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Key stages of the Menopause

Technically speaking, the menopause is the stage at which those assigned female at birth completely stop having periods, which happens at an average age of 51 for most women in the UK. However, the term menopause is also used to describe the whole time period within which a woman is experiencing symptoms of the menopause – which happens up to several years before she stops menstruating and can persist for several years after.

There is no one-size-fits-all timeline of the menopause symptoms, as most women will experience them at different times and stages, and with different levels of severity.

We’ve outlined the 4 key stages of the menopause below, and the typical symptoms associated with each one. This should help you understand more about what happens to your body during the menopause process, and what to expect when you (or a loved one) go through this ageing process.

1. Premenopause

Premenopause is the time between hitting puberty (usually in a woman’s teens) and experiencing the first indication of ‘perimenopause’. During this time, the majority of women will have regular periods naturally guided by their reproductive hormones, and are able to fall pregnant. During the menstrual cycle, a woman’s hormones fluctuate and this can very often cause premenstrual syndrome (PMS) symptoms – commonly causing abdominal cramps, irritability, low mood, headaches and breast tenderness.

Of course, there are exceptions to this, as not all women experience regular periods and experience fertility difficulties, and some will have gone through early menopause (our blog ‘what is the menopause?’ explains more).

2. Perimenopause

The perimenopause tends to begin in a woman’s early to mid-forties, lasting for around 3-5 years – until she stops menstruating completely. Although in some cases the perimenopause will last just a few months, or even up to 10 years. The perimenopause is when the ovaries begin ageing and produce less reproductive hormones than they did before (for example oestrogen, progesterone and testosterone). Because these hormones naturally guide the menstrual cycle, as their levels decline a woman tends to experience less frequent and more irregular periods.

Declining oestrogen levels in the body typically causes a range of physical symptoms including hot flushes, elevated heart rate, urinary issues, and vaginal dryness. It also impacts a woman’s mood, and they’ll often experience low mood or mood swings. Loss of libido (the desire to be physically intimate) is another common, yet challenging, symptom – affecting between 20-40% of women during the menopause process. Read our blog ’managing the symptoms of the menopause’to find out more about ways to treat and manage the key symptoms.

Because most women are still menstruating during perimenopause, although often less frequently or irregularly, they can still fall pregnant. Moreover, it’s not always obvious that the symptoms they’re experiencing are caused by the menopause – but GPs can offer a range of perimenopausal tests which measure hormone levels and can confirm this.

3. Menopause

The menopause is the stage at which a woman stops menstruating completely. Usually, a woman must have had 12 consecutive months without a period for it to be classed as the menopause, as there are several other factors and conditions that may cause periods to temporarily stop or become infrequent.

The symptoms caused by the perimenopause will very often persist during the menopause stage. The main change to a female’s body here is that she is no longer able to naturally fall pregnant.

4. Postmenopause

The stage beyond 12 months after a woman stops menstruating is the ‘postmenopause’. For some women, their perimenopause symptoms will linger for some time during this stage too. But for every woman at the postmenopausal stage, hormone levels permanently remain low after declining during the perimenopause. This increases the risk of developing more serious health conditions – particularly if symptoms aren’t addressed and treated early enough.

For example, a lack of oestrogen can lead to osteoporosis, which is a disease that weakens the bones – increasing the risk of sudden fractures. Oestrogen also helps control cholesterol levels, so once this drops, it increases the risk of heart disease.

The good news, however, is that there are several simple ways to help manage and prevent symptoms before they escalate into health risks. Read our blog ’managing the symptoms of the menopause’ to find out more.


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