What Signals the End of Menopause?

What signals the end of menopause? Are there symptoms I should be looking for, or a general time frame of how long it lasts?

—Anonymous

Technically, menopause is never done. You are in menopause for the rest of your life. But I don’t think that is what you are asking. Rather, I suspect you want to know how to identify the end of the perimenopausal transition, when many women’s symptoms subside.

Thinking in the broader context of the perimenopausal transition, menopause begins with the last menstrual period. The STRAW+10 criteria divide menopause into early perimenopause — the first five to eight years after your last menstrual period — and late menopause — essentially the rest of your life after that. The criteria subdivide early perimenopause into the first two years and the three to six years after that based on symptoms and the levels of some hormones in the blood.

an adult sitting at a workplace using laptop and holding the head — kaboompics.com / Pexels

Early menopause still feels like part of the perimenopausal transition for many women. In fact, it is in the first two years after the last menstrual period that women are most likely to have hot flushes and night sweats. Typically women see these symptoms dissipate after a few years, though there is a subset of women who still have hot flushes or night sweats more than a decade after their last menstrual period.

If your doctor checks your follicle-stimulating hormone (FSH) in early menopause, you may find it still fluctuates quite a bit, but as you get further beyond your last menstrual period, FSH levels will stabilize.

In late menopause, women often note that not only do hot flushes and night sweats subside, their brain fog improves as well. However, vulvovaginal atrophy is most common in late menopause. It is also when the risk for heart disease, stroke, Type 2 diabetes, and osteoporosis begin to rise. As a result, establishing care with a trusted primary care physician is key to minimizing your risk for chronic disease.

Ultimately, there is no hard-and-fast cutoff for when the perimenopausal transition ends, but for most women, their perimenopausal symptoms will taper off over the 5 to 10 years after their last menstrual period.