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Menopause is the point when your periods stop permanently, and it is a normal stage of life rather than a disease. It is officially reached after 12 months in a row without a period, and the years leading up to it, called perimenopause, can bring changes that look different for every woman. Menopause awareness starts with knowing the basics, so this guide explains what menopause and perimenopause are, what changes are commonly reported, and when it makes sense to talk with a health care provider.
What Is Menopause?
According to the Office on Women's Health (OWH), part of the U.S. Department of Health & Human Services, menopause is when your period stops permanently and you can no longer get pregnant. You have reached it only after a full year with no bleeding, including spotting. The National Institute on Aging (NIA) is equally clear that menopause is not a disease or disorder but a normal part of aging.
After menopause, the ovaries make very low levels of the hormones estrogen and progesterone. That hormonal shift is behind many of the changes women notice, which is why the transition is sometimes described as unfolding over several years rather than happening all at once.
What Is Perimenopause, and How Is It Different?
Perimenopause means "around menopause." It is the transition leading up to your last period, and it is when many women first notice something is changing. During this time your ovaries make different amounts of estrogen and progesterone than usual, and hormone levels can shift unpredictably. Because you may not ovulate every month, periods can become longer, shorter, heavier, lighter, or skip a month or more.
In plain terms:
- Perimenopause is the transition, when hormones fluctuate and periods become irregular.
- Menopause is a single point in time, confirmed after 12 months without a period.
- Postmenopause is the stage that follows and lasts for the rest of your life.
How Long Does the Transition Last?
OWH says perimenopause can last between two and eight years, and for most women it lasts about four. NIH's MedlinePlus Magazine describes the whole process, across all phases, as usually lasting about seven years but sometimes as long as 14. The phases can overlap, and no two timelines look exactly alike.
Can You Still Get Pregnant During Perimenopause?
Yes. OWH notes that you can still get pregnant during perimenopause, even if you miss a period for a month or several months, because you may still ovulate on some months. If you do not want to become pregnant, OWH advises continuing birth control until one full year after your last period, and it suggests talking with your provider about your options.
At What Age Does Menopause Usually Happen?
The average age of menopause in the United States is around 51 to 52, depending on the source. OWH reports the usual range is between 45 and 58, and MedlinePlus lists 45 to 55 as the most common ages. Perimenopause typically starts earlier, in the mid- to late 40s, though MedlinePlus Magazine notes it can begin as early as 40 for some women.
Timing is influenced by several factors, including genetics, medical history and medications, and lifestyle habits. According to OWH, smoking can bring on menopause up to two years earlier, and chemotherapy or surgery to remove both ovaries can cause menopause earlier than it would otherwise happen. MedlinePlus defines menopause before age 45 as early menopause and before age 40 as premature menopause. If your periods stop at a young age, that is a reason to talk with a provider.
Does Everyone Have the Same Symptoms?
No, and this is one of the most important things to know. OWH states that some women have no or very mild symptoms during perimenopause or menopause, while others notice changes in many areas. Symptoms may begin suddenly and be very noticeable, or start mildly. NIH's MedlinePlus Magazine puts it simply: everyone's experience is different, and you may have many symptoms or hardly any.
Commonly reported changes include:
- Irregular periods, which may be longer, shorter, heavier, or lighter
- Hot flashes, which the NIA calls the most common menopause symptom, affecting as many as three out of four women
- Sleep problems and night sweats
- Mood changes, such as irritability
- Vaginal dryness, which can make sex uncomfortable
- Trouble concentrating or memory changes
Our companion guide on common menopause symptoms goes deeper on each of these. The key point for awareness is that having a different experience from a friend, a sister, or a celebrity story does not mean something is wrong with you.
Other Changes Worth Knowing About
Some changes are less noticeable than hot flashes. OWH explains that lower estrogen can lead to a loss of bone density, which can contribute to osteoporosis, a condition in which bones become weak and break more easily. Changing estrogen levels can also raise cholesterol levels. MedlinePlus Magazine adds that hormone changes can increase the risk of heart disease and osteoporosis, which is why healthy lifestyle habits and regular check-ups matter during and after this stage.
When Should You Talk to a Health Care Provider?
Only a health care provider can evaluate what is behind your symptoms, since some symptoms can have other causes. OWH advises telling your provider about any menopause symptoms that bother you, and it recommends tracking your periods, since irregular periods may be your first sign of the transition. You do not need to wait until symptoms feel unbearable.
It is especially worth making an appointment if:
- Your periods come very close together, last more than a week, or are heavy (MedlinePlus Magazine)
- Bleeding or spotting returns after you have gone a year without a period. OWH says any vaginal bleeding after menopause is not normal and should be checked as soon as possible
- Your periods stop at a younger age than usual, such as before 45
- Symptoms such as poor sleep, mood changes, or hot flashes affect your daily life
- You are unsure whether you are still able to get pregnant
OWH also notes that providers do not usually recommend blood hormone testing to confirm perimenopause without a medical reason, because hormone levels rise and fall unpredictably during the transition. A conversation about your symptoms, history, and health risks is the more useful starting point.
A Note on Supplements and Where PumPums Fits
Many products are marketed for menopause, and it is natural to be curious. MedlinePlus says research on supplements and herbs marketed for menopause has produced mixed results, that information on long-term safety is limited, and that some can cause side effects or interact with medicines, so you should check with your provider before taking any of them.
PumPums Menopause Relief is a dietary supplement in capsule form that contains black cohosh and red clover. NIH's National Center for Complementary and Integrative Health (NCCIH) reports that evidence on red clover has not been conclusive, and that black cohosh has been studied for menopause symptoms but is associated with rare reports of liver problems. As with any supplement, talk with your provider first, particularly if you take medicines, are pregnant or breastfeeding, or have a hormone-sensitive condition.
FAQ
What is the difference between perimenopause and menopause?
Perimenopause is the transition leading up to your last period, when hormones fluctuate and periods become irregular. Menopause is reached after 12 months in a row without a period.
What is the average age of menopause in the U.S.?
The average is about 52 according to OWH and the NIA, and around 51 according to MedlinePlus Magazine. The usual range is 45 to 58.
Do all women have hot flashes?
No. Hot flashes are the most common symptom and affect as many as three out of four women, according to the NIA and OWH, which also means some women never have them.
Is bleeding after menopause normal?
No. OWH says any vaginal bleeding after menopause is not normal and should be evaluated by a health care provider as soon as possible.
Is menopause a medical condition?
No. The NIA describes menopause as a normal part of aging, though its symptoms can affect quality of life and are worth discussing with a provider.
Sources
- What Is Menopause?, National Institute on Aging (NIH)
- Menopause basics, Office on Women's Health, U.S. Department of Health & Human Services (updated April 2, 2026)
- Menopause, MedlinePlus, National Library of Medicine (NIH)
- Menopause: What you need to know, NIH MedlinePlus Magazine
- Menopause symptoms and relief, Office on Women's Health (updated May 30, 2025)
- Black Cohosh: Usefulness and Safety, NCCIH, NIH
- Red Clover: Usefulness and Safety, NCCIH, NIH
