Editing Menopause (section)

=== Age ===
Menopause typically occurs at some point between 47 and 54 years of age.<ref name="Tak2015" /> According to various data, more than 95% of women have their last period between the ages of 44–56 (median 49–50).  2% of women under the age of 40, 5% between the ages of 40–45 and the same number between the ages of 55–58 have their last bleeding.<ref>{{cite journal |vauthors=Morabia A, Costanza MC |date=December 1998 |title=International variability in ages at menarche, first livebirth, and menopause. World Health Organization Collaborative Study of Neoplasia and Steroid Contraceptives |journal=American Journal of Epidemiology |volume=148 |issue=12 |pages=1195–205 |doi=10.1093/oxfordjournals.aje.a009609 |pmid=9867266 |doi-access=free}}</ref> The average age of the last period in the United States is 51 years, in Russia is 50 years, in Greece is 49 years, in Turkey is 47 years, in Egypt is 47 years and in India is 46 years.<ref>{{cite journal |vauthors=Ringa V |year=2000 |title=Menopause and treatments |journal=Quality of Life Research |volume=9 |issue=6 |pages=695–707 |doi=10.1023/A:1008913605129 |jstor=4036942 |s2cid=22496307}}</ref> Beyond the influence of genetics, these differences are also due to early-life environmental conditions<ref>{{Cite journal |last1=Begum |first1=Khurshida |last2=Muttukrishna |first2=Shanthi |last3=Sievert |first3=Lynnette Leidy |last4=Sharmeen |first4=Taniya |last5=Murphy |first5=Lorna |last6=Chowdhury |first6=Osul |last7=Kasim |first7=Adetayo |last8=Gunu |first8=Richard |last9=Bentley |first9=Gillian R. |date=March 2016 |title=Ethnicity or environment: effects of migration on ovarian reserve among Bangladeshi women in the United Kingdom |url=https://linkinghub.elsevier.com/retrieve/pii/S0015028215021081 |journal=Fertility and Sterility |language=en |volume=105 |issue=3 |pages=744–754.e1 |doi=10.1016/j.fertnstert.2015.11.024|pmid=26706133 }}</ref> and associated with epigenetic effects.<ref>{{Cite journal |last1=Bar-Sadeh |first1=Ben |last2=Rudnizky |first2=Sergei |last3=Pnueli |first3=Lilach |last4=Bentley |first4=Gillian R. |last5=Stöger |first5=Reinhard |last6=Kaplan |first6=Ariel |last7=Melamed |first7=Philippa |date=2020-09-15 |title=Unravelling the role of epigenetics in reproductive adaptations to early-life environment |url=https://www.nature.com/articles/s41574-020-0370-8 |journal=Nature Reviews Endocrinology |language=en |volume=16 |issue=9 |pages=519–533 |doi=10.1038/s41574-020-0370-8 |issn=1759-5029}}</ref> The menopausal transition or perimenopause leading up to menopause usually lasts 3–4 years (sometimes as long as 5–14 years).<ref name="NIH2013-Basics" /><ref name="NIA2017" />

Undiagnosed and untreated [[coeliac disease]] is a risk factor for early menopause. Coeliac disease can present with several non-gastrointestinal symptoms, in the absence of gastrointestinal symptoms, and most cases escape timely recognition and go undiagnosed, leading to a risk of long-term complications. A strict [[gluten-free diet]] reduces the risk. Women with early diagnosis and treatment of coeliac disease present a normal duration of fertile life span.<ref name="TersigniCastellani2">{{cite journal |vauthors=Tersigni C, Castellani R, de Waure C, Fattorossi A, De Spirito M, Gasbarrini A, Scambia G, Di Simone N |year=2014 |title=Celiac disease and reproductive disorders: meta-analysis of epidemiologic associations and potential pathogenic mechanisms |journal=Human Reproduction Update |volume=20 |issue=4 |pages=582–93 |doi=10.1093/humupd/dmu007 |pmid=24619876 |doi-access=free|hdl=10807/56796 |hdl-access=free }}</ref><ref name="LasaZubiaurre2">{{cite journal |vauthors=Lasa JS, Zubiaurre I, Soifer LO |year=2014 |title=Risk of infertility in patients with celiac disease: a meta-analysis of observational studies |journal=Arquivos de Gastroenterologia |volume=51 |issue=2 |pages=144–50 |doi=10.1590/S0004-28032014000200014 |pmid=25003268 |doi-access=free}}</ref>

Women who have undergone [[hysterectomy]] with ovary conservation go through menopause on average 1.5 years earlier than the expected age.<ref name="auto2" />