Last updated: October 2026
Menopause itself is a single point: the day you reach 12 months without a period. The change around it lasts much longer. Perimenopause usually runs for several years, and the NHS says symptoms typically last 7 to 9 years, sometimes longer. In a major US study, hot flushes lasted a median of 7.4 years.
The timeline in brief: perimenopause often starts in your 40s and lasts several years. Menopause is reached at around 51 on average in the UK. Most symptoms ease over the following years, but hot flushes can carry on for a decade or more in some women, and vaginal dryness can continue unless it’s treated.
The three stages of menopause
“The menopause” is often used to mean the whole change, which is why answers to “how long does it last?” vary so much. Doctors split it into three stages.
| Stage | What happens | Typical timing | Key signs |
|---|---|---|---|
| Perimenopause | Hormone levels rise and fall unpredictably as the ovaries wind down | Can start in your late 30s or early 40s and often lasts several years | Irregular periods, hot flushes, poor sleep, mood changes, brain fog |
| Menopause | Your periods have stopped for good | A single point: 12 months after your last period, usually between 45 and 55 | Only known looking back, once a full year has passed |
| Postmenopause | Oestrogen stays low for the rest of your life | From that point onwards | Most symptoms gradually ease; vaginal dryness and joint aches can continue |
Women’s Health Concern, the patient arm of the British Menopause Society, says perimenopause is often when symptoms are most noticeable, because hormone levels fluctuate. For the early signs, see perimenopause symptoms.
What age does menopause start and end in the UK?
The NHS says menopause usually happens between the ages of 45 and 55. NHS inform puts the average age at 51 in the UK. Women’s Health Concern notes research suggesting Black and Hispanic women may reach menopause about two years earlier than White or Asian women.
For example, if your last period came at 51, you would know you had reached menopause a year later. Everyone is different, and Women’s Health Concern notes that some women have no symptoms at all.
Menopause before 45 is called early menopause, and before 40 is premature menopause (more on both below).
How long do menopause symptoms last?
The NHS says symptoms usually last 7 to 9 years, sometimes longer, and can change during that time. Here is what the research shows for the main ones.
| Symptom | How long it tends to last | Read more |
|---|---|---|
| Hot flushes and night sweats | Median 7.4 years; longer if they start early | Hot flushes |
| Sleep problems | Rise through perimenopause, often with night sweats | Perimenopause and sleep |
| Low mood | Risk is highest before the last period, then falls | Menopause and anxiety |
| Brain fog | Usually temporary; learning recovers after menopause | Menopause brain fog |
| Joint aches | Can continue after menopause | Joint pain |
| Vaginal dryness and bladder symptoms | Can continue; often return if treatment stops | Waking up to pee |
Hot flushes and night sweats
The best evidence comes from the US Study of Women’s Health Across the Nation (SWAN), which followed more than 3,000 women for up to 17 years. In women with frequent flushes or night sweats, they lasted a median of 7.4 years, including 4.5 years after the final period. Women whose flushes began before or early in perimenopause had the longest run, a median of more than 11.8 years. African American women reported the longest duration, a median of 10.1 years.
A Pennsylvania study found moderate or severe flushes peaked in the first two years after the last period, and about a third of women still had them 10 or more years after menopause. See also night sweats.
Sleep
SWAN also found that trouble falling asleep, staying asleep and waking early all became more common as women moved through the transition. Night sweats are a common reason for waking, and NICE recommends menopause-specific CBT for sleep problems linked to them. If you’re waking at 3am and can’t drop off again, see middle insomnia.
Mood and anxiety
A 14-year study found the risk of depressive symptoms was higher in the years before the final period and lower after it. Women with no history of depression had a low risk two or more years after menopause; a past history raised the risk both before and after, so tell your GP about it early.
Brain fog
In SWAN, women in perimenopause didn’t learn new material as well as before, but scores bounced back after menopause. The researchers concluded these difficulties may be time-limited.
Vaginal dryness, joints and other lasting changes
The NHS says joint pain and vaginal dryness can continue after menopause. Vaginal dryness, painful sex and bladder symptoms such as urgency and repeated UTIs are now called genitourinary syndrome of menopause. They can carry on after other symptoms settle, but they are treatable (see what helps). Weight changes are common too: see menopause weight gain.
Does menopause ever end?
Yes, in the way most people mean it. Once you have gone 12 months without a period you are postmenopausal, and for most women symptoms ease over the next few years. Two things don’t end, though:
- You stay postmenopausal. Women’s Health Concern points out that lower oestrogen can lead to thinner bones and a higher risk of heart disease, so strength exercise, calcium and vitamin D matter more from here. See calcium supplements.
- Some symptoms can linger. Some women still get hot flushes 10 years or more after menopause, and vaginal symptoms can persist without treatment.
If you’re still struggling years later, you don’t have to put up with it. Talk to your GP.
How do you know when menopause is over?
You have reached menopause when you have gone 12 months in a row without a period and you’re not using hormonal contraception.
- Over 45: NICE guidance says GPs should identify menopause from your symptoms and periods, without blood tests.
- Aged 40 to 45: a GP may consider a follicle-stimulating hormone (FSH) blood test.
- Under 40: a GP will usually check FSH on two blood samples 4 to 6 weeks apart.
- On hormonal contraception or HRT: these can mask your natural periods, so the 12-month count doesn’t work. Ask your GP or nurse.
Don’t stop contraception too soon. Women’s Health Concern advises carrying on until you have had no periods for two years if you’re under 50, or for one year if you’re over 50.
Can menopause symptoms come and go over years?
Yes. Women’s Health Concern explains that oestrogen falls over several years, not overnight, which is why symptoms can come and go. The NHS adds that hot flushes may improve and be replaced by other symptoms.
Periods can do the same. A gap of several months doesn’t mean you have reached menopause: the 12 months have to be consecutive, so if a period returns, the count starts again.
Symptoms may also return when you stop HRT, and NICE says you can restart it if needed. Tapering may limit this in the short term, but in the longer term it makes no difference whether you taper or stop at once.
Early and premature menopause
The NHS defines early menopause as periods stopping before the age of 45, and premature menopause as before 40. It can happen naturally, or after surgery to remove the ovaries, or after some cancer treatments.
An early menopause means more years with low oestrogen, which matters for your bones and heart. The NHS says it’s important to replace missing hormones if menopause starts before 45, so ask your GP about HRT and how long to take it. The Daisy Network supports women with premature ovarian insufficiency. For other causes of missed or changing periods, see hormonal imbalance symptoms.
How long does menopause last after a hysterectomy?
If your ovaries were removed
The NHS says that if a hysterectomy removes your ovaries, you go through menopause straight away, whatever your age. This is called a surgical menopause. NHS inform notes symptoms after surgery can be more sudden and, in some cases, more severe, because hormone levels drop overnight instead of over years.
HRT is usually used to manage symptoms after a hysterectomy. The NHS advises that if both ovaries have been removed and you can take HRT, you should continue until you reach the average age of natural menopause, which is 51. There is no reliable figure for how long untreated symptoms last after a surgical menopause, so ask your GP what to expect.
If your ovaries were kept
You won’t go into menopause straight away, but the NHS says you may reach it sooner than you would have otherwise. With no periods, you can’t use the 12-month rule. NICE says GPs should recognise menopause from your symptoms, such as hot flushes, and Women’s Health Concern says blood tests may sometimes help.
What helps while it lasts
You don’t have to wait for symptoms to fade. The main UK options:
- HRT. Women’s Health Concern calls HRT the most effective treatment for menopause symptoms and, for most, a low-risk option. How long you take it is reviewed regularly with your GP.
- CBT. NICE recommends menopause-specific CBT as an option for hot flushes, and for sleep problems and low mood linked to them, alongside HRT or instead of it.
- Non-hormonal medicines. If HRT isn’t suitable, NICE recommends fezolinetant for moderate to severe hot flushes. The NHS says a doctor may also suggest clonidine or an antidepressant.
- Vaginal oestrogen. NICE recommends it for vaginal and bladder symptoms, even alongside HRT. Non-hormonal moisturisers and lubricants are another option.
- Everyday habits. Women’s Health Concern suggests 150 minutes of exercise a week including strength work, stopping smoking (it triggers more frequent and severe hot flushes) and under 14 units of alcohol a week.
Medicines are a decision for you and your GP. The NHS says there is very little evidence on how well or how safely herbal remedies work, and some interact with medicines. Our guides to the best supplements for menopause and magnesium for menopause go through the evidence, and supplements for women over 40 covers the basics.
If you’d like a simple evening routine during these years, our Magnesium Glycinate Sleep Complex is a berry-flavoured drink with magnesium bisglycinate and citrate, glycine, L-theanine and botanicals such as chamomile. Magnesium contributes to a reduction of tiredness and fatigue and to normal psychological function. It isn’t a treatment for menopause or its symptoms. It’s for adults only, and we don’t recommend our products during pregnancy or breastfeeding. If you take HRT or any other medicine, check with your GP or pharmacist first.
When to see a GP
The NHS advises contacting your GP if:
- you think you have menopause or perimenopause symptoms and want to know your options
- you get palpitations (a fast or pounding heartbeat)
- you still have periods but are bleeding more, not less, than before
If you’re under 45 and have symptoms, see a GP too. The NHS says a GP may sometimes do blood tests at that age.
Bleeding after menopause: if you have not had a period for 12 months or more and you get any vaginal bleeding, see a GP. The NHS says postmenopausal bleeding is not usually serious but can be a sign of cancer, so get it checked even if it only happened once, or was only spotting or pink or brown discharge.
If your mood is very low or you have thoughts of harming yourself, call NHS 111, Samaritans on 116 123, or 999 in an emergency.
See also how to fix brain fog, step by step.
FAQs
How long does menopause last on average?
Menopause itself is one point, 12 months after your last period. The NHS says symptoms usually last 7 to 9 years, sometimes longer.
Is menopause just one day?
Technically, yes: the point when you have gone 12 months without a period. Before it is perimenopause; after it is postmenopause.
Does menopause ever end?
The transition ends and most symptoms ease within a few years of your last period, though some women still get hot flushes 10 or more years later.
How do you know when you’re at the end of menopause?
Once you have had no period for 12 months in a row, and you’re not on hormonal contraception, you have reached menopause. If you’re over 45, you usually don’t need a blood test.
Can menopause symptoms come back years later?
Symptoms can come and go during the transition, and they may return when you stop HRT. If you get any bleeding a year or more after your last period, see a GP.
How long does menopause last after a hysterectomy with ovaries removed?
Menopause starts straight away. The NHS advises that if you can take HRT, you continue it until around 51, the average age of natural menopause.
What is the average age of menopause in the UK?
51. Most women reach menopause between 45 and 55. Before 45 is called early menopause, and before 40 is premature menopause.
Sources
- NHS. Symptoms of menopause and perimenopause.
- NHS. Early menopause.
- NHS. Hysterectomy: considerations.
- NHS inform. Menopause.
- NICE (2024). Menopause: identification and management (NG23).
- Women’s Health Concern. Perimenopause and menopause: your questions answered.
- Avis NE et al (2015). Duration of menopausal vasomotor symptoms over the menopause transition. JAMA Internal Medicine.
- Freeman EW et al (2014). Risk of long-term hot flashes after natural menopause: evidence from the Penn Ovarian Aging Study cohort. Menopause.
- Freeman EW et al (2014). Longitudinal pattern of depressive symptoms around natural menopause. JAMA Psychiatry.
- Greendale GA et al (2009). Effects of the menopause transition and hormone use on cognitive performance in midlife women. Neurology.
- Kravitz HM et al (2008). Sleep disturbance during the menopausal transition in a multi-ethnic community sample of women. Sleep.
- Portman DJ, Gass ML (2014). Genitourinary syndrome of menopause: new terminology for vulvovaginal atrophy. Maturitas.
This guide is general information, not medical advice. Evopure makes the Magnesium Glycinate Sleep Complex.
