What Is Menopause?
Menopause is a milestone. It’s when you’ve gone 12 consecutive months without a menstrual period (Lumsden et al., 2025). But that’s as long as there’s no other medical reason for your periods to stop, like pregnancy or a health condition. Most women experience menopause naturally between the ages of 45 and 55.
But before you reach menopause, there’s a transition phase called perimenopause that can last several years. During this time, your hormone levels often change unpredictably. You might notice symptoms of menopause, even though your periods have not fully stopped. Once you pass the 12-month milestone, you enter postmenopause, the phase after menopause that lasts for the rest of your life.
Some women experience menopause sooner than expected. Early menopause occurs before age 45. When these changes begin before age 40, it’s called primary ovarian insufficiency (POI). There’s also induced menopause, which is caused by certain medical treatments.
What Causes Menopause
Menopause naturally develops as the ovaries gradually become less active with age.
Inside the ovaries are thousands of tiny sacs called follicles. They hold eggs and help produce the hormones estrogen and progesterone. With age, the number of active follicles decreases. Hormone levels and ovulation become less predictable as a result, and menstrual cycles become irregular.
In response, the brain sends stronger signals to the ovaries to help keep the menstrual cycles regular. This causes the hormonal ups and downs often felt during perimenopause.
Eventually, the ovaries stop responding to the signals from the brain. They no longer release eggs and produce very low levels of hormones. That drop in estrogen causes your periods to end permanently and triggers most of the symptoms you experience.
Who Is At Risk
Menopause is a natural part of aging. Anyone with ovaries who lives long enough will experience it at some point. Age is the biggest risk factor, with most people reaching menopause in midlife.
That said, other factors can determine when menopause begins, such as:
Genetics: If your mother or sisters experienced menopause early, you’re more likely to as well. A study of about 200,000 women found nearly 300 genes that help determine how quickly the ovaries age and when menopause begins (Ruth et al., 2021).
Smoking: There’s a link between smoking and early menopause. A study of over 116,000 nurses found that current smokers were nearly twice as likely to experience early menopause compared to non-smokers (Whitcomb et al., 2018). The more cigarettes someone smoked per day and the more years spent smoking, the higher the risk of early menopause.
Autoimmune conditions: Some health conditions, particularly thyroid disorders like Hashimoto’s thyroiditis, are linked to earlier menopause and a higher risk of POI (Szeliga et al., 2021).
Medical treatments: Chemotherapy, pelvic radiation, or surgery to remove the ovaries can cause menopause to happen immediately or sooner than expected.
All of these can help explain why menopause can begin earlier for some people than others.
What Are The Symptoms
You’ll likely notice several changes as your estrogen levels start to decrease. Some of these symptoms don’t appear related to the menstrual cycle or reproductive health at all, which many people find surprising. But that’s because estrogen helps regulate many systems in the body, including the brain, bones, skin, and heart.
Menopausal symptoms you might experience include:
Hot flashes
Night sweats
Irregular periods
Periods that are heavier or lighter than usual
Trouble falling or staying asleep
Mood changes, including irritability, anxiety, or feelings of sadness
Vaginal dryness
Discomfort during sex
Decreased interest in sex
Low energy levels
Brain fog, trouble concentrating, or memory lapses
Weight changes, especially around the midsection
Joint aches or muscle stiffness
Thinning hair
Dry skin
Heart palpitations
Changes in cholesterol levels
Some symptoms are subtle. Others are hard to ignore. And it’s not unusual to not recognize these changes as the transition to menopause at first.
How Is Menopause Diagnosed
Your symptoms are often the strongest clues that you may be in menopause. A visit with your gynecologist or healthcare provider can help put things into context. They’ll take your age into account and talk about your menstrual history and symptoms.
Though blood tests can measure hormone levels, they’re not always reliable during this phase. Hormones can change from one day to the next, especially during perimenopause. So a test may show normal hormone levels even when menopause is approaching. This can be frustrating, especially when you have symptoms but are told everything looks normal.
Generally, if you’re over 45 and it’s been a full year since your last period (and there’s no other medical explanation for it to stop), no testing is needed to confirm menopause.
Testing is generally reserved for certain situations. Say you’re under 40 and have menopausal symptoms, your healthcare provider may order blood work. These tests can help check for POI and other health conditions, like thyroid disease, that can mimic menopause symptoms.
How Is Menopause Treated With Regenerative Therapies
Menopause is a natural process and part of aging. But if you find your symptoms disruptive, several types of treatments are available.
What’s helpful depends on your symptoms, your medical history, your overall health, and your preferences. For some, that includes functional, integrative, and regenerative treatments combined with conventional medical care. Treatment examples include:
Hormone Replacement Therapy (HRT)
HRT is one of the most studied treatments for menopause symptoms. It replaces the estrogen and progesterone your body is no longer making.
Some providers may use bioidentical hormones. These are chemically identical to the hormones your body produces naturally (Stuenkel, 2021). A review of 29 randomized controlled trials found that bioidentical hormones may help with vaginal dryness and other menopause symptoms (Liu et al., 2022). Whether they offer clear advantages over conventional HRT is still being researched.
Some bioidentical hormones are FDA-approved. Others are custom-compounded, meaning they’re prepared by a pharmacy without FDA oversight. We don’t yet have strong evidence on how safe or effective those compounded versions are (Stuenkel, 2021).
Stem Cell Therapy
In a study published in 2025, 15 women with ovarian dysfunction received stem cell infusions made from their own menstrual blood. These are cells that can help repair damaged tissue. Nearly all participants reported fewer hot flashes, better mood, and improved sleep within one month (Izawa et al., 2025). These improvements lasted for up to six months after treatment.
Still, this is very early research. The study was small. It did not include a comparison group of women who didn’t receive treatment. Without that comparison, we don’t know how much of the improvement was due to the treatment itself. We also don’t yet know about the long-term effects of this treatment.
Nutritional Support
Omega-3 fatty acids, magnesium, and vitamin D can help keep your bones strong and hormones balanced.
Foods like flax and soy contain plant compounds called phytoestrogens. These act like weak forms of estrogens in the body and may help relieve menopausal symptoms.
Lifestyle Modifications
Some lifestyle changes can help improve your overall well-being and how you experience menopause. These include managing stress in healthy ways, exercising regularly, and getting consistent quality sleep.
What Are Possible Complications
In addition to regulating menstrual cycles, estrogen plays other protective functions in the body. It helps keep the blood vessels healthy, maintains bone strength, and affects how the brain and metabolism work.
When estrogen levels decrease during menopause, the body loses some of that protection. This increases the risk of certain health problems, especially for women who experience early menopause.
Women who experience menopause before age 45 have a higher risk of heart disease (Kamińska et al., 2023). When menopause occurs before age 40, the chance of heart attack and stroke later in life increases significantly (Bast et al., 2025).
Part of this comes from cholesterol changes. After menopause, low-density lipoprotein (LDL), the “bad” cholesterol, often rises. On the flip side, high-density lipoprotein (HDL), the “good” cholesterol, tends to fall (Inaraja et al., 2020). This combination makes plaque buildup in the arteries more likely, which increases the risk of blockages that can lead to heart attacks and strokes.
The bones also become more fragile. Without enough estrogen, they lose density faster and are more prone to breaking.
Can Menopause Be Prevented
Since it’s a natural part of aging, it’s not possible to prevent menopause. But researchers are looking into whether it might be delayed someday, though that research is still early.
But there are things you can do to help your body better handle the transition to menopause. Smoking, for example, can damage the ovaries and trigger early menopause. So quitting smoking (or never starting) may be helpful.
Foods high in antioxidants may help protect your eggs from cellular damage. Staying physically active and taking care of your overall health can also help you manage symptoms better.
Takeaway
For most women, menopause is a natural phase of life. The drop in estrogen can increase certain health risks, especially if menopause happens early. But several types of treatment can help manage the symptoms. Research to find ways to delay menopause is also being done.
