If hot flashes, broken sleep and irregular periods have started to affect your working day, you may be wondering how long menopause lasts and when you will feel like yourself again. And the question often comes up in the middle of a busy career, when a hot flash in a meeting or a night of poor sleep is hard to ignore.
Most women who ask want to know when the hot flashes and poor sleep will stop. Menopause symptoms usually last for several years, but for some women they continue for a decade or more. Because the timing varies so widely, consulting a women’s health doctor can help you understand which stage you are in and which treatments may suit you.
In this article, we will cover the stages of menopause, when it starts and ends, what changes after a hysterectomy and how menopause is treated.
What Are the Stages of Menopause?
Menopause happens in three stages, and the length of each one varies from woman to woman. Here is how long each stage lasts:
- Perimenopause – the years before your final period, when hormone levels rise and fall unevenly and periods become irregular. It lasts four years on average, but it can be as short as a few months or as long as eight years.
- Menopause – the point when you have gone 12 months in a row without a period. It is a single day rather than a stage you live through, although many people use the word for the whole transition.
- Postmenopause – every year after that point, for the rest of your life. For most women, the symptoms become milder during this stage.
So when people ask how long menopause lasts, they usually mean how long perimenopause and the symptoms that follow it last.
What Age Does Menopause Start?
Menopause usually starts between the ages of 45 and 55, and the average age is 51. Perimenopause often begins in the mid-40s, although some women notice changes in their late 30s.
Menopause before 45 is called early menopause, and menopause before 40 is called premature menopause. Because genetics plays a part, your mother’s age at menopause can give a rough guide to your own, and smoking is linked to menopause starting one to two years earlier. Chemotherapy, radiation to the pelvis and surgery to remove the ovaries can also cause menopause to start earlier.
Periods that stop before 45 should generally be medically assessed, because early menopause can affect bone and heart health over time.
When Does Menopause End?
Most women find that the symptoms of menopause end, or become much milder, within a few years of their final period. However, the timing varies from one symptom to the next:
- Hot flashes – these sudden waves of heat last seven years in total on average, and many women still have them four to five years after the final period. They tend to last longer when they start early in perimenopause, a
- Night sweats – these are hot flashes that happen during sleep, so they usually follow a similar pattern.
- Sleep problems – trouble sleeping often improves once night sweats ease, although it can continue for other reasons.
- Mood changes – irritability and low mood are most common during perimenopause and often improve after the final period.
- Vaginal dryness – unlike hot flashes, dryness and pain during sex tend to continue or worsen after menopause unless they are treated. This is part of genitourinary syndrome of menopause (GSM), which affects the vagina and bladder as estrogen levels fall.
Any vaginal bleeding after you have gone 12 months without a period should be checked by a doctor promptly, because it is not a normal part of menopause.
What Happens to Menopause After Hysterectomy?
A hysterectomy, an operation to remove the uterus, does not cause menopause on its own. The timing of menopause then depends on whether your ovaries are removed too, because the ovaries, not the uterus, make most of your estrogen.
If both ovaries are removed, menopause begins on the day of surgery. This is known as surgical menopause, and because estrogen falls within a day or two rather than over several years, hot flashes and night sweats often start within days and can be more severe.
If your ovaries are kept, they usually continue to make hormones, so menopause happens naturally, sometimes a year or two earlier than it otherwise would. Because you no longer have periods to track, hot flashes or night sweats are often the first sign that menopause has begun. After that, the symptoms usually last as long as they would without surgery.
How Is Menopause Treated?
Menopause is treated by easing its symptoms, because menopause itself is a natural stage of life rather than an illness. That means treatment does not shorten menopause, but it can make the years of symptoms much easier to manage.
Here is what each option is used for:
- Hormone therapy – hormone replacement therapy (HRT) replaces some of the estrogen your body no longer makes, and it is often the most effective treatment for hot flashes and night sweats. It is not suitable for everyone, so whether it suits you is best discussed with a doctor first.
- Non-hormonal medicines – some antidepressants and other prescription medicines can reduce hot flashes for women who cannot take hormones or prefer not to.
- Vaginal treatments – low-dose vaginal estrogen and vaginal moisturizers can ease dryness and pain during sex.
- Lifestyle changes – regular exercise, a cooler bedroom, layered clothing and less alcohol and caffeine may reduce how often hot flashes happen. At work, a desk fan and breathable clothing can also help.
In Sum: Most Symptoms Ease With Time
Menopause is a single point in time, and for most women the symptoms around it become milder in the years that follow. Sleep problems and mood changes often improve after menopause, and effective treatments are available while hot flashes and other symptoms last.
A women’s health doctor can be a good starting point, helping you find a treatment that suits your health and your working life. With the right support, many women sleep better, feel more like themselves and look ahead to the years after menopause with confidence.
Disclaimer: This article is for general information only and is not medical advice. Please check with your own doctor about how menopause is affecting you and which treatments are right for you.
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