Menopause is the permanent end of menstruation and fertility, defined as occurring 12 months after your last menstrual period. Menopause can happen in your 40s or 50s, but the average age is 51 in the United States. Menopause is a natural biological process. Although it ends fertility, you can stay healthy, vital and sexual. Some women feel relieved because they no longer need to worry about pregnancy. Even so, the physical and emotional symptoms of menopause may disrupt your sleep, cause hot flashes, lower your energy or — for some women — trigger anxiety or feelings of sadness and loss. Don’t hesitate to seek treatment for symptoms that bother you. Many effective treatments are available, from lifestyle adjustments to hormone therapy. SYMPTOMS: In the months or years leading up to menopause (perimenopause), you might experience these signs and symptoms: Irregular periods Vaginal dryness Hot flashes Night sweats Sleep problems Mood changes Weight gain and slowed metabolism Thinning hair and dry skin Loss of breast fullness