5 minute read

What to know about menopause—at 40, 50, and beyond

Published May 2, 2023

The journey through menopause can feel like an adventure with surprising twists and turns. From memory changes and peek-a-boo periods to hot flashes and joint pain, you might feel like you're on/in for a wild ride. With no set itinerary or map, it’s easy to wonder where you are. But it is possible to feel empowered through menopause by listening to a trusted guide – your body. Whether subtle or loud-and-clear, your body reveals important clues about the direction you’re heading.

When does menopause start?

Natural menopause usually happens between the ages of 40 and 58, but the average age for menopause is 51.(1) It can also happen earlier (30s) or later (60s) for some women.

If you didn’t know when menopause starts (or ends) or if you’re menopausal—you’re not alone. Over 1 million women in the US experience menopause each year.(1) That’s a lot of skipped periods, brain fog, and sleepless nights. But 27% of women have no idea when perimenopause starts.(2) And 73% of women aren’t treating their symptoms, leaving them to suffer in silence, not just at home but also in the workplace.(3)

How do you know if you’re going through menopause?

When you think of menopause, you may believe it to be a single life stage. But the truth is, menopause is a transition. It’s a gradual process that can take several years or even over a decade. The menopause transition has different stages, each with its own set of potential signs and symptoms. 

What are early menopause, perimenopause, menopause, and post menopause?

  1. Early Menopause- Early menopause is when a person starts menopause before the age of 45, much earlier than natural menopause that typically occurs around age 51.”Smoking, medical procedures, and genes can contribute to early menopause. Those who experience early menopause may be at higher risk for certain health conditions, such as bone loss (osteoporosis) and heart disease.
  2. Perimenopause- This is when your body is preparing for menopause. Your ovaries start to produce less estrogen and progesterone. This drop in hormones can cause irregular periods, hot flashes, or night sweats. During this time, there is still a chance you could become pregnant. Perimenopause can last 4 to 8 years, and stops when menopause begins.
  3. Menopause- After perimenopause, you’ll enter menopause (usually around 51 years of age). Your ovaries will no longer release eggs, hormone levels will become very low, and your period will stop completely. Once you’ve been period-free for 12 months in a row, you will have transitioned to menopause and then be in post-menopause. But if you haven’t had a period in a few months and then it returns, the clock starts over, and you’re back in perimenopause. 
  4. Post Menopause- Post-menopause follows menopause and is the period of time when your body adjusts to the changes that have happened. Hot flashes and other symptoms may continue for a few years, but eventually, they will disappear. It’s important to know that bleeding is not a symptom of post menopause. Bleeding during this time is not normal you should speak with a healthcare provider if it occurs. (4)

What is premature menopause?

Menopause that starts before age 40 (whether natural or caused by medical treatments) is called premature menopause. This condition affects about 1% of women in the US. Premature menopause may be caused by genetics, metabolic issues, autoimmune diseases, and other factors we don't fully understand.

The difference between premature menopause and early menopause is the age of when menopause happens:

  • Premature menopause is when menopause happens before 40 years of age
  • Early menopause is when menopause happens before 45 years of age

Premature menopause should be evaluated thoroughly by a healthcare provider.5 Women who experience premature menopause are at a higher risk of developing osteoporosis, heart disease, and other health issues associated with menopause. Because of this, it’s crucial to receive proper medical care and support.5

How to tell if you’re transitioning through menopause—learning the signs and symptoms

Menopause isn’t just the end of periods. It can cause symptoms that impact your body, mind, and quality of life. Some women experience no symptoms at all, while others experience a wide range of severe symptoms. These symptoms can vary from woman to woman. 

Some of the signs and symptoms to look out for:

  • Period changes
  • Mood swings
  • Brain fog
  • Forgetfulness
  • Problems paying attention
  • Depression
  • Anxiety
  • Sleep problems
  • Hot flashes
  • Night sweats
  • Vaginal dryness
  • Migraines
  • Loss of interest in sex
  • Fatigue
  • Weight gain
  • Joint pain
  • Muscle pain
  • Urinary issues (going more often, leaking urine)
  • Dry skin
  • Thinning hair

Can I test for menopause?

Quest understands that each woman's experience is unique—and sometimes confusing. Knowing when menopause has arrived (or will arrive) can help you prepare for the journey ahead. We offer 3 unique tests to help you understand where you are in the menopause transition. No matter what part of your journey you're in, our menopause tests can help you take charge of your health

To your journey!

No doctor visit is required to buy your own lab test at questhealth.com. PWNHealth and its affiliates review your purchase to ensure its medically appropriate before submitting the test order for processing. PWNHealth also reviews your test results and will contact you directly if they require prompt attention. Included in each purchase is the option to discuss your test results with an independent physician; however, you are also encouraged to speak with your primary health care provider. 


  1. National Institute on Aging
  2. Bonafide’s State of Menopause Survey (2022)
  3. Bonafide’s State of Menopause Survey (2021)
  4. Mayo Clinic Q and A: Spotting, perimenopause and menopause. Mayo Clinic. Accessed March 28, 2023.
  5. Menopause FAQs: Premature, Early, and Induced Menopause. The North American Menopause Society. Access March 28, 2023.


  1. Are we there yet? Navigate now with you guided menopause tour. The North American Menopause Society. Access March 28, 2023. https://www.menopause.org/for-women/menopauseflashes/menopause-symptoms-and-treatments/are-we-there-yet-navigate-now-with-our-guided-menopause-tour
  2. Dealing with the symptoms of menopause. Harvard Health Publishing. Harvard Medical School. https://www.health.harvard.edu/womens-health/dealing-with-the-symptoms-of-menopause#:~:text=Hot%20flashes%20and%20vaginal%20dryness,changes%2C%20and%20quality%20of%20life
  3. What is menopause? NIH National Institute on Aging. Accessed March 28, 2023. https://www.nia.nih.gov/health/what-menopause#transition
  4. Menopause 101: A primer for the perimenopausal. The North American Menopause Society. Accessed March 28, 2023. https://www.menopause.org/for-women/menopauseflashes/menopause-symptoms-and-treatments/menopause-101-a-primer-for-the-perimenopausal
  5. Menopause FAQs: Premature, Early, and Induced Menopause. The North American Menopause Society. Access March 28, 2023. https://www.menopause.org/for-women/menopause-faqs-premature-early-and-induced-menopause