A Journey Through Menopause: The Different Stages and What To Expect

This article was written by guest contributor Julia Walker RN, BSN, a perimenopause expert, women's health nurse, and writer from Perry.

Perry is a social network that connects like-minded warriors in the same stage of life. This community offers a safe space for women to unite and tap into knowledge and resources from menopause experts.

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In many ways, we have debunked so many myths and stigmas surrounding the various life stages in a woman’s life. Yet, there is one frontier that still appears to be taboo in many circles - menopause. Most of us know very little about menopause and are consequently underprepared when our bodies begin to transition into this stage. No matter where you are in life, it is never too early to learn what to expect when you enter this life-stage. 

 

Menopause - An Overview

 

Menopause is a part of the reproductive cycle that all women will eventually enter. Some women will enter it earlier, while others will begin menopause later in life. Additionally, while most women start menopause naturally, many women will experience medically-induced menopause.  

 

When it comes to menopause, no woman’s journey is the same. And it certainly is not always a linear process. Yet, there are certain stages and milestones within menopause that you can watch and prepare for when you begin this time of life. 

 

Read on to get a general road map of the menopause journey.

 

What Are The Different Stages of Menopause

 

There are four different stages most women will encounter during a natural menopause. Each of these stages is accompanied by its own average age range, symptoms, hormone levels, and duration. 

 

1. Premenopause

This first stage is loosely defined as the time before you begin to notice changes in your body. For example, women in premenopause do not have any usual changes to their periods and are still fertile. 

 

2. Perimenopause

This term literally means “around menopause.” Perimenopause is the “official” start of the menopause journey because this is where you begin to notice changes in your body. One of the hallmark signs of perimenopause is an irregular period. However, there are 34 symptoms that women in perimenopause can experience. Fluctuating estrogen and progesterone levels are the primary culprits behind these 34 symptoms.

 

3. Menopause

A woman is considered in menopause when her ovaries are no longer releasing eggs and her periods stop. This change in ovarian function results in the loss of estrogen production. Menopause is diagnosed when you have not had a period in at least 12 months. Women in menopause can still experience some uncomfortable symptoms for a few years after their final period, like hot flashes and insomnia, but are no longer able to get pregnant naturally. 

 

4. Postmenopause

After we reach menopause, we spend the rest of our life in postmenopause. This final stage in our reproductive lives is marked by very low levels of estrogen, which means that many frustrating “menopausal” symptoms resolve. However, other challenges arrive, including osteoporosis.  

 

Let’s now dive deeper into the specifics of each of these stages, so you know what and when to expect changes.

 

Premenopause

 

Age of Onset

Generally, women in their 30s and early 40s are premenopausal if they are still having normal periods and are not experiencing any symptoms associated with fluctuating estrogen levels. Keep in mind that some women enter menopause in their 30s (called premature menopause), so age is not necessarily an indicator when it comes to this, or any, stage. 

 

Duration

Because premenopause is loosely defined, there is no average duration of this phase. Instead, the duration is the time before you start to experience changes. 

 

Signs and Symptoms

There are no unusual changes related to menopause that occur during this stage. 

 

Proactive Steps

Now is the time to learn about menopause and its various stages (well done, you are already doing this!). Educate yourself by researching reliable sources, talking with your doctor, and connecting with other women at various life stages. Of course, it is never too early to start taking steps to stay healthy, including:

 

  • Eat a wholesome diet and taking supplements to support a healthy body
  • Watching your weight
  • Getting plenty of exercise
  • Finding healthy coping mechanisms for stress
  • Establishing a sleep routine

 

Perimenopause

 

Age of Onset

On average, women enter perimenopause around age 45. However, many women experience perimenopausal symptoms earlier in life, whereas others may notice changes well into their fifties.

 

Duration

A “typical” perimenopause lasts about 5 years. However, symptoms can last nearly a decade, which means we can spend a good portion of our life in this transitional period. 

 

Signs and Symptoms

Irregular periods are one of the first signs that you are entering perimenopause. Changes to your period can include it becoming unpredictable, heavier, longer, and you may experience spotting in between cycles.

 

There are 34 symptoms associated with perimenopause (which you can read about here!). Alongside irregular periods, there are 4 other highly common symptoms: hot flashes, night sweats, loss of libido, and vaginal dryness. Women can experience a range of symptoms that can be physical or mental. In many cases, your first sign that you are in perimenopause may not be an irregular period but rather may be the development of anxiety, brain fog, weight gain, or migraines. 

 

Some perimenopause symptoms may even sound bizarre, including heart palpitations, electric shocks, and burning mouth. The cause behind all of these symptoms is fluctuating estrogen levels. While your estrogen levels will be trending downward during perimenopause, it is not a slow, steady decline. Instead, hormone fluctuations are somewhat erratic, which affects all systems in your body (hence why there are 34 symptoms of perimenopause!). 

 

Proactive Steps

The start of perimenopause is a good time to have a complete health workup and is an opportunity for you to connect with your doctor on what you can expect in the coming years. Depending on the severity of your symptoms, many options can help make this stage of the menopause journey more manageable. Additionally, women in perimenopause can still get pregnant, so some form of birth control is necessary if you do not wish to conceive.

 

Also, keep the lines of communication open with those you live with, such as a partner and children. Perimenopause symptoms can make you feel moody, irritable, uncomfortable, and anxious, but few people know just what women really go through during this time. Therefore, it is helpful to let those close to you know what you are going through.  

 

Menopause

 

Age of Onset

The average age women reach menopause is 51. If you would like to know when you may expect it, check in with female relatives such as your mother, sisters, aunts, grandmothers, etc. Often, women enter menopause around the same age in families. 

 

Duration

Women are considered in menopause once they have been period-free for 12 months. On average, women continue to experience menopause symptoms for 3-5 years after reaching menopause. 

 

Symptoms

While you can finally say goodbye to unpredictable periods, there are still symptoms you may experience, including:

 

  • Vaginal dryness
  • Hot flashes and night sweats
  • Sleep problems
  • Moodiness
  • Weight gain
  • Thinning hair 
  • Dry skin
  • Loss of breast fullness
  • Joint pain

 

Proactive Steps

Donate your pads and tampons, and toss out the birth control because you are free from periods for the rest of your life! However, you may need to take up some of that freed cabinet space with bone-protective supplements like vitamin D and calcium. Because estrogen levels naturally lower after ovarian function ceases, women are more prone to certain health conditions, including osteoporosis and possibly heart disease. 

 

Postmenopause

 

Age of Onset

A woman can be considered postmenopausal anytime after reaching menopause. 

 

Duration

We spend the rest of our lives in postmenopause once we have had our final period.

 

Symptoms

After a few years pass from when you reach menopause, your symptoms generally begin to resolve as your body adjusts to lower and more stable estrogen levels. You may notice that new symptoms arise or existing symptoms can worsen if you experienced them in perimenopause, including:

 

  • Weight gain
  • Thinning hair
  • Joint pain
  • Dry skin

 

Proactive Steps

Make sure to have regular health screenings and check-ups with your doctor to watch for bone density changes. Most women need to take supplements with calcium and vitamin D to keep their bones strong and healthy. Also, regular weight-bearing exercise can help prevent bone loss, as can curbing weight gain.

 

It is never too early to start learning how to prepare for your menopause journey. If you think you are entering perimenopause or are struggling with some unusual symptoms that have you stumped, meet with one of Binto’s certified health care professionals anytime through a chat or by scheduling a telehealth consult. And, whether you are just starting perimenopause or in the throes of it, join the Perry community of like-minded women in perimenopause, learn from experts, and have a few laughs. 

 

Disclaimer: This is not medical advice, does not take the place of medical advice from your physician, and is not intended to treat or cure any disease. Patients should see a qualified medical provider for assessment and treatment.

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About Julia Walker

Perry Babe Julia (RN, BSN, BA) is a registered nurse based in Colorado. Julia's nursing background in women’s health has ranged from neonatal and postpartum care to labor and delivery, to outpatient gynecological medicine for both adolescent and adult populations. She specializes in helping women optimize their health during perimenopause and beyond. 

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