When does perimenopause start, and at what age does menopause happen?

What's the average age of menopause?

The NIA puts the US average at 52¹. ACOG's patient guide says 51², and its October 2026 guideline announcement says natural menopause happens on average at age 50 in the US³. These are averages from different sources, not a deadline. The range around them is wide.

When does perimenopause usually begin?

The NIA says most women start the transition between 45 and 55, and that it "may last for several years"¹. ACOG says that from your 30s and 40s, the amount of estrogen the ovaries make "begins to fluctuate"². A common first sign is a change in your periods².

How do you know you've reached menopause?

Only in hindsight. The NIA says you'll know you've reached menopause once you've gone a full year without a period or spotting¹. That's why it advises continuing birth control for at least 12 months after your last period if you don't want to get pregnant¹.

Does everyone get symptoms?

No. The NIA says some women have no or mild symptoms¹, and ACOG says others have many symptoms that can be severe².

The limitation

These ages are averages for women whose menopause comes naturally. Menopause can also follow surgery to remove both ovaries¹, and ACOG notes it can come earlier after medical treatments such as chemotherapy or radiation³.

One thing to try, one thing to ask

Jot down your cycle dates for the next few months. Our printable tracker has a row for them. Then ask your clinician: "Given my age and my periods, does this look like perimenopause, and is there anything else we should rule out?"

Talk to a menopause-trained provider