Periods can stop abruptly, or the transition can occur with irregular-length cycles over many months to years. Often, patients experience symptoms of hot flashes, night sweats, vulvovaginal dryness, difficulty sleeping, mood symptoms, and a change in energy levels. Factors that may contribute to an earlier age of menopause are smoking, alcohol use disorder, certain autoimmune disorders, chemotherapy, surgery, and some genetic disorders.
The time directly preceding menopause is called perimenopause and sometimes can last 4-8 years. Perimenopause begins with the first irregular menses (usually a change in cycle length) and culminates at menopause with the final menses.
Related topic: drug-induced menstrual changes
Z78.0 – Asymptomatic menopausal state
161712005 – Menopause
Differential Diagnosis & Pitfalls
- Premature ovarian insufficiency – Age 40 or younger with absence of menstruation. Check lab work to rule out other causes of secondary amenorrhea.
- Induced menopause – Usually secondary to chemotherapy; often happens at younger ages. If periods do return, it could happen within months to years after treatment. If ovulation also returns, it is possible to become pregnant.