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Symptoms of menopause after age 45

Alexey Kryvenko, medical expert
Last reviewed: 06.07.2025

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Climacteric syndrome occurs in all women, and every woman knows that her ability to become pregnant and give birth to a child (fertility) decreases with age and – sooner or later – she will lose her reproductive function. Symptoms of menopause after 45 years indicate the depletion of the functional reserve of the ovaries and the loss of their follicular activity.

During this period, the inevitable transition of the female body from the reproductive period of life to the physiological stage of menopause occurs, which is characterized by certain changes in the body.

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The main changes in a woman's body during menopause

Normally, the period of decline in the functions of the female reproductive system (production of the egg and development of the fetus before birth) lasts from 45 to 55 years. And the first signs of menopause - disruption of the regularity of the menstrual cycle - usually begin to appear after 45 years (plus or minus 2-3 years). Also part of the climacteric syndrome is a more pronounced unpleasant premenstrual condition. Gynecologists call all this premenopause, and the only reason for the processes taking place is irreversible hormonal changes in the body.

As is known, the activity of the female reproductive system is regulated by hormones throughout life:

gonadotropin-releasing hormone (GnRH), produced by the hypothalamus, which controls the secretion of follicle-stimulating hormone (FSH) and luteinizing hormone (LH) by the pituitary gland;
FSH, which is released by the anterior pituitary gland and stimulates the growth of immature eggs (follicles) in the ovaries;
LH, also synthesized by the anterior pituitary gland and causing ovulation and the formation of the corpus luteum from follicle cells;
estrogen, which is produced by the growing egg and the corpus luteum.

Hormonal changes in a woman's body during menopause are expressed in a decrease in the synthesis of luteinizing and follicle-stimulating hormones, which ensure regular maturation of the egg in the ovaries (and, accordingly, the menstrual cycle). This leads first to disturbances in the monthly cycle, and then to its complete cessation. At the same time, the level of estrogen synthesized by the ovaries also drops sharply.

Usually, from the onset of obvious instability of the menstrual cycle to its complete cessation, it takes from 1.5 to 4.5 years (which is associated with individual characteristics of the process of production of sex hormones and existing somatic or endocrine diseases). Menstruation may become scanty and short or longer and more abundant than usual.

In addition to irregular periods, symptoms of menopause after 45 years include:

paroxysmal feeling of heat in the head and upper body ("hot flashes"), often accompanied by hyperemia of the skin and tachycardia. According to specialists of the International Menopause Society (IMS), this is associated with both changes in the functioning of the hypothalamus, which contains the temperature regulation center, part of the limbic-hypothalamic-reticular system of the body, and with physiological hypofunction of the thyroid gland, which manifests itself as part of hormone-dependent changes in the body during this period.