Predicting Your Menopause Age: What Factors Matter
This is a question that many women ask, especially if you are thinking about family planning and your 20s are in the distant past.
How many more years of fertility can you have, and how many more will it take before you start experiencing the “change”?
Here’s what does and doesn’t affect a woman’s age at menopause.
The main factor
Several factors influence the age of menopause in women, but one is more important than any other: the age at which their mother went through menopause.
“Menopause has a lot to do with genetics, so it’s very likely that within a few years, you will end up at the same age as your mother had menopause anyway,” says Nanette Santoro, MD, director of reproductive endocrinology and infertility at the University of New York. Colorado Denver Medical School.
This is not always true, of course. Some women reach menopause at an unusually early age – before the age of 45 or so – for an unknown reason, which may result from a hereditary problem or a single genetic mutation. “These can be random events, but they can also be transmitted,” says Howard Zakur, MD, head of reproductive endocrinology and infertility at Johns Hopkins School of Medicine.
So if your mother went through menopause at 40 and her sisters and grandmother were around 50 on average, it’s not clear if you’re going to follow your mother’s path or theirs.
But if most of the women in your family, including your mother, go through menopause early, late, or somewhere in between, you can keep track of your calendar with some confidence.
Age of Menopause: 4 More Influences
Your mother’s age at menopause is a crucial factor, but not the only one. Here are four others to consider:
- Smoking. No other lifestyle factor is more damaging to your ovaries than smoking. So if you smoke and your mother doesn’t, you will probably achieve menopause earlier than her. If she smoked and you didn’t, you’ll probably reach menopause later than she does.
- Chemotherapy. Many women experience temporary menopause during chemotherapy; if the cycles return (and they don’t always return), you can still expect regular menopause a couple of years earlier than otherwise. Most forms of chemotherapy used in young women are at least moderately toxic to the ovaries.
- Ovarian surgery. “The more you operate on the ovaries, the more healthy tissue is damaged,” says Marcel Cedars, MD, director of reproductive endocrinology. So, for example, if you’ve had exploratory surgery for endometriosis, Cedars recommends using medical options (such as hormone suppression) to treat the condition to avoid repeat surgeries.
Not a factor
Here are three things you think might affect menopause age but don’t:
- Age in the first period. While the average age of first menstruation for women in the US has been getting younger, there has not been a corresponding shift in the average age of menopause. The average age of first menstruation is around 12.4 years, compared to 13.3 years for women born before the 1920s, but the average age at menopause for decades has been about 51.5 years. “One would assume that a woman does not have many cycles in her life, and if she has a later period, then menopause will come later, but this does not seem to be true,” says Cedars.
- Pregnancy and breastfeeding. They do not affect the age of menopause.
- Hormonal methods of contraception. “Even if you use a birth control method that stops ovulation, it doesn’t stop the loss of follicles, a constant process where the ovary takes them from the resting egg pool,” Cedars says. “All the follicles available in the cohort this month die even if you don’t ovulate, so birth control doesn’t delay menopause.”
- Ethnicity. A study of premenopausal and early perimenopausal women found that race/ethnicity did not play any role in the age at which women went through menopause. The Women’s Health in Country Study (SWAN) looked at a cross-section of women of different races from seven states and found that most women went through menopause between 52 and 54.
It is impossible to delay menopause; it can only be accelerated, not slowed down, under the influence of external factors.
Predicting the age of menopause
Some factors are still unknown. For example, some research has linked exposure to certain “endocrine-disrupting” chemicals to an earlier age at menopause. But it’s not sure that these chemicals cause earlier menopause, as the study only shows a link and doesn’t rule out other possible causes. In general, the typical age at which menopause begins has not changed much in the years these chemicals have been around.
Besides quitting smoking, there is probably little you can do to change the age you go through menopause. But as we get closer to that time, it will be easier to predict when that will happen more accurately.
“If you’re over 45 and you’re missing at least three periods in a row, that tells us you’re going into menopause relatively soon,” says Santo