How long does menopause last?

If you want to see where your own age and dates sit, use the perimenopause or menopause stage checker. It asks for your age and how many months have passed since your last period.

The three stages on one timeline

Perimenopause is the time before menopause, while you are still having periods. Menopause is that point. After that point, perimenopause has ended, and the NHS symptoms page calls the next stage postmenopause. The NHS page on menopause and perimenopause is where that point is defined.

Symptoms often start during perimenopause, while periods are still happening, and they can continue into postmenopause. The perimenopause guides cover the years leading up to menopause.

The notes worth keeping are the month symptoms began and, if periods have stopped, the month of the last one. The months before the menopause point are perimenopause. The months after it are postmenopause, and symptoms can continue during that time.

Contact a GP if you have not had a period for 12 months or more and any vaginal bleeding returns. The NHS symptoms page advises contacting a GP even if the hot flushes have already eased.

How long does perimenopause last?

A Northern Ireland government survey says perimenopause, the menopause transition, can last many years. Symptoms of that transition can go on for a long time, up to menopause and beyond it (menopausal symptoms at work survey).

The nidirect menopause page says symptoms can begin months or years before periods stop. While you are still having periods, that transition is still underway, however long the symptoms have already lasted. I would treat the whole run-up, up to the menopause point, as perimenopause.

How long do menopause symptoms last?

The NHS figure of 7 to 9 years, sometimes longer, starts at the first signs and covers the transition. The nidirect figure of about four years starts after periods have stopped, and some women have symptoms for much longer. Use the NHS figure for the length of the whole experience, from the earliest change. Use the nidirect figure for how long symptoms last once periods stop.

If symptoms start years before periods stop and continue afterwards, the total can come close to the NHS estimate above. Women who still have symptoms long after the four-year mark are the group both pages describe when they say it can last longer. Over those years the pattern can change. Hot flushes and night sweats may ease, and low mood and anxiety can become what you notice most. How those changes feel day to day is covered in the symptoms guides. What can help with the low mood and anxiety, including HRT and CBT, is in HRT, anxiety and low mood in menopause.

How long do hot flashes last, and when do they stop?

A hot flush is a sudden feeling of being very hot or cold in the face, neck and chest. You may sweat, have palpitations, and feel anxious or dizzy. A single episode can last several minutes. People also call that a hot flash. The figures below are about how many years the episodes keep happening.

A Barnsley NHS patient leaflet says hot flushes tend to start just before menopause and typically go on for 2 to 3 years (Barnsley menopause and HRT leaflet). A Darent Valley Hospital NHS leaflet says these symptoms last about 2 years on average (Darent Valley menopause leaflet). Both leaflets give a short estimate for most women.

The Darent Valley leaflet also says that for about 10% of women, the symptoms can continue for more than 15 years. A draft scope for the NICE menopause guideline gives a similar proportion for vasomotor symptoms, meaning flushes and sweats: in 10% of women who have them, they can last up to 15 years (NICE menopause draft scope). A Barnsley formulary guideline says 5% of women will have them for life (Barnsley HRT formulary guideline).

The NHS symptoms page does not give a set time after menopause when hot flushes stop for everyone. The leaflet averages cover a few years, and menopause symptoms overall can last longer than the flushes. Ways to ease hot flushes, including cognitive behavioural therapy, are covered in the hot flashes guides. The guide to hormone replacement therapy for menopause explains what the treatment is and which forms it comes in.

What to do if your symptoms last longer than you expected

The leaflets already include women whose flushes outlast the averages, and a smaller group with lifelong flushes.

Bring two dates if you have them: when symptoms began, and when periods stopped. The stage checker turns the second date into a stage. The checklist turns what you feel into a list you can talk through. Together they give a GP your timeline and the impact of the symptoms.

If sleep, work or mood is suffering, print the menopause symptom checklist for your GP and take it to the appointment. Ask your GP about hormone therapy, and about the non-drug options in the hot flashes guides.

Contact a GP promptly if bleeding starts again after menopause, whether or not you still have flushes. The timeline above sets out when a gap without periods is long enough to see a GP.

My take

I would start with the stage checker, enter the months since periods stopped, and read the result before comparing it with the estimates above. I would keep both estimates in view: the one that starts with the first signs, and the one that starts after periods stop.

If flushes are still strong several years later, that still falls within the longer estimates in the leaflets. I would book a review with a clinician and take the checklist.

Sources

• NHS: what are menopause and perimenopause
• NHS: menopause and perimenopause symptoms
• nidirect: menopause
• nidirect consultation: menopausal symptoms at work survey
• Barnsley NHS: menopause and HRT patient leaflet
• Barnsley formulary: HRT treatment options guideline
• Darent Valley Hospital NHS: menopause patient leaflet
• NICE: menopause guideline draft scope