The first sign that you are entering menopause is usually a change in your menstrual cycle; periods may come closer together or farther apart, and bleeding may be lighter or heavier, said Siobán Harlow, director of the Center for Midlife Science at the University of Michigan School of Public Health. These changes can be unpredictable and unnerving, and in women who experience heavier periods, it’s possible to have a dangerous amount of blood loss, warranting medical care, said Dr. Harlow.
At the same time, fluctuations in estrogen can cause a person to “get hot flashes and night sweats, or get migraines, or not sleep well, or feel super irritable,” said Dr. faubion. Then they may have a few normal cycles and a hiatus in symptoms, followed by a resurgence, she said. A range of other symptoms can also occur with the menopause, including depression, anxiety, brain fog, changes in skin and hair, joint pain, and vaginal dryness.
Once you go 60 days without bleeding, you are in what is known as late menopause; from here, most women will have their last period within two years, said Dr. Nanette Santoro, a professor of obstetrics and gynecology at the University of Colorado School of Medicine. At this stage, “the symptoms tend to increase, so if they were annoying in early menopause, they get a little worse,” she said.
Hot flashes, sometimes accompanied by night sweats, are among the most common symptoms of menopause, experienced by so many people 80 percent of women† In a 2015 study of the roughly 1,500 U.S. women who regularly experienced hot flashes or night sweats, these symptoms lasted an average of 7.4 years, usually several years before their last menstrual period and then an average of 4.5 years. Women who experienced hot flashes earlier in menopause — before reaching the 60-day milestone of no periods — had to endure these symptoms longer, averaging a total of 11.8 years. “If it starts early, it can be a very long, nasty menopause,” said Dr. Santoro, and given this, “you may want to seek help sooner rather than later.”