what are the 3 stages of menopause

Menopausal Spectrum: What Are The 3 Stages of Menopause

Menopause is a natural biological change that occurs when a person reaches a certain age, in the United States this is around the age of 51 or 52 years. Menopause marks the time in a person's life when they begin to experience irregular menstrual periods, and have gone at least 12 consecutive months without a menstrual period, according to the Mayo Clinic. 

Menopause marks the end of a biological time in a person’s life, and although it may cause mild to severe discomfort, depending on menopause symptoms from person to person, this transitional period can take place over seven to fourteen years. 

Seeing as the process of menopause can seem endless, and sometimes tedious, understanding the various stages of menopause helps to shed more light on the different changes a person may expect to experience, and how to overcome the discomfort and embrace this natural change. 

Menopause and Its Stages

As already mentioned, menopause takes place over several years, often lasting on average seven years, but maybe as long as fourteen years. However, it’s important to remember that each person’s experience with menopause is different and that various lifestyle and health-related conditions may have an impact on the time and symptoms of menopause.

stages of menopause and symptoms chart

Stage 1: Perimenopause

Perimenopause marks the beginning of the menopause period and is usually referred to as the natural transition period. 

Explanation of Perimenopause

Known as the beginning of menopause, perimenopause can start anywhere from eight to ten years before actual menopause. During the perimenopause stage, certain changes may occur, including irregular menstrual periods due to the decreasing levels of estrogen production. 

The perimenopause stage will continue until the point when the ovaries will cease to release new eggs. Seeing as this stage may take several years to complete, in the final years of perimenopause, usually the last two years, estrogen levels begin to decrease rapidly, although it’s important to remember that some people may still experience menstrual cycles, and may still be able to get pregnant. 

On top of this, some people will often experience mild symptoms, such as fatigue, hot flashes, mild vaginal atrophy (vaginal dryness), or physical bodily changes. 

Age range and Duration

Certain people may enter the perimenopause stage during their mid-40s, often between the age of 42 and 46 years. There may be instances where people may experience mild perimenopausal symptoms sooner, however, these are far and wide between. 

The duration of perimenopause can last anywhere between eight and ten years before actual menopause.

Common Symptoms During Perimenopause

According to experts, people may experience either a few or several perimenopausal symptoms, which may include: 

  • Changes in mood and emotional well-being 
  • Mild to severe hot flashes
  • Decreased sexual arousal
  • Lower levels of fertility 
  • Unfavorable changes in cholesterol 
  • Loss of natural vaginal lubrication 

How Hormones Change During This Stage

Some hormonal alterations typically occur during perimenopause. According to research by Harvard Medical School, irregular menstrual cycles may cause estrogen levels to begin to decrease, which is mainly controlled by two types of hormones - follicle-stimulating hormone (FSH) and luteinizing hormone (LH). 

The highly complex process of producing estrogen may begin to decrease, causing a steady decrease in progesterone. Seeing as some hormonal fluctuations are fairly common during this stage, a decrease in some hormone levels, such as estrogen and progesterone may lead to irregular menstrual cycles, and decreased stimulation of the ovaries. 

Stage 2: Menopause

Once the perimenopause stage has concluded, the next phase is usually followed by menopause, at which point hormonal changes begin to accelerate and more severe menopausal symptoms may be experienced. 

Explanation of Menopause

Menopause marks the point at which a person no longer has regular menstrual cycles. This usually occurs when a person has gone 12 consecutive months (1 year) without a menstrual period. Usually during this stage, the body will begin to decrease the production of estrogen and will cease to release eggs, further stopping the menstrual cycle. 

Average Age of Menopause

The average age of menopause can be different and may be influenced by a variety of personal and external factors. In the United States, the average age of menopause is usually around 52 years. However, in other parts of the world, where people may have a lower quality of life, this may be sooner or even later. 

Physical and Emotional Symptoms of Menopause

Physical symptoms of menopause

  • Hot flashes: the feeling of sudden warmth across the body and in the face. 
  • Irregular sleeping patterns: increased discomfort caused by hot flashes and vaginal atrophy may lead to irregular sleeping patterns, increasing feelings of fatigue. 
  • Bladder and urinary changes: a person may experience a need for more frequent visits to the bathroom or have less control over their bladder. 
  • Night sweats: a common symptom may be night sweats, which leads to increased discomfort due to elevated body temperature. 
  • Sexual discomfort: vaginal dryness may cause elevated sexual discomfort, and may lead to bleeding after sexual intercourse. 
  • Dryness: some areas of the body such as the skin or eyes may feel dryer than usual. 
  • Tender breasts: people may experience tenderness around the breasts. 
  • Irregular menstrual periods: as already mentioned, irregular menstrual periods are a common symptom among people entering menopause. 
Other physical symptoms may include: 
  • Hair loss or thinning of hair 
  • Weight gain 
  • Temporary memory loss
  • Mild headaches or migraines 
  • Heart palpitations 
  • Elevated blood pressure
  • Joint and muscle pain 

Emotional symptoms of menopause

  • Irritability: the feeling of being overly irritated or annoyed during the day. 
  • Mood swings: changes in emotional stability may cause regular mood swings, i.e. sudden feelings of sadness or happiness at any given time. 
  • Lower sexual drive: some people often experience decreased feelings of sexual arousal or lower levels of regular libido. 
  • Mild depression or anxiety: this may be different from person to person, however, some people may undergo feelings of mild depression and/or anxiety. 

Hormonal Changes During Menopause

During menopause production of estrogen and progesterone decreases rapidly. Aside from these two hormones, testosterone, a male androgen, will begin to decrease. Testosterone helps to promote the production of estrogen and contributes to libido and sex drive. 

Take A Look At Menopause, Perimenopause, Symptoms and Management: 


Stage 3: Postmenopause

The “final” stage of menopause is the postmenopausal period, which marks the end of the reproductive cycle, although additional changes may still continue during this stage. 

Explanation of Postmenopause

During postmenopause, a person may completely stop having menstrual periods, however, this may be different for each person. The postmenopause stage also marks the end of the reproductive cycle, meaning the chances of falling pregnant during this time are incredibly low due to decreased ovulation and no longer being able to release an egg. 

Age Range and Characteristics

There is no defined age or time when a person enters menopause, however, this could potentially mean that postmenopause would occur after menopause, thus the age range can be anywhere between 52 and 60. 

Some characteristics of postmenopause:

  • Mild symptoms of night sweats or hot flashes 
  • Bleeding after sexual intercourse 
  • Dry skin and dry eyes 
  • Changes in weight, either weight gain or loss
  • Sleeplessness i.e. insomnia 
  • Urinary incontinence 
  • Mild to severe feelings of depression and/or anxiety 
  • Decreased sex drive and libido
  • Increased sexual discomfort caused by vaginal dryness

Health Considerations During Postmenopause

Some changes to a person's lifestyle and diet may be beneficial during postmenopause. 

  • Dietary changes: consuming food rich in phytoestrogens may be beneficial. These include food items such as wholegrain, cereals, legumes, and flaxseeds. 
  • Reduction in caffeine and alcohol: further reducing consumption of caffeine and alcohol may help to contribute to the overall well-being of physical health. 
  • Regular exercise: making time to do regular exercise, such as walking, running or meditation may be beneficial. 
  • Reduction of smoking: either reducing the intake of nicotine or stopping altogether is one of the best ways to improve physical health. 
  • Dietary supplements: taking a combination of dietary supplements to alleviate severe postmenopausal symptoms. It’s advised to consult with a medical practitioner beforehand. 

Hormonal Changes and Long-term Effects

Some research suggests that during postmenopause production of estrogen and progesterone may further steadily decline over time. Symptoms experienced during menopause may continue, however these may be milder, and less severe. 

Long-term side effects may include: 

  • Cardiovascular disease: due to lower levels of estrogen present in the body, increased risks of cardiovascular disease are more common among older people who have experienced menopause. 
  • Osteoporosis: some people may lose up to 25% of their bone density, leading to a further decrease in the overall structural well-being of their bones which could lead to osteoporosis and put them at risk of bone fractures.
  • Vaginal atrophy: feelings of discomfort during sexual intercourse may continue due to the lack of natural vaginal lubrication. 
  • Weight gain: in some instances, a person may experience weight gain, or have difficulty reducing the presence of fat. 


What are the 2 Most Common Symptoms During the First 3 Years of Menopause?

Common symptoms experienced during the first three years of menopause may be different from person to person, however irregular menstrual cycles, hot flashes, and night sweats are among the most common symptoms people may experience during the early years of menopause. 

At What Stage of Menopause Are Symptoms Worse?

There isn’t a definitive time or age at which menopausal symptoms may become more severe. However, due to the natural aging process, and the body having decreased levels of estrogen, menopausal symptoms typically become more severe after the perimenopause stage, and near the age of 52. 

What Is The Biggest Symptom of Menopause?

One of the biggest and perhaps most common symptoms of menopause is usually hot flashes. However, various personal and external factors may elevate some symptoms more, such as night sweats, breast tenderness, vaginal atrophy, or other symptoms such as headaches, migraines, weight gain, or mood swings. 

Final Thoughts

Although the various stages of menopause may take place over several years, it’s however a natural biological occurrence that simply means the end of one phase of a person’s life and the beginning of something new. 

During each stage, people may experience symptoms at different ages or intervals, and the severity of each of these symptoms may differ from person to person. It’s important to remember that there are certain remedies and treatments available to alleviate some severe menopausal symptoms, and it’s strongly advised for people to visit their healthcare provider or conduct routine visits to their OB/GYN. 


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