Menopause is a natural part of aging, marking the end of menstrual cycles. But it doesn’t happen all at once. For many, the transition begins years earlier during a stage called perimenopause.

Recognizing the early signs can help you understand what’s happening in your body — and when to check in with a doctor.

When does menopause usually start?

In the U.S., the average age of menopause (defined as 12 months without a period) is 51. But symptoms often begin much earlier, typically in your 40s, and sometimes even in your late 30s.

This transition stage is called perimenopause, and it can last anywhere from a few months to over 10 years.

Early signs of menopause you shouldn’t ignore

1. Irregular periods

Cycles may become shorter, longer, heavier, or lighter. Skipped periods are common, but sudden changes should still be discussed with a doctor.

2. Hot flashes and night sweats

One of the most well-known symptoms, hot flashes are sudden waves of heat that can disrupt sleep and daily life.

3. Mood changes

Hormonal shifts can trigger irritability, anxiety, or even depression. If mood changes feel overwhelming, it’s important to seek support.

4. Sleep problems

Insomnia, frequent waking, or restless nights can be linked to fluctuating hormones.

5. Vaginal dryness and discomfort

Declining estrogen levels can cause dryness, itching, or discomfort during sex.

6. Decreased fertility

While pregnancy is still possible during perimenopause, declining egg quality makes it less likely.

7. Changes in libido

Some experience a decrease in sexual desire, while others may not notice much change.

8. Brain fog and memory issues

Difficulty concentrating or occasional forgetfulness can appear during perimenopause.

When to see a doctor

While many symptoms are a normal part of the menopause transition, some changes shouldn’t be ignored:

• Extremely heavy bleeding
  
  
• Bleeding after sex
  
  
• Periods resuming after 12 months without one
  
  
• Severe mood changes or depression
  

A healthcare provider can rule out other conditions, discuss treatment options, and offer support for managing symptoms.

Managing early menopause symptoms

You don’t have to just “tough it out.” Options include:

• Lifestyle changes: Regular exercise, balanced diet, good sleep habits
  
  
• Stress management: Yoga, meditation, or therapy
  
  
• Medical treatments: Hormone therapy or non-hormonal medications (prescribed by a doctor)
  
  
• Vaginal moisturizers/lubricants: To ease dryness and discomfort
  

The bottom line

Menopause is a natural transition, but the early signs can be confusing or disruptive. Irregular periods, hot flashes, mood changes, and sleep issues are all common, but it’s important to know when to seek medical advice.

Understanding these early symptoms — and getting support when needed — can help you navigate this stage of life with more confidence and comfort.

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