Your Last Period Before Menopause: What to Expect

Menopause is a significant milestone, marking the end of menstrual cycles and the beginning of a new stage of life.

However, before officially reaching menopause, there’s one final period. It’s often unpredictable, sometimes heavy, sometimes barely noticeable. For many women, this last menstrual cycle can bring a mix of relief, uncertainty, and even curiosity.

Understanding what to expect can help you feel more prepared and in control during this transition. From your first missed period before menopause, changes in flow and cycle length, and common symptoms leading up to your final menstrual cycle, this guide will walk you through the signs that your last period before menopause may be approaching and what happens next.

How to recognise your final period before menopause

The stage before menopause is known as perimenopause and each woman’s experience of perimenopause can be different. For some, it can last just a few months whereas others can be in this transitional chapter for a decade. The average duration of perimenopause is 4 years (1).

This means it can be difficult to determine when your final period before menopause may occur and whether your periods have stopped completely or have just become irregular.

Find out more about the signs that you’re perimenopausal.

Age

Age is one of the strongest indicators that a period may be your last. Menopause typically occurs between the ages of 45 and 55, although the average age of menopause in the UK is 51 (2).

As women approach this age, periods often become more irregular, with longer gaps between cycles before they stop altogether. If you’re in your late 40s or early 50s and experience a missed period or significant changes in flow, it could be a sign that menopause is near.

Changes to your period

Another way to determine that your periods are coming to an end is their frequency. The closer you get to menopause, the further apart your periods typically become (1). You’re considered to be in the later phases of perimenopause when your periods are more than 60 days apart, although this stage of perimenopause can last for up to 3 years (1).

In addition to each period becoming further apart, you may also notice other variations in your menstrual bleeding that signal your final period is close including:

Missed periods
Heavier or lighter periods
Longer or shorter periods
Increased cramping and/or pain

It’s possible, though, that your last menstrual period before menopause is typical of how you’d expect your period to be. Around 15-20% of women experience little to no change in menstrual regularity before their final period before menopause (3).

Menopause symptoms

Further, there can be other physical changes as a result of hormonal fluctuations that indicate you’re in perimenopause and accompany your final menstrual cycle such as:

Hot flushes and night sweats
Sleep disturbances
Mood changes
Genitourinary symptoms including vaginal dryness and urinary incontinence
Loss of libido (4,5)

Take a look at our guide to perimenopause and menopause symptoms for a deeper dive into the physical changes that can occur.

Other reasons for irregular periods

However, not every skipped or erratic period means menopause is near. Other factors can cause irregular cycles or missed periods, including:

Stress
Weight changes
Eating disorders
Hormonal contraception
Excessive exercise
Pregnancy (6,7)

There are also underlying health conditions that can cause periods to become irregular:

Polycystic ovary syndrome (PCOS)
Thyroid disorders
Endometriosis
Pelvic inflammatory disease
Fibroids
Adenomyosis (6,7)

If you’re not sure whether you’ve had your last period, tracking symptoms and speaking to your GP can help provide clarity and rule out any other underlying causes for changes to your menstrual cycle.

The 12-month rule and confirming menopause

Menopause is when you stop having periods altogether. A woman is considered to have reached menopause when she has not had a period or spotting for 12 consecutive months.

In most instances, no testing is required to confirm menopause – a loss of periods accompanied by other symptoms is adequate. However, there are some circumstances in which additional testing may be recommended to diagnose or rule out menopause:

Under 40 with suspected premature ovarian insufficiency
Between 40 - 45 with menopausal symptoms, including a change in menstrual cycles
Over 45 with atypical symptoms
Over 50 and using progesterone-only contraception (8).

The time after menopause is called postmenopause and women remain in this stage for the rest of their lives. Any bleeding from the vagina after menopause is considered abnormal and should be discussed with a doctor as it may require further investigation.

Postmenopausal bleeding can be a side effect of HRT or an indication of an underlying health condition. It can also be a sign of womb or ovarian cancer (8,9) so it is important to discuss this with your doctor and further assessment can be carried out when required.

Learn more about post-menopausal bleeding.

Health screenings and check-ups during perimenopause

Around and after your periods have stopped, there are health screenings and check-ups that are offered and recommended to monitor overall well-being and manage the risks associated with menopause-related changes.

NHS Health Check: A free, 20–30-minute check-up of your overall health can determine whether you're at increased risk of heart disease, diabetes, kidney disease or stroke (11).
Blood pressure: Menopause increases the risk of high blood pressure, so regular monitoring is important. Up to 50% of women develop hypertension before the age of 60 (12).
Cholesterol: Menopause is associated with a gradual increase in total cholesterol, which is a significant risk factor for cardiovascular disease (13).
Bone density: Oestrogen decline can cause bone loss, increasing the risk of osteoporosis. A DEXA scan may be recommended for those at higher risk (14).
Breast screening: While menopause and breast cancer don’t directly correlate, your risk of breast cancer does increase with age and is further elevated if you reach menopause after the age of 55 (15).
Cervical screening: Continue regular screenings after menopause, as 60% of cervical cancers occur in women over 45 (16).
Thyroid function: Menopause and thyroid issues share symptoms, and up to 20% of women over 60 have an underactive thyroid (17).

Lifestyle adjustments for the next phase

Your last menstrual period before menopause can bring with it many emotions. Some women can find themselves experiencing a sense of loss and grieving their younger years while others may be relieved to no longer have periods and be looking forward to the next segment of their lives.

There’s no right or wrong way to navigate this stage but making small adjustments to your lifestyle and outlook can be beneficial to your overall well-being and serve you better as you enter this new chapter.

Lifestyle adjustments that can support your emotional, social, physical, and overall well-being in postmenopause include:

Practice stress management: Utilise mindfulness, meditation, or deep breathing exercises to help with periods of stress or overwhelm.
Prioritise sleep: Maintain a consistent sleep schedule and create a relaxing bedtime routine.
Seek emotional support: Talk to friends, family, a support group, an online community or a therapist about any concerns or struggles you face in postmenopause. Discussing your needs and experiences can help you feel more understood and strengthen relationships.
Engage in hobbies: Creative activities, reading, or learning new skills can boost mental well-being.
Exercise regularly: Aim for a mix of strength training, cardio, and flexibility exercises to support bone health, heart health, and overall fitness.
Adopt a balanced diet: Focus on a varied diet, rich in fruit and vegetables, lean proteins, healthy fats and fibre to help you feel your best and reduce long-term health risks.
Keep a check on your health: Attending routine screenings and scheduling appointments when you have worries is the best way to proactively manage your health and maintain your well-being.

At Menopause Care, we offer affordable all-in-one care plans to help you spread the cost of appointments, prescriptions and mentoring so that you don't have to negotiate about your well-being during menopause. With regular appointments with the same doctor, you can be assured that you’ll have a holistic, tailored approach to care from your last menstrual period through to menopause and beyond. To find out more, take a look at our menopause services and treatments.

DisclaimerAt Menopause Care, we ensure that everything you read in our blog is medically reviewed and approved. However, the information provided is not meant to replace professional medical advice, diagnosis, or treatment. It should not be relied upon for specific medical advice.

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