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As women we know menopause is coming, but how do we know when it’s actually starting? Knowing the signs of menopause and at what age they may start can help us recognize this transition and, importantly, help us find ways to control discomfort and health risks.

According to the National Institutes of Health (, the term menopause refers to the time when menstruation naturally stops, usually between the ages of 45 and 55. Periods stop when the ovaries stop producing the hormones estrogen and progesterone. A woman is considered to be “in menopause” when she has had no menstrual periods for 12 months and has no other medical reason for menstruation to stop. Your healthcare provider can determine whether your periods have stopped naturally or as the result of another medical issue.

The years leading up to the time your period stops are considered perimenopause, and it’s during this phase that you may start noticing signs that you’re approaching menopause. Perimenopause can begin in your thirties or forties and may last as little as a few months or, more commonly, a few years.

There are no conclusive tests to tell you if you’ve entered perimenopause, so it’s up to you be aware of the signs of this transition, listen to your body, and discuss changes with your healthcare team. Each symptom is related to fluctuating hormone levels. Here’s what to look for:

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  • Hot flashes and night sweats are very common symptoms of perimenopause, affecting more than half of all women.
  • Irregular periods during perimenopause can mean more frequent periods, missing periods, heavier or lighter, or longer or shorter periods—any noticeable changes to your regular periods.
  • Many women have trouble sleeping as they approach menopause—whether due to night sweats waking you up or other stresses and changes in your body.
  • If you’ve been prone to premenstrual headaches, you may begin to experience more headaches during perimenopause.
  • Feeling more irritable, fatigued, or down than usual? Mood swings can often accompany perimenopause.
  • Vaginal dryness is caused by a drop in estrogen levels, which occurs with perimenopause and menopause.

Though the above symptoms are linked with perimenopause and menopause, they can also be related to other medical issues. So, even if you’re at an appropriate age for menopause, you’ll want to discuss these changes with your healthcare provider to rule out other health concerns.