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Menopause is a biological process that occurs when a woman’s ovaries stop releasing mature eggs and her body produces less estrogen and progesterone.

Your doctor or gynecologist can also help determine if you’re beginning menopause. They’ll ask about your symptoms, track your cycle, and possibly conduct a few tests.

Menopause usually begins between the ages of 40 and 60, though it’s most common for it to start around age 51. It’s likely to have begun if you haven’t had a period in over six months. It’s clinically confirmed after 12 full months without a period.

You may first start noticing menopause symptoms a few months or even years before menopause actually begins. This is known as perimenopause. Some of the symptoms you may notice include:

You may go months without a period during the perimenopause phase. However, if you miss a period and aren’t using contraception, see your doctor or take a test to make sure that you aren’t pregnant.

Menopause can be self-diagnosed in most cases. Talk to your doctor to confirm a diagnosis and to identify ways to reduce bothersome symptoms. This will also give you a chance to ask questions about what to expect.

Before you visit your doctor, track any symptoms you’re experiencing, how often they occur, and how severe they are. Note when you had your last period and report any irregularities in timing that might have occurred. Make a list of medications and supplements you’re currently taking.

Your doctor will ask you about the date of your last period as well as how often you experience symptoms. Don’t be afraid to discuss all of your symptoms, which may include hot flashes, spotting, mood swings, trouble sleeping, or sexual problems.

Menopause is a natural process and your doctor can give you expert advice. Usually, the symptoms you describe provide enough evidence to help diagnose menopause.

Your healthcare provider can swab your vagina to test its pH levels, which can also help confirm menopause. Vaginal pH is about 4.5 during your reproductive years. During menopause, vaginal pH rises to a balance of 6.

If you’re having menopausal symptoms, your doctor may order tests to rule out other conditions, such as ovarian failure or a thyroid condition. These tests may include:

  • a blood test to check your levels of follicle stimulating hormone (FSH) and estrogen
  • a thyroid function test
  • a lipid profile
  • tests for liver and kidney function

Your doctor may order a blood test to check your levels of follicle-stimulating hormone (FSH) and estrogen. During menopause, your FSH levels increase and your estrogen levels decrease.

During the first half of your menstrual cycle, FSH, a hormone released by the anterior pituitary gland, stimulates maturation of eggs as well as the production of a hormone called estradiol.

Estradiol is a form of estrogen that is responsible for (among other things) regulating the menstrual cycle and supporting the female reproductive tract.

In addition to confirming menopause, this blood test can detect signs of certain pituitary disorders.

Your doctor may order an additional blood test to check your thyroid-stimulating hormone (TSH), as hypothyroidism can cause symptoms that are similar to menopause.

A recently approved diagnostic test called the PicoAMH Elisa test measures the amount of anti-Mullerian hormone (AMH) in the blood. It can help your doctor determine when you will enter menopause if you haven’t already.

Early menopause is menopause that begins between the ages of 40 and 45. Premature menopause starts even earlier, before age 40. If you start noticing symptoms of menopause before you turn 40, you may be experiencing premature menopause.

Early or premature menopause can happen for a number of reasons, including:

If you’re under 40 and haven’t had a period in over 3 months, see your doctor to get tested for early menopause or other underlying causes.

Your doctor will use many of the same tests mentioned above for menopause, especially tests used to determine your levels of estrogen and FSH.

Early menopause can increase your risk for osteoporosis, heart disease, and other health problems.

If you suspect that you might be experiencing it, getting tested for menopause can help you decide early on how best to manage your health and symptoms if you’re diagnosed.

Once menopause has been confirmed, your doctor will discuss treatment options. You may not need any treatment if your symptoms aren’t severe.

But your doctor may recommend certain medications and hormone therapies to deal with symptoms that can affect your quality of life. They may also recommend hormone treatments if you are younger when you reach menopause.

Some symptoms can make it hard to go about daily activities, such as sleep, sex, and relaxation. But you can make lifestyle changes to help manage your symptoms:

  • For hot flashes, drink cold water or leave a room to somewhere that’s cooler.
  • Use water-based lubricants during sexual intercourse to minimize the discomfort of vaginal dryness.
  • Eat a nutritious diet, and talk to your doctor about taking supplements to make sure you’re getting enough nutrients and vitamins.
  • Get plenty of regular exercise, which can help delay the onset of conditions that happen as you get older.
  • Avoid caffeine, smoking, and alcoholic beverages as much as possible. All of these can cause hot flashes or make it hard to sleep.
  • Get plenty of sleep. The number of hours necessary for a good sleep vary from person to person, but seven to nine hours per night is usually recommended for adults.

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Menopause can increase your risk of other conditions, especially those associated with aging.

Continue to see your doctor for preventive care, including regular check-ups and physical exams, to make sure that you’re aware of any conditions and to ensure your best possible health as you get older.