Menopause is a natural stage in a woman’s life when monthly periods stop and the ovaries stop making certain hormones. This change usually happens between ages 45 and 55. After menopause, a woman can no longer get pregnant. Most women experience symptoms such as hot flashes, night sweats, or mood changes, but the severity and duration can vary. While menopause is not a disease, effective treatments are available for those who have bothersome symptoms. With the right support and care, most women can manage menopause and stay healthy.

Menopause is the permanent end of menstrual periods, marking the end of a woman’s reproductive years. It is defined as having no periods for 12 months in a row, provided this change is not caused by another medical condition. Menopause happens when the ovaries stop releasing eggs and stop making the hormones estrogen and progesterone.

Menopause is a normal part of aging and is not considered a disease. Most women reach menopause between ages 45 and 55, with the average age being about 51. It can also happen earlier due to surgery, certain medical treatments, or health conditions that affect the ovaries.

The process leading up to menopause, called perimenopause or the menopausal transition, can last several years. During this time, periods become irregular and symptoms such as hot flashes may begin.

After menopause, it is no longer possible to get pregnant naturally.

Menopause is caused by the decline in the number and function of ovarian follicles, which are the structures in the ovaries that contain eggs. As women age, the ovaries eventually stop releasing eggs and produce less estrogen and progesterone.

This decrease in hormone levels leads to the end of menstrual cycles and the symptoms of menopause. In some cases, menopause can be triggered earlier by surgical removal of both ovaries, cancer treatments such as chemotherapy or radiation, or certain medical conditions that damage the ovaries.

The main cause of menopause is aging, but factors such as genetics and certain health conditions can affect when it happens. Once menopause is complete, the body produces very little estrogen and no progesterone, which leads to the changes seen during this stage.

While age is the most important factor, several other factors can influence the timing and severity of menopause.

Risk factors for menopause include:

• Family history, as menopause tends to occur at similar ages within families
• Smoking, which can cause menopause to start one to two years earlier
• Medical treatments that can damage the ovaries, such as chemotherapy or radiation
• Surgical removal of both ovaries (oophorectomy)
• Some health conditions, such as autoimmune diseases, that can affect ovarian function
• Certain genetic conditions, which may lead to earlier menopause

While most women experience menopause in midlife, some may have early menopause before age 45 or primary ovarian insufficiency before age 40. These situations may increase the risk of certain health problems, such as bone loss or heart disease.

Symptoms of menopause vary widely, but most women experience changes in their periods and other physical or emotional symptoms.

Menopause symptoms often affect the menstrual cycle, body temperature, mood, sleep, and sexual health.

• Irregular periods, with cycles becoming shorter, longer, or skipped before stopping completely
• Hot flashes, sudden feelings of heat in the upper body and face, often with sweating and sometimes chills
• Night sweats, hot flashes that occur during sleep and may cause women to wake up drenched in sweat
• Sleep problems, such as trouble falling asleep, staying asleep, or waking up too early
• Mood changes, including irritability, anxiety, sadness, or depression
• Vaginal dryness, which can cause discomfort or pain during sex
• Decreased interest in sex or changes in sexual response, such as less desire or arousal
• Difficulty with memory or concentration, sometimes called "brain fog"
• Joint or muscle aches, stiffness, or discomfort
• Headaches, which may become more frequent or severe
• Urinary symptoms, such as needing to urinate more often or leaking urine during activities such as coughing or laughing
• Heart palpitations, a feeling of the heart pounding or racing

Not every woman will have all these symptoms, and their severity can range from mild to severe. Some women have only a few symptoms, while others may have symptoms that last for several years.

To diagnose menopause, a doctor typically reviews a woman’s medical history, performs a physical exam, and may order one or more diagnostic tests.

Diagnosis is usually based on a woman’s age, symptoms, and changes in menstrual patterns. For most women over age 45 who have not had a period for 12 months, menopause can be diagnosed without special tests.

Tests that may be used to help confirm menopause or rule out other causes include:

• Follicle-stimulating hormone (FSH) test, which measures a hormone that rises as the ovaries stop working
• Estradiol test, which measures the main form of estrogen in the body and usually drops during menopause
• Luteinizing hormone (LH) test, which may also rise as menopause approaches
• Thyroid-stimulating hormone (TSH) test, to rule out thyroid problems that can cause similar symptoms
• Bone density test, to check for bone loss related to lower estrogen levels, especially if there are risk factors for osteoporosis

A pelvic exam may also be done to look for changes in the vagina or other signs of low estrogen. In most cases, menopause is diagnosed based on symptoms and history, and blood tests are not always needed.

Treatment for menopause focuses on relieving symptoms and preventing long-term health problems related to lower hormone levels.

Not every woman needs treatment, but options are available for those with bothersome symptoms.

• Menopausal hormone therapy, which uses estrogen alone or with progesterone to relieve hot flashes, night sweats, mood changes, and vaginal dryness. Women with a uterus (those who have not had a hysterectomy) need both estrogen and progesterone to protect the uterine lining from cancer. (Estrogen alone is never used in women with a uterus.) Newer hormone regimens that substitute a selective estrogen receptor modulator for the progestin are also available.
• Vaginal estrogen, available as a cream, tablet, or ring, to treat vaginal dryness and discomfort during sex. This is a lower dose than hormone therapy that affects the whole body (such as pills or patches) and is used directly in the vagina.
• Nonhormonal medicines, such as certain antidepressants (paroxetine, venlafaxine, and fluoxetine), gabapentin (a seizure medicine), or clonidine (a blood pressure medicine), which can help reduce hot flashes and mood symptoms. Two newer medications, Veozah™ (fezolinetant) and Lynkuet® (elinzanetant), are approved by the Food and Drug Administration (FDA) for the treatment of hot flashes due to menopause.
• Lifestyle changes, including regular exercise, a healthy diet, dressing in layers, using fans, and avoiding triggers such as caffeine, alcohol, or spicy foods, which may help manage symptoms.
• Over-the-counter vaginal lubricants or moisturizers, to relieve vaginal dryness and make sex more comfortable.
• Cognitive behavioral therapy or relaxation techniques, such as yoga, meditation, or deep breathing, which may help with sleep and mood problems.

Doctors will consider a woman’s symptoms, health history, and preferences when recommending treatment. Some women may need a combination of approaches to feel their best.

Hormone therapy for menopause can provide important benefits, but it also carries some risks that should be discussed with a doctor.

The main benefits of hormone therapy for women include:

• Relief of hot flashes and night sweats, which can greatly improve quality of life
• Better sleep, as hormone therapy can reduce night sweats and help with sleep problems
• Improvement in mood and reduction in depression or anxiety related to menopause
• Relief of vaginal dryness and discomfort during sex, especially with vaginal estrogen
• Prevention of bone loss and fractures, as hormone therapy helps maintain bone strength
• Possible reduction in the risk of heart disease and Alzheimer's disease when started within 10 years of menopause

In November 2025, the U.S. Food and Drug Administration (FDA) removed longstanding “black box” warnings from hormone therapy products for menopause, citing research that shows that starting hormone therapy within 10 years of menopause may lower the risk of fractures and may reduce the risk of heart disease and Alzheimer’s disease.

However, hormone therapy may not be right for every woman. The risks of hormone therapy may include:

• A small increased risk of blood clots or stroke, especially with oral estrogen
• A possible increase in the risk of breast cancer with long-term use of combined estrogen and progesterone therapy. This risk is not elevated with the use of estrogen alone or estrogen with a selective estrogen receptor modulator.
• Gallbladder problems, such as gallstones or inflammation, especially with oral estrogen

The FDA recommends starting hormone therapy within 10 years of menopause or before age 60 for most healthy women who need symptom relief. The decision to use hormone therapy should be made together with a doctor, considering personal health history and preferences. For women who cannot or do not want to use hormone therapy, nonhormonal treatments are available.

Potential problems from menopause most often involve the bones, heart, and urinary or sexual health, and can include long-term issues due to lower estrogen levels.

• Osteoporosis, a condition where bones become weak and more likely to break
• Increased risk of heart disease, as lower estrogen can affect cholesterol and blood vessel health
• Bone fractures, especially in the hip, spine, or wrist, due to bone loss
• Vaginal dryness and pain during sex, which can affect quality of life and relationships
• Urinary problems, such as more frequent infections or trouble controlling urine
• Mood disorders, including depression or anxiety, which may worsen during menopause
• Memory or concentration problems, sometimes called "brain fog"
• Joint or muscle pain, which can affect daily activities

Women should contact a doctor if they have vaginal bleeding after menopause, heavy or prolonged bleeding, or new symptoms that are severe or do not improve. These could be signs of other health problems that need attention.

For most women, the outlook is very good, and menopause is a normal part of aging that can be managed with the right support.

Most symptoms improve over time, and many women find relief with lifestyle changes or treatment if needed. While menopause can increase the risk of certain health problems, such as osteoporosis or heart disease, regular checkups and healthy habits can help reduce these risks.

The experience of menopause is different for every woman. Some women have few or mild symptoms, while others may need more support. With proper care, most women can continue to lead active, healthy lives after menopause. Regular follow-up with a doctor can help address any ongoing symptoms or concerns.

“Yale doctors have been leaders in menopausal care and research,” says Yale Medicine’s Hugh Taylor, MD, chair of the Department of Obstetrics, Gynecology, and Reproductive Sciences. “We have conducted some of the most influential clinical trials on menopausal health. We have a team of menopause experts who are knowledgeable about all the symptoms of menopause and perimenopause. Our doctors are available to guide patients through this difficult transition and individualize treatment options.”