Menopause typically begins between ages 40-65 and can be affected by genetics, health, and lifestyle. Symptoms may include missed periods, hot flashes, and weight gain.

As people age, hormone levels start to change. For instance, as individuals assigned female at birth (AFAB) become older adults, they start transitioning into menopause, which can include hot flashes, mood swings, and other symptoms.

Even though people experience menopause differently, certain trends in the age of onset and symptoms can provide some guidance on what you can expect as you get older.

As you get older, your ovaries produce less of the hormones estrogen and progesterone. Without these hormones, periods become erratic for a time, and then eventually stop.

Once you’ve been without a period for 12 months, you’re most likely officially in menopause. On average, most vagina owners start menopause between the ages of 45 and 55.

The physical changes that usher in menopause can begin as early as age 40 or may not start until your late 50s.

The transition stage, or perimenopause, can last about 7 years, but for some, it can last as long as 14 years. During this phase, hormone levels begin to drop.

Smoking, along with age of onset, race, and ethnicity, can all affect how long perimenopause symptoms last.

Similarly, certain factors, such as smoking, can affect when menopause starts. A 2018 review of studies showed that smoking can greatly increase the chance of early menopause onset.

Here’s a look at menopause through the ages, and what types of symptoms to possibly expect as you reach each milestone.

It’s important to keep in mind that early menopause, perimenopause, and menopause symptoms are not linear or fully defined by age. You may find yourself experiencing some when you’re younger and others as menopause is underway.

No matter how it progresses, it’s important to talk with your doctor, so they can help you to manage your symptoms.

A couple of missed periods when you’re 40 might make you think you’re pregnant, but it’s also possible to begin menopause around this age.

About 5 percent of women go into early menopause, experiencing symptoms between the ages of 40 and 45. One percent of women go into premature menopause before age 40.

Early menopause can occur naturally. Or, it may be triggered by surgery to remove your ovaries, cancer treatments like radiation or chemotherapy, or autoimmune diseases.

Signs you’re in early menopause include:

  • missing more than three periods in a row
  • heavier or lighter than usual periods
  • trouble sleeping
  • weight gain
  • hot flashes
  • vaginal dryness

Because these can also be symptoms of pregnancy or other medical conditions, you should consider seeing your doctor for evaluation.

If you’re in early menopause, hormone therapy can help alleviate hot flashes, vaginal dryness, and other menopausal symptoms.

Going into menopause early could prevent you from starting a family if you’ve been waiting. You may want to consider options, like freezing your remaining eggs or using donor eggs to conceive.

Many AFAB folks enter the perimenopausal phase in their late 40s. Perimenopause means “around menopause.” At this stage, your estrogen and progesterone production slows, and you begin to make the transition into menopause.

Perimenopause can last 7 to 14 years. You’ll likely still get a period during this time, but your menstrual cycles will become more erratic.

During the last year or two of perimenopause, you may skip periods. The periods you do get could be heavier or lighter than usual.

Symptoms of perimenopause are due to rising and falling estrogen levels in your body. You may experience:

  • hot flashes
  • mood swings
  • night sweats
  • vaginal dryness
  • difficulty sleeping
  • changes in sex drive
  • trouble concentrating
  • hair loss
  • fast heart rate
  • urinary problems

It’s harder to get pregnant during perimenopause, but it’s not impossible. If you don’t want to conceive, continue to use contraception during this time.

During your early 50s, you may be in menopause, or you may be making the final transition into this phase. At this point, your ovaries are no longer releasing eggs or making much estrogen.

The change from perimenopause to menopause can take several years. Symptoms, like hot flashes, vaginal dryness, and sleeping difficulties, are common during this time.

If these symptoms are imposing on your daily life and activities, talk with your doctor about hormone therapy and other treatments that can help relieve them.

By age 55, most AFAB individuals have gone through menopause. Once a full year has passed since your last period, you’re officially in the postmenopausal phase.

You may still have some of the same symptoms you experienced during perimenopause and menopause, including:

  • hot flashes
  • night sweats
  • mood changes
  • vaginal dryness
  • difficulty sleeping
  • irritability and other mood changes
  • urinary problems

In the postmenopausal stage, your risk for heart disease can increase. Talk with your doctor about making lifestyle changes to protect yourself against heart disease and other age-related diseases.

A small percentage of AFAB folks are late going into menopause. This isn’t necessarily a bad thing.

Studies have linked late menopause to a lower risk of:

  • heart disease
  • heart attack
  • stroke
  • osteoporosis

It’s also linked to a longer life expectancy. Researchers believe that prolonged exposure to estrogen protects the heart and bones.

If you’ve already been through menopause, it doesn’t always mean you’re done with all the symptoms. An estimated 40 percent of women ages 60 to 65 still get hot flashes.

Hot flashes between ages 60 and 65 are infrequent, but some individuals can have hot flashes often enough that they become bothersome.

If you’re still getting hot flashes or other symptoms of menopause at this age, talk with your doctor about hormone therapy and other treatments, as well as other possible conditions that could be causing those symptoms.

The transition to menopause begins and ends at different times. Factors like your family history, personal health history, and whether you smoke can all impact the timing.

If you think you’re in perimenopause or menopause, talk with a healthcare professional. A simple test can tell you for sure based on hormone levels in your blood.