The onset of the menopause is largely determined by genetics. Large cohort studies also show that certain habits can prevent an early menopause and realistically shift the transition by months to a few years. This guide separates robust evidence from myths and summarises practical recommendations — with reference to the NHS, NICE and publications in PLoS Medicine, JAMA and the Journal of Epidemiology & Community Health.
What determines timing?
The menopause is defined retrospectively after twelve months without a menstrual period. In Europe the median age is around 51 years. Genes are the strongest drivers. Environment and behaviour have a moderating effect — mainly by reducing risk factors for an early menopause. Basic information is provided by the NHS.
What really delays it (consistent evidence)
Not smoking
Smoking is the clearest factor for an earlier onset. The association is dose-dependent; quitting smoking earlier substantially lowers the risk. See the meta-analysis in PLoS Medicine.
Reducing exposure to pollutants
Endocrine-disrupting chemicals such as BPA are associated with an earlier onset. Practically this means: use BPA-free containers, glass or stainless steel for hot foods, ventilate regularly and reduce dust. The evidence is mostly observational but consistent.
Pregnancies and breastfeeding
Multiple births and breastfeeding are associated with a lower risk of an early menopause; the effect on median age is moderate. Data include the Nurses’ Health Study II (JAMA Network Open).
Diet: patterns and evidence
There is no “anti‑menopause diet”. In a large UK cohort the following associations were observed:
- Tending to later: more frequent consumption of oily fish (e.g. salmon, mackerel) and fresh legumes (lentils, beans).
- Tending to earlier: a high proportion of highly refined carbohydrates (white rice, light pasta). Source: UK Women’s Cohort Study (J Epidemiol Community Health).
Phytoestrogens (soya, red clover): may relieve hot flushes, but do not reliably delay the timing (Cochrane and other reviews).
Exercise, sleep and stress
Regular physical activity, good sleep hygiene and practiced stress management stabilise metabolism and hormonal axes. The timing of the menopause usually changes little as a result, but symptoms, sleep and cardiovascular risk clearly benefit — in line with NICE.
- Aerobic: around 150 minutes per week at moderate intensity
- Strength: two sessions per week for major muscle groups
- Sleep: regular timings, dark cool room, evening routine
- Stress: breathing exercises, meditation, yoga, or cognitive approaches as appropriate
Overview: levers and effect size
| Levers | Evidence | Typical effect | Practical tip |
|---|---|---|---|
| Quitting smoking | strong (meta-analyses) | prevents early menopause, effect months to years | quit early, plan relapse prevention; PLoS Medicine linked in the text |
| Fewer endocrine disruptors | moderate (associative) | reduces risk of earlier onset | BPA-free, glass/stainless steel, wipe damp and ventilate often |
| Dietary patterns | moderate (cohorts) | fish and legumes later; refined carbohydrates earlier | two fish meals per week, legumes three to four times per week |
| Pregnancies/breastfeeding | moderate (large cohorts) | lower risk of early menopause | effect moderate, consider individual factors |
| Exercise, sleep, stress | consensus/guidelines | timing little changed, symptoms markedly better | aerobic plus strength, sleep routine, establish stress tools |
What does not delay it (but may relieve symptoms)
- Hormone therapy (HRT): relieves symptoms, but does not change the biological timing. Clarification in NICE NG23.
- The contraceptive pill: masks bleeding and does not change the menopause age.
- “Detox” cures or miracle remedies: no robust evidence for delay.
- Single vitamins/supplements: vitamin D and calcium are useful for bone health, but do not delay timing.
Experimental approaches: state of the evidence
Ovarian PRP (“rejuvenation”) and autologous ovarian tissue transplantation are under research. Reliable long-term data demonstrating targeted delay in healthy individuals are lacking. Use outside clear medical indications should be considered only in trials and after thorough informed consent.
When to see a doctor
Typical signs of perimenopause are irregular bleeding, hot flushes, night sweats, sleep disturbances and low mood. Seek medical assessment for bleeding after twelve months without a period, very early menopause (under 40 years), severe symptoms or uncertainty about treatment options. Further recommendations: NICE and the NHS.
Conclusion
The menopause cannot be fully controlled. Realistic levers to delay it are: not smoking, avoiding pollutants, a Mediterranean-style diet emphasising fish and legumes and a stable daily rhythm with exercise, good sleep and active stress management. HRT, the contraceptive pill or single supplements do not change the timing — they mainly relieve symptoms. Focus on the strong, proven levers and make decisions together with your gynaecologist.