The 3 stages of menopause

Wouldn’t it be nice if we could know exactly what to anticipate from menopause? Ideally, our doctors could give us a script like: periods until age 46, one year of hot flushes, and officially done with menopause at 47. Well, as you well know, bodies don’t quite work like that. Think of it less like a train schedule and more like the puberty process, when some girls developed breasts, got their periods, and could play centre on a netball team at 11 - and others were still waiting at 15.

Similarly, the age in which you’ll go through each phase of menopause, how long it will last, and the symptoms you’ll experience - as well as the severity of those symptoms - all vary from person to person. Plus, there’s not a test to conclusively know where you are in the process. All of that can all be intimidating or frustrating to those of us who don’t love the unknown.

Here, we can share what to expect for the different phases each person goes through in the menopause journey and common things to expect.

Menopause is divided into three stages: “There's premenopause, perimenopause, and postmenopause,” says Dr. Stephanie Faubion, M.D.,the director for the Centre for Women's Health at the Mayo Clinic, medical director for The Menopause Society, and member of the WeightWatchers Scientific Advisory Board. Let’s take a closer look at each stage.

Premenopause (which Faubion refers to as the “late reproductive stage”) is hallmarked by regular periods. “Your cycle length could vary month to month, but it's less than a seven-day variation,” says Faubion. “What that means is you could have a 26-day cycle and a 32-day cycle.” That would still be considered regular, even if they’re not happening on the exact same day in your cycle month after month, and it means that you haven’t missed a period yet.

The average age for this is 47, per one study in Menopause. One clue that you’re entering this time is the variation in the length of your cycle. But even if you do have regular periods, “women [may] have the same symptoms as women in menopause transition - hot flushes, night sweats, sleep disturbances, mood disturbances, joint aches - and they're not expecting to have those,” she says. That’s because your estrogen levels are rising (sometimes higher than during your reproductive years) and then falling, which triggers symptoms.

Once you reach a variation in your period lengths that’s greater than seven days, or you skip a period, you’ve officially entered perimenopause, which Faubion calls “the start of the menopause transition.”

This phase continues for two to eight years (the average is four years), until you’ve reached a full year without a period. Just as in premenopause, the pendulum-swinging hormonal variations are the source of your symptoms during this time.

Learn more about perimenopause

Once you haven’t had your period for 12 months, you’re officially in menopause…which is, confusingly, also called postmenopause; the terms are interchangeable. You’ll stay in the postmenopause stage for the rest of your life. In this phase, symptoms aren’t caused by a rise and fall in estrogen, but by consistently lower estrogen.

Learn more about postmenopause

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