What Is Menopause, And When Does It Happen?

Medically reviewed by Julie Dodson, MA
Updated February 22, 2024by BetterHelp Editorial Team

Women and people who can experience menopause can go through a lot of different stages in their lives. As teenagers, many might have experienced the joy (and subsequent frustration) of a first period, possibly followed by the realization that this can occur for many more years. Then, when menstruation ceases, a woman can enter menopause. 

The natural hormone processes that can allow eggs to mature for possible fertilization might cease in this stage, meaning that a person might lose the ability to release the egg to foster a healthy pregnancy. Menopause is considered by many to be the final stage in a woman's reproductive life cycle.

Read on to learn more about menopause, its effects, and how online therapy can impact one’s experience with their personal physical and mental health.

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Having a hard time with menopause?


The first stage of menopause is generally known as perimenopause, and its timing can be unrelated to how early a woman gets her first period.

Perimenopause, for many, is a transition that can start as early as in a person’s 30s when hormone levels begin to shift—which can cause secondary changes in their bodies.

Perimenopause might typically last for about four years but can occur for as little as a few months, or as long as ten years. The signs may start as slightly irregular periods, extra moodiness, and fatigue for many.

We do want to note that during perimenopause, women can still ovulate—so they can still get pregnant. That said, ovulation might become more irregular in this season, so getting pregnant may be more difficult for some. 

True menopause

True menopause is not generally thought to occur until a person goes for 12 months without having a period. After menopause, a person may no longer menstruate—but they may have many of the same symptoms, such as moodiness, vaginal bleeding, hot flashes, and weight gain. 

Menopause can vary significantly from one person to the next—but the transition generally begins between ages 45 and 55 for many and can last for seven to 14 years. If menopause occurs before age 40, it can be considered to be early menopause. While this can be natural, it might also be medically triggered by damage to the ovaries or a hysterectomy.

In naturally occurring menopause, the ovaries might not be able to release eggs, and estrogen production can fall steeply (and may even stop completely). Various medications and supplements can treat menopausal side effects, but as the symptoms can vary on an individual basis, many might choose to create a personalized treatment plan with their practitioner. 


Many people might find that menopause isn’t generally a “stage,” but is instead a medically recognized occurrence that can happen when a menstrual cycle is absent for 12 months or more. Symptoms of menopause can occur before menopause itself does and are colloquially known by many as pre-menopause.


Many might find that menopausal symptoms can lessen within a couple of years of onset. However, many people might have some changes post-menopause. These changes can include hot flashes and night sweats, hair loss, dry skin, depression, weight changes, insomnia, vaginal dryness and sexual discomfort.

Exploring the timing of perimenopausal symptoms

The onset of menstrual changes during the transition to menopause can vary from person to person. However, many people can experience a similar, universal progression of symptoms during the perimenopause transition.

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Having a hard time with menopause?

Physical symptoms

Physical symptoms can be the first signs many might observe at the start of their perimenopause experience. For example: Weight fluctuations can be commonly noticed by some. Additionally, others might feel more bloated, swollen, or uncomfortable—an experience that can be prompted by possible water retention from hormone changes. 

Many might experience that their more noticeable symptom is drastic temperature changes, which many call “hot flashes.” These can occur when estrogen levels drop, triggering a shift in temperature control and sensation.

Researchers at Johns Hopkins estimate that approximately 75% of women experiencing perimenopause get hot flashes, which can occur at any time. 

We do want to note that this symptom is not necessarily exclusive to the stages of menopause. Some people can experience hot flashes with their periods because of the estrogen fluctuations—however, when they start happening more regularly (and without a period involved), it can be a sign of perimenopause.

Another possibly prevalent symptom in many can be the loss of a menstrual cycle, which can occur gradually—and may start as an occasional skipped or “light” period that can be associated with long periods of regular menstruation.

Cognitive symptoms

Many women can experience cognitive symptoms as a result of menopause, which can be very difficult to handle for some. Many of these symptoms can feel similar to what one might experience with PMDD or PMS as well—which can make it difficult for some to determine the true cause. 

While there is no singular, scientifically recognized cure for menopause, there are many ways to live well with related mood and cognitive symptoms. Speaking with your practitioner can be a helpful step that can support you in living well and coping with your personal experiences. Additionally, online therapy can be a supportive choice if the emotional changes impact your ability to have a fulfilling life.

How can online therapy support those in (or approaching) menopause?

Living with the symptoms of perimenopause and menopause can be challenging, as can coming to terms with the idea that you may be entering a time of your life when you are no longer able to have children. If you are feeling overwhelmed or having difficulty coping with these changes, talking to a therapist can help.

Online therapy can help many through major life changes. When you sign up for online treatment, you generally don’t have to worry about finding a local therapist, commuting to their office, or the risk of being put on a waiting list and postponing treatment. 

Is online therapy worth it?

Research shows that online therapy can be effective for many. One study found details that suggest that those participating in online therapy had “significant and clinically meaningful improvements in depression and anxiety scores” after 12 weeks of treatment, which improvements were sustained six months after treatment. 

If you want to learn more, reach out to a BetterHelp therapist for more information.


Menopause happens at different times for every woman, but the average age for perimenopausal symptoms to begin is typically in ones 40’s. The transition to menopause and the experiences thereafter can affect women in many ways, physically, cognitively, and emotionally. If you’re having a hard time dealing with these significant life changes, online therapy can help.
Understand how menopause impacts the body and mind
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