The average age of menopause is 52 in the United States.

When it comes to women’s health, there are many topics that aren’t discussed as often as they should be — or discussed without shame. Menopause is, unfortunately, one of the topics, even though an estimated 1.3 million Americans enter menopause each year.

The secrecy leads to false information and fear, in addition to unnecessary discomfort for those going through the change. Many people don’t even know what menopause is, other than hot flashes (which can be part of it).

“The definition of menopause is one full year without a period in the absence of something else to explain it, like pregnancy,” said Dr. Mary Jane Minkin, a gynaecologist at Yale Medicine in Connecticut.

And, we only know it’s our last period when looking back in time, added Dr. Karen E. Adams, a clinical professor in the department of obstetrics and gynaecology at Stanford University School of Medicine in California and the director of Stanford’s menopause and healthy aging program.

“When you have your last period, you don’t know that’s your last period until a year later, and you say, ‘Well, I guess that was it,’” Adams added.

The average age of menopause in the United States is 52 (and 51 is the average age throughout the world), said Dr. Ella Speichinger, an OB-GYN at University of Missouri Health Care.

Menopause is just one day — “it’s the day that you have gone 12 months without a period,” Adams added. After that, you’re in post-menopause, which is the phase of life you remain in until you die.

There are signs and symptoms associated with this time in life, along with the segments before it. Below, doctors share what they want everyone to know about perimenopause, menopause and post-menopause.

1. The symptoms you likely associate with menopause start during perimenopause, which generally happens in your 40s.

“The buildup to that last period is the perimenopause timeframe, and perimenopause, on average, lasts four to seven years, but it can be one to 10 years,” Adams said.

Meaning with menopause at an average age of 52, perimenopause will start for many people in their mid-40s or even early 40s.

“It’s not necessarily when you’re 55 or 60 that you need to be thinking about this. It could be in your mid-30s that you need to be thinking about it and putting the pieces in place to have that transition go smoothly and go well,” Adams said. (More on that below.)

While there’s a misconception that symptoms such as hot flashes and night sweats happen once you reach menopausal age, that’s not the case.

“Perimenopause often is the most symptomatic time, and people aren’t even really aware of it yet. It’s not even on their radar screen,” she added.

People tend to notice changes to their menstrual cycle, like skipped........

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