Medical Author: Melissa Conrad Stöppler, MD
Medical Editor: William C. Shiel Jr., MD, FACP, FACR
Some of the symptoms of menopause can actually begin years before menstrual periods stop occurring. Doctors generally use the term "perimenopause" to refer to the time period beginning prior to the menopause (when some of the signs and symptoms of menopause begin to occur) up through the first year following menopause. Menopause itself is defined as having had 12 consecutive months without a menstrual period.
Menopause symptoms begin gradually while the ovaries are still functioning and a woman is still having menstrual periods. These symptoms can begin as early as the 4th decade of life (when a woman is in her 30s) and may persist for years until menopause has occurred. The symptoms occur early because the levels of hormones produced by the ovaries (estrogen and progesterone) decline slowly over time, explaining why pregnancy is still possible, but less likely to occur, as a woman reaches her forties. The severity and duration of symptoms vary widely among individuals - some women may experience only minimal symptoms for a year or two, while others may experience at least some of the symptoms for several years.
While most women will experience a gradual transition to menopause with a slow onset of symptoms, some women will experience an early (premature) menopause that may bring on immediate symptoms, depending on the cause of the ovarian failure. One common cause of immediate symptoms is a "surgical menopause" following the surgical removal of functioning ovaries.
Menopause symptoms can be perceived as physical problems, emotional disturbances, or problems associated with sexual functioning.