The average age
In the UK the average age at menopause is 51. The NHS describes menopause as usually happening between the ages of 45 and 55, although it can happen earlier (NHS, Menopause). Menopause is defined in retrospect: a person is considered to have reached it after 12 consecutive months without a period, when this is not due to another cause.
Perimenopause comes first
The years before menopause are called perimenopause. Hormone levels change, periods often become irregular, and symptoms such as hot flushes, sleep problems or mood changes can begin. Perimenopause can last several years. During this time pregnancy is still possible, which is why contraception advice continues until menopause is confirmed.
Early menopause and premature ovarian insufficiency
Menopause before the age of 45 is called early menopause. Health information based on NHS sources estimates that natural early menopause affects around 5% of women (Healthtalk / University of Oxford, What is the menopause?).
Menopause before 40 is called premature menopause, or premature ovarian insufficiency (POI). NHS sources put it at around 1 in 100 women. It can follow surgery to remove the ovaries, chemotherapy or radiotherapy, or certain conditions; often no clear cause is found. Because the ovaries stop working normally much earlier than expected, POI has consequences for fertility, bone health and heart health, and hormone treatment is usually recommended until the average age of menopause.
Fertility declines long before menopause
The most important point for fertility is that the decline starts well before periods stop. Egg quantity and quality fall over the thirties and more steeply after about 37 to 40. National IVF data show this clearly: in the UK in 2023, the birth rate per embryo transferred using a patient's own eggs was 35% for ages 18–34 and 5% for ages 43–44 (see IVF success rates explained). The NHS advises women aged 36 and over to see a GP sooner if they are having trouble conceiving (see how common is infertility?).
In other words, the average age of menopause, 51, is not a guide to the age until which pregnancy is likely. It is the end point of a decline that begins years before.
Can you predict your own menopause?
Not precisely. Family history gives some indication, and tests of ovarian reserve such as AMH reflect the number of remaining follicles, but neither can give an exact age. The AMH test in particular is better at predicting the response to IVF stimulation than natural fertility (see what an AMH test can and cannot tell you).
When to seek advice
- Periods that stop or become very irregular before 45, especially before 40.
- Menopausal symptoms that affect daily life, at any age.
- Concerns about fertility in the late thirties or forties, where earlier advice can widen the options available, including egg freezing for some people.
This article summarises health information from NHS-based sources and is not medical advice. A GP can assess symptoms and discuss treatment options.
Symptoms
Symptoms of perimenopause and menopause vary widely. The NHS describes changes to periods, hot flushes, night sweats, difficulty sleeping, low mood or anxiety, problems with memory and concentration, and vaginal dryness among the most common. Some people have few symptoms; others find them disruptive for years. Symptoms can start while periods are still regular.
Treatment and support
Hormone replacement therapy (HRT) is the main treatment for menopausal symptoms and replaces the hormones that fall during menopause. Other options include non-hormonal medicines and cognitive behavioural therapy, which can help with symptoms such as low mood and anxiety. Lifestyle measures, including regular exercise and limiting alcohol and caffeine, can also help. A GP can discuss the benefits and risks of each option, which depend on personal and family history.
Contraception around menopause
Because pregnancy is still possible during perimenopause, contraception is advised until menopause is confirmed. NHS guidance generally advises continuing contraception for two years after the last period if it happens before the age of 50, and for one year if it happens after 50.
Related conditions
Some conditions that affect fertility earlier in life, such as polycystic ovary syndrome, also influence long-term health after menopause, which is why follow-up continues; see PCOS explained.
Bone and heart health
The fall in oestrogen at menopause affects more than periods. Oestrogen helps maintain bone density, so the risk of osteoporosis rises after menopause, especially when it happens early. Changes in cholesterol and blood vessels also contribute to a rising risk of cardiovascular disease with age. This is why early menopause and premature ovarian insufficiency are treated as conditions that need follow-up, not only as the end of fertility, and why exercise, not smoking and a balanced diet matter in midlife.
Talking about it
Menopause is now discussed far more openly than a generation ago, including at work, where adjustments such as flexible hours or temperature control can help people with troublesome symptoms. Many people find that understanding what is happening, and knowing that treatment exists, is itself a relief.
For anyone whose periods change before the age of 45, the practical message is simple: it is worth mentioning to a GP, because early diagnosis allows treatment that protects long-term health, and because it may change decisions about fertility.