What Is Menopause? Everything You Need to Know

Most women picked up a hazy version of menopause somewhere between school biology and a half-heard conversation with an aunt. Menopause is the point at which periods stop for good, defined as twelve months in a row without a period, with nothing else to explain it. In the UK that happens at 51 on average, anywhere between 45 and 55 counts as normal, and the years of change that come before it have a name of their own, perimenopause.

The hazy version goes something like this. Periods stop, hot flushes arrive, and oestrogen is involved somehow. That is roughly right and badly incomplete.

The hormones in question reach well beyond your cycle, into your mood and memory, your heart and your bones. For a transition this big, the public conversation has stayed remarkably thin.

What does menopause mean, medically?

In medical terms, menopause is a single moment. It falls on one date, and you only know it has passed when you look back a year later and count the months.

The definition can sound pedantic, yet it has real consequences. People often say "menopause" when they mean perimenopause, the transition that leads up to it, and that muddle can leave women waiting years for support because they assume, or hear, that they are not there yet. Our guide to perimenopause covers that stage in detail.

What happens in your body at menopause?

You were born with a finite supply of follicles in your ovaries. Those follicles make oestrogen and progesterone, the two hormones that run your menstrual cycle. Over the decades the supply dwindles, hormone production falls with it, and in time ovulation stops and so do your periods.

Your brain notices the drop in oestrogen and responds with more follicle-stimulating hormone (FSH), sending ever more insistent signals to ovaries that no longer answer as they once did. That rise explains why FSH turns up in hormone testing, although a single FSH reading tells you only part of the story, as our guide to biomarkers explains.

Oestrogen also does far more work than most people were taught. It has receptors in the brain, heart, bones, gut, bladder and skin, so when levels fall the effects can reach right across the body.

What are the three stages of menopause?

Perimenopause is the transition. It can last anywhere from two to twelve years, and it is when most women notice symptoms. Hormone levels swing unpredictably through these years, which helps explain why this stage can feel rougher than the one that follows.

Menopause is the marker itself, twelve months without a period, recognised in hindsight. Everything before it counts as perimenopause and everything after it as postmenopause.

Postmenopause covers the rest of your life from that date. Some symptoms settle as your body adjusts to a new, lower hormonal baseline. Others, especially those tied to long-term low oestrogen, need ongoing attention.

This is also the stage when your heart health, bone density and brain health come to the fore.

Is menopause only about hot flushes?

Hot flushes and night sweats are the best known symptoms. About 75% of women have them during the transition, and roughly one in four find them severe.

They sit on a much longer list, though. The recognised symptoms of menopause run into the dozens, from mood changes and brain fog to joint pain, palpitations and changes in your skin.

Over the longer term, the years after menopause bring a step change in cardiovascular risk and bone loss, and emerging research points to effects on brain health as well. Menopause is a normal stage of life with no built-in story of decline. Good information, early awareness and access to the right support all change how women fare through it.

Part of that awareness is knowing what your own hormones looked like before anything changed, so that you and your doctor have a reference point. That idea of knowing your own normal sits behind what we test, and our guide on whether to get a perimenopause blood test sets out the pros and cons.

Questions women ask

What is the average age of menopause in the UK?

The average age is 51, and anywhere between 45 and 55 is considered normal. Perimenopause, the transition before it, starts earlier and can last from two to twelve years. Our guide to what age menopause starts goes into more detail.

How do you know when you have reached menopause?

Menopause is defined as twelve consecutive months without a period, when nothing else accounts for it, so it can only be recognised in hindsight. Everything after that date is called postmenopause. A GP or menopause specialist can help you make sense of where your own pattern fits.

What is the difference between menopause and perimenopause?

Perimenopause is the transition, when hormone levels swing and most symptoms appear. Menopause is the single point at the end of it, twelve months after your final period. Our explainer on perimenopause vs menopause sets the two side by side.