Your body
5 mins

Your essential guide to the stages of menopause

by Gayle O'Brien Kennedy

You’re not alone in finding menopause and the terms associated with it confusing. After all, the main term we are used to is “the change”! To save you time and energy, we’re here with our essential guide to menopause to explain the stages of premenopause, perimenopause and postmenopause, so you can figure out where you stand.

“I want to scream into my pillow. Is that normal?”

Allie

Menopause and even perimenopause are slowly becoming part of mainstream conversation and getting some attention – about time too! The ridiculously long absence of talking about menopause openly means it can be difficult for women to get help. 

Stella is working to change this by providing better information, support and relief to women to manage their menopause better. We believe you deserve to be heard and diagnosed properly.

Do you know what stage you are in?

If you ask your friends, it would be unusual for the majority to have heard of premenopause, perimenopause or postmenopause and be able explain them. It’s completely understandable why this is the case – it simply hasn’t been part of any sex education.

“I know very little about menopause – who knew it even came in stages?”

Rachel

We are all unique and no two women’s symptoms are alike. This is why it helps to understand the stages of menopause, what to expect, the range of menopausal symptoms and how to describe them to your doctor.

Paying attention to your body at this time is important, as your menopause experience can depend on lifestyle, genetics and medical history.

Top five things that can help

  1. Follow us on social media – find people like you

  2. Visit our blog to read more – our expertise is available for you when you need it

  3. Understand menopause better and subscribe to our newsletter – get our curated highlights on the latest menopause health news, scientific research and treatments

  4. Browse our symptoms library (coming soon!) – discover the facts on each menopause symptom, from hot flushes to insomnia

  5. Get menopause relief you can trust. Find personalised plans and support from trained experts – try Stella

“I’ve found that menopause symptoms can be so subtle that at first, you don’t quite realise what’s going on”

Rowena

What is the difference between menopause stages?

First, let’s debunk menopause. It can mean a woman with ovaries hasn’t had a period for a year and isn’t using hormonal contraception. In these cases, the problem is that you won’t know you’re in it until your periods have stopped completely! Alternatively, you may have had your ovaries removed or be on medication which has stopped your ovaries from working. This is known as surgical or medically induced menopause. In this situation, you are aware that it is happening but that doesn’t mean it’s any easier.

Menopause doesn’t describe a woman’s entire journey and this is why it is more useful, both in terms of diagnosis and treatment, to break down its distinct stages.

Premenopause and perimenopause

A woman is premenopausal before menopause. This is when you are without menopausal symptoms and you have periods, even if your cycle is irregular.

Perimenopause is the time leading up to the menopause milestone. For many, this is when menopausal symptoms appear, such as unexplained mood swings, erratic menstruation, restless sleep, increased anxiety and the dreaded hot flushes, plus many more. This phase tends to occur between the ages of 45 and 55.

Menopause is different for every woman and other factors can contribute to an earlier menopause, which we explore later on. Read Rowena’s story.

Postmenopause

Postmenopause begins when you have not had a period for a year. Symptoms experienced through perimenopause can carry on into this phase.

Women can and do suffer from menopausal symptoms during premenopause and postmenopause and not just when they reach menopause.

Why does it happen?

Menopause is a natural consequence of your ovaries aging and producing fewer hormones. Ovaries are a major source of oestrogen and they produce less as they age in the run-up to menopause, leading to menopausal symptoms.

Menopause can also happen when a woman’s ovaries are removed or damaged, if this happens, women can also experience early or ‘induced’ menopause.

How long does it last?

It differs from woman to woman, but the time between perimenopause and menopause tends to last for an average of 10 years. Menopausal symptoms can last well into postmenopause.

“Menopause could be an incredible journey of self-discovery”

Jamila

What are the signs?

There are over 40 menopausal symptoms that can appear throughout perimenopause and postmenopause. You may get lucky and experience just a few (to the envy of your friends!), or you may have to manage many symptoms. The intensity and duration varies greatly from woman to woman, which is why you may feel different to others going through menopause.

If you have several symptoms, it can be difficult to work out what’s menopause and what might be a separate health problem. Common menopausal symptom areas include:

  • Vasomotor symptoms: hot flushes and night sweats
  • Musculoskeletal symptoms: joint and muscle pain, osteoporosis and reduced muscle mass
  • Mood symptoms: depression, anxiety and low mood
  • Urogenital symptoms: vaginal dryness and recurrent urine infections
  • Sexual issues: low libido, painful sex and difficulty in achieving orgasm
  • Memory and concentration: brain fog, forgetting words

There are some symptoms that you need to look out for, where you may need to see your doctor.

Hot flushes, anxiety, leaking wee, or struggling to sleep?

What causes early menopause?

For some, menopause can come early.

Surgical menopause

A surgical menopause is when both ovaries are removed during an operation as a result of medical reasons, such as an ovarian cyst, endometriosis, ovarian torsion, ectopic pregnancy and ovarian cancer. This type of surgery will trigger the postmenopause phase in women who haven’t reached menopause.

Premature ovarian insufficiency (POI)

Sometimes, menopausal symptoms arrive far earlier than anticipated, between puberty and 40 years of age. The most common cause of this is premature ovarian insufficiency (POI), which occurs if your ovaries stop producing enough hormones for ovulation. The causes for this vary and can be a result of genetics, autoimmune diseases, surgery and cancer treatment. It doesn’t always result in complete menopause.

Part of the investigation into POI may include checking your follicle stimulating hormone (FSH) levels. Rising FSH levels can ‘trick’ the body into earlier menopause.

The big question still left unanswered?

How do menopausal symptoms affect different ethnicities and women with different medical histories and lifestyles.

Read more about menopause on our blog.