How long does menopause last? Explained per phase

"When is this over?" It is the question many women ask somewhere in the middle of a night with sweated-through bedding. The honest answer is uncomfortable: menopause is not a moment you pass, but a process that stretches over years. The good news is that you can reasonably estimate what to expect per phase, and that the most intense period is usually not the longest.

Menopause in three phases

Menopause unfolds in three main phases, each with its own duration and features. This table gives the overview; we explain each phase afterwards.

Perimenopause: the longest phase

Perimenopause begins on average around age 45, though some women notice the first changes around 40. In this phase your estrogen and progesterone levels start to fluctuate. Your cycle becomes irregular and the first symptoms can appear: hot flashes, sleep problems, mood swings. The average duration is 4 to 8 years, but for some women up to 10.

Menopause: a single moment

Menopause is technically not a phase but a moment: the point at which you have had no period for 12 consecutive months. The average age in the Netherlands is 51, with 45 to 55 as the normal range, as the NVOG also maintains.

Postmenopause: the phase after

After menopause you are in postmenopause. Your hormone levels stabilise at a lower level. Many women notice that hot flashes and night sweats gradually ease in the first years. Bone health and cardiovascular health do deserve extra attention in this phase.

How long do symptoms last?

The duration of symptoms differs strongly per woman. These guidelines give an impression.

• Hot flashes: around 7 years on average, longer for some women
• Sleep problems: can span perimenopause and part of postmenopause
• Mood symptoms: ease for most women after menopause
• Vaginal dryness: can persist without treatment in postmenopause
• Joint complaints: variable, temporary for some women

What affects the duration?

• Genetics: the age at which your mother went through menopause gives an indication
• Smoking: can bring menopause forward by 1 to 2 years; the RIVM names smoking as an aggravating factor
• Lifestyle: chronic stress and little exercise can worsen symptoms
• Ethnicity: research shows differences in duration and type of symptoms

Our view: you cannot speed up menopause, but you can do a lot about how you get through it. Exercise, attention to your bones and, where appropriate, hormone therapy in consultation with a doctor often make more difference than waiting for it to pass.

What can you do?

• Exercise regularly, also for your bone health
• Eat varied with attention to calcium and vitamin D
• Consider hormone therapy if symptoms affect your daily life, in consultation with a doctor
• Have your hormones measured if you want to know which phase you are in

To know where you stand, a menopause blood test can bring values such as FSH and estradiol into view. For the broader context, read our pillar on perimenopause. We wrote separately about bone health after menopause in osteoporosis after menopause.

What is normal, and when to check in

A long menopause is unpleasant, but not in itself a reason for concern. The duration says little about your health. Still, there are signals where it is wise to see your GP, regardless of how long you have had symptoms:

• Unexpected vaginal bleeding after you have had no period for a while
• Symptoms that seriously affect your daily functioning or your work
• Low mood or anxiety that persists longer
• Fatigue or weight changes that could equally fit a thyroid problem

Thuisarts.nl advises always having unexpected bleeding in postmenopause assessed. That is no reason for panic, but it is something you should not wait out yourself.

Our view: focus on getting through, not sitting it out

The idea that you simply have to "sit out" menopause keeps many women in their symptoms longer than necessary. The duration is largely fixed, but how you get through it is not. Exercise, attention to your bones and, where appropriate, treatment in consultation with a doctor can make the difference between years of surviving and years in which you feel reasonably well. You do not have to wait for it to pass on its own.

Frequently asked questions

Can menopause last less than 4 years?

Yes, some women have a relatively short course. With surgical menopause, where the ovaries are removed, menopause is immediate, which can cause more abrupt symptoms.

How do I know I am through menopause?

Officially, you are in postmenopause after 12 months without a period. Symptoms like hot flashes can persist for a few more years, but gradually lessen.

How long does menopause last if my mother went through it early?

Genetics play a role in timing, but less in duration. You can start early and still have an average course. A hormone test can, in consultation with your doctor, help determine your current phase.