What age does menopause start? The numbers, and what they mean for you

The World Health Organization says most women experience menopause between the ages of 45 and 55 as a natural part of ageing.

Remember that menopause is one specific day: the point when you have gone 12 months in a row without a period. So "menopause age" means the age at your final period, which you only know a year later.

The changes start earlier. Perimenopause, the transition when cycles shift and symptoms appear, usually begins in the 40s and can last several years (WHO). That is why so many women ask about "signs of menopause at 40" even though their last period may still be years away.

Philippine data on menopause age is limited, which is a gap we hope local researchers fill.

The best figure we found comes from a 2012 community study by Matsuo and colleagues, with researchers from the University of the Philippines Manila and Xavier University. It surveyed women aged 41 to 60 in Manila, Muntinlupa and Cagayan de Oro. Among the 79 Filipino women included:

• the average age at menopause was 48.9 years
• the range was 36 to 57
• about 23% were still having periods

A Japanese group in the same study averaged 49.5, and the difference was not statistically significant.

Two caveats. First, 79 women is a small sample, so 48.9 is a rough guide, not a national average. Second, women reported their own age at menopause, which can be fuzzy years later. Still, it sits comfortably inside WHO's 45 to 55 range.

Here is what is typical at each age. Everyone is different, so treat this as a map, not a schedule.

At 40. Most women are still having periods. Early perimenopause signs are possible: cycles that vary by a week or more, worse sleep, mood changes, heavier periods. If your periods stop or become very irregular at this age, see a doctor, since that may be early menopause.

At 45. Perimenopause is common. Hot flashes, night sweats, brain fog and irregular cycles are typical. From 45, doctors following NICE guidance can usually diagnose perimenopause from your symptoms and period changes without blood tests, if you are otherwise healthy (NICE NG23 and QS143).

At 47. Many women are in late perimenopause: skipping periods for two months or more, with hot flashes and sleep problems at their peak. You can still get pregnant, so do not stop contraception yet.

At 50. Many women have reached menopause or are close. If you have had no period for 12 months, you are postmenopausal. From here, any bleeding needs a check-up. This is also a good age to discuss a bone density test, as St. Luke's suggests from 50.

To estimate your own stage, use the stage finder or read stages of menopause.

• Before 45: early menopause.
• Before 40: premature menopause, also called premature ovarian insufficiency (POI). WHO notes causes can include chromosomal conditions, autoimmune disorders or unknown causes.
• At any age, after removal of both ovaries: surgical menopause. Chemotherapy and pelvic radiation can also bring menopause on early (WHO).

The Menopause Society (2022) says women with early menopause or POI have higher risks of bone loss and heart disease, and recommends hormone therapy at least until the average age of menopause unless there is a reason not to. Read our full early menopause guide or try the early menopause check.

Many women ask whether they will follow their mother's timing. Your mother's age at menopause is a useful thing to tell your doctor, but it is a hint, not a forecast. We have not found Filipino data on this, so we will not give you a number.

What does change the timing for certain: surgery that removes both ovaries, and cancer treatment.

See a doctor if:

• you are under 40 and your periods have stopped or become very irregular
• you are 40 to 45 with hot flashes, night sweats or big period changes
• you are any age and symptoms are affecting your sleep, work or relationships

See a doctor soon for any bleeding 12 months or more after your last period. Read bleeding after menopause.