

Can you have symptoms of both low and high progesterone?

Some symptoms like breast tenderness and mood changes can occur with both low and high progesterone, making it confusing. However, the timing, intensity, and accompanying symptoms differ. Hormone testing is the best way to determine which imbalance you're experiencing.