How Do I Know Which Stage of Menopause I’m In?

Remember the fun of puberty, when some changes seemed gradual and others just showed up out of nowhere? Well, the fun is coming again, because menopause can be like that, too. And just like puberty, menopause’s unpredictability can last for quite a while. If puberty were a blockbuster film, menopause would be titled Puberty 2: Return of the Angst. Your symptoms may blindside you like a teenage driver who just got his license. Or, they may happen sporadically over an extended period of time like a faulty “service required” light that can’t seem to decide if it’s on or off. So, how will you know which stage of menopause you’re in when The Big M pulls into your lane?

How To Figure Out What Stage of Menopause You’re In

What’s The Best Way to Figure Out If You’re Going Through Menopause?

I’m going to let you in on a little secret. The best way to figure out if you’re going through menopause is to track yourself. Let’s face it: Remembering things is getting harder and harder, right? You may find yourself walking all over your house trying to find your reading glasses. Bewildered, you scratch your head only to discover . . . there are your glasses! With so many calendars, reminders, and boxes to check on our to-do list, letting things slip is easy. Disregarding or simply not noticing changes happening in our own bodies also can be easy. That’s why tracking your physical and emotional symptoms in a daily log just as you might track what you eat in a food journal, can give you much-needed clarity about your health, especially how your menopause symptoms are progressing.

Let’s talk about how this forgetfulness, not noticing, or disregarding plays out ever so easily,  and why that makes tracking a priority.

You overlook feeling extra bloaty one afternoon. Maybe it’s just the cheese you ate. You forget how irritable you’ve been over the past few weeks or months. After all, you were only irritable for like a hot second when you found a sock sitting next to the hamper instead of in the hamper. Anyone would get testy about that, right? Meanwhile, your partner is like, “Hold the phone. A hot second? Try a hot month!” And speaking of hot, imagine you  disregard the raging inferno that overtook your body a few weeks ago, or when you woke up at 3 a.m. feeling like your bed had been dropped smack dab in the middle of the rainforest. Maaaaaybe it was because you were standing in the kitchen with the oven baking or you just had too many covers on?

Why Tracking Your Menopausal Symptoms Is Critical

If you were tracking your daily symptoms, you would notice your body is acting up. Specifically, you would have jotted down that you felt bloated, were irritable, and had hot flashes and night sweats on the regular.

Menopausal symptoms like these can creep up and be easy to explain away. But combined, they paint a picture of what’s really going on—a picture that screams: “Wake up, buddy! It’s me, your new pal Menopause. You are going through my stages!” But, without keeping a menopause journal, connecting the dots is as clear as a San Francisco sky. 

Regular daily tracking will help you do the following:

• Create a baseline so you know what “normal” feels like. That way it’ll be easier to know when something is not normal. 
• Notice patterns in your symptoms. Identify which stage of menopause you are in based on how your symptoms progress.
• Understand what might be causing symptoms.
• Teach yourself how to best manage the symptoms.
• Set yourself up for success so that you can best manage the symptoms.
• Establish self-awareness so that you can be in control of your body.

How to Track Your Menopausal Symptoms

When you first start tracking, get a dedicated physical or digital notebook or download  a tracking app where you can record your daily symptoms. Set a time each day (ideally the same time) to do a quick self-assessment. Give yourself your own Oprah Moment: Sit yourself down and gently ask yourself the following questions:

• Did I have my period today? Was the flow heavy, medium, or light? 
• Did I feel bloated? 
• Did I experience out-of-the-norm anxiety or feel panicked? 
• Was I extra irritable?
• Did I feel a burning radiating from the inside out?
• Or, did I feel overheated and couldn’t seem to cool off, even if just on the outside?
• Was I forgetful or did I experience even minor memory loss?
• Did I sweat at night?
• How was my sleep? Did I get a full 7-8 hours or was it interrupted?
• How is my energy? Do I feel fatigued?
• How is my sex drive/libido? Am I feeling “in the mood?”
• Do I have more or less control over my bladder than normal?
• Did I experience vaginal dryness?
• Is my hair thinning?
• Are my nails brittle?
• Is my complexion clear or going through noticeable changes (drier than normal,extra unwanted facial hair, acne)?
• Did I experience any joint aches or pains?

For the full Oprah experience, hide prizes under your chair in advance. At the end of your interview, proclaim, “You get a prize! You get a prize! You get a prize!” And, because you’re the only “you” in the audience, you get all the prizes.

Four Ways to Determine Which Stage of Menopause You’re In

Even though you are your best resource for tracking your symptoms, you don’t have to figure out which stage of menopause you’re in all on your own. While a perfect menopause test doesn’t exist, plenty of options exist to give you more information. Consider one or all of the following options:

1. Talk to Specialists in Their Respective Fields.

Let’s be honest, not all OBGYNs are equally equipped. The designation of “menopause doctor specialist” isn’t even recognized by the American Board of Medical Specialties, but anyone can call themselves a “menopause doctor specialist.” Luckily, figuring out if your doctor has a good understanding of menopause care is neither rocket science nor brain surgery. You’ll want to first, find a doctor. Good news! The North American Menopause Society recommends providers by zip code. Once you have a list of practitioners (consider medical doctors and nurse practitioners), interview them to decide which one is right for you and your menopausal journey. Here are a few questions to ask:

1. Are you certified by the North American Menopause Society?
2. Will you explain your position on hormone replacement and why?
3. What lifestyle changes do you recommend, if any, and why?
4. How do you treat those in menopause and perimenopause differently than premenopausal patients?
5. What kinds of problems and outcomes have you seen for women dealing with menopause issues?

Ultimately, you’ll need to listen to your gut. You’re dealing with personal, sensitive issues and seeing a doctor who makes you feel comfortable is key. During the visit(s), you may need to discuss your sex life, intimate areas, and things we’ve been culturally conditioned to feel squeamish about  (e.g., periods, hot flashes, aging, libido, painful sex, and vaginal dryness). Remember that you’re dealing with a medical professional and menopause is an NBP. So, there’s no need to feel squeamish when you’re in a doctor’s office. If any of your doctors make you feel uneasy discussing these things, kick them to the curb and find new ones that make you feel comfortable.

Your menopause doctor or nurse practitioner specialist can check your follicle stimulating hormone (FSH). The levels will jump when your ovaries start closing up shop. The tissue in and around the vagina will begin to thin out as estrogen levels decrease. He or she can check for this via a Pap test. Since this is rarely done, you will need to seek professional help from a professional who specializes in menopause, ask specific questions, and request tests like these.

Remember! MDs and nurse practitioners (or medical professionals) aren’t your only option. You can reach out to any other professionals when trying to diagnose the stage of menopause. I’m talking about therapists, naturopaths, nurse practitioners, pelvic floor specialists … the list goes on and on. Yes, there are a lot of different types of specialists who are necessary at different stages of the journey. Always keep that in mind. Regardless of who you choose, be sure to find a specialist who is a great fit for you and your needs.

2. Take an At-Home Test. 

Research and find a reputable brand that will allow you to do an at-home test to help you figure out where you’re at on the menopausal journey. Some brands will send you a kit that you will send back to the lab with a simple finger prick or saliva collection. The lab will run the sample you mail in and provide you with a breakdown of your health status related to menopause. Tests vary, but some popular ones test hormone levels, including estrogen and progesterone. 

3. Take a Self-Assessment Online Quiz. 

Taking an online self-assessment, such as this fast and free quiz, is an easy way to help you determine which stage of menopause you might be in.

4. Track Your Menopausal Symptoms in a Daily Journal.

As mentioned above, the easiest way to tell whether or not you’re going through menopause is to track your symptoms daily. Watch your menstrual cycle for 12 months. Mark down your start and end dates. Are you noticing a difference? Are your periods becoming more irregular? Has it been 2 months, 6 months, 12 months since your last period? If it’s been 12 months, then you’re in full blown menopause. But what about the months leading up to menopause? Also, what phase comes after menopause?

All of these questions are why you should track, track, and track some more. You will learn so much about your body in such a short amount of time! If and when you choose to see a specialist, take your tracker with you to share more details about what health symptoms you’re struggling with.

What Stage of Menopause Am I In?

So, now that you know several ways to figure out which stage of menopause you’re in, how do you actually confirm it? Great question. Menopause is a natural transition period in a woman’s life when her ovaries no longer produce eggs, her body produces less estrogen and progesterone, and menstruation becomes less frequent, eventually stopping altogether (see ya later, Aunt Flo!). To get to the point of no longer having periods, you have to go on quite the little menopause adventure (or not so little, as it can take between 2-14 years). Pinpointing precisely where you’re at in the journey can feel a little (or a lot in some instances) like rocket science. Your best bet is to learn the differences between the three stages, track your symptoms, and see which stage you most match up with.

Stage 1: Perimenopause

Perimenopause—meaning “around menopause”—is the first stop on your journey to being period free. You may notice perimenopausal symptoms as early as your  40s or at the average onset age of 51. Some women notice changes as early as their mid-30s. So, the “around” menopause definition is very accurate indeed.

Here are the most common symptoms related to perimenopause:

• Irregular Periods: As ovulation becomes more unpredictable, the length of time between periods may be longer or shorter, your flow might be heavier or lighter, and you might even skip periods. Keep in mind that if you have a space of 60 days or more between periods, then you’re most likely going through perimenopause.
• Hot Flashes: Your body might experience mild or intense hot flashes. The frequency of these hot flashes varies but the average duration is from 30 seconds to five minutes.
• Sleep Issues: You can thank hot flashes among other symptoms for sleep issues such as trouble falling or staying asleep, waking up early, getting less sleep, and experiencing fatigue during the day.
• Mood Changes: Hello hormones! Mood swings, irritability, lack of motivation, or increased risk of depression and anxiety may happen during perimenopause due to changing volume of estrogen, progesterone, and testosterone. 
• Vaginal and Bladder Problems: According to the Mayo Clinic, “When estrogen levels diminish, your vaginal tissues may lose lubrication and elasticity, making intercourse painful. Low estrogen may also leave you more vulnerable to urinary or vaginal infections. Loss of tissue tone may contribute to urinary incontinence.”
• Bone Loss: Protect your bones. Your declining estrogen levels will make it so that you lose bone more quickly than you replace it. In other words, your bones will become more fragile, increasing your risk of osteoporosis.
• Sexual Changes: With everything your body is going through and/or preparing to go through, you might realize a difference in your sexual arousal and desires, including a decreased sex drive. It’s totally normal.

Stage 2: Menopause

According to the National Institute of Aging, “menopause is a point in time 12 months after a woman’s last period. The years leading up to that point, when women may have changes in their monthly cycles, hot flashes, or other symptoms, are called the menopausal transition, or perimenopause.” According to Healthline, “menopause occurs when a woman hasn’t menstruated in 12 consecutive months and can no longer become pregnant naturally. It usually begins between the ages of 45 and 55, but can develop before or after this age range.”

Here are the most common symptoms related to menopause:

• Insomnia
• Vaginal dryness
• Weight gain
• Depression
• Anxiety
• Difficulty concentrating
• Memory problems
• Reduced libido or sex drive
• Dry skin, mouth, and eyes
• Increased urination
• Sore or tender breasts
• Headaches
• Racing heart
• Urinary tract infections (UTIs)
• Reduced muscle mass
• Painful or stiff joints
• Reduced bone mass
• Less full breasts
• Hair thinning or loss
• Increased hair growth on other areas of the body, such as the face, neck, chest, and upper back

Stage 3: Postmenopause

Postmenopause, or after-menopause, describes the years after menopause. Once you’ve experienced menopause, this final phase lasts the rest of your life. You made it through menopause!

Achieving postmenopause comes with its positive and negative effects. On one hand, you don’t have to worry about dealing with Aunt Flo ever again. On the other hand, with a decrease in estrogen, your body can become affected as follows:

• Cardiovascular Disease — A decrease in estrogen levels might be a factor in the increase in heart disease among post-menopausal women.
• Osteoporosis — A decrease in estrogen means that your bones are more prone to become weak and brittle.
• Urinary Issues — Low estrogen levels means that the urethra lining might become thin, resulting in weaker pelvic muscles, resulting in bladder leakage and urinary tract infections.
• Cancer Risks — The risk of breast and ovarian cancer rises after menopause due to hormonal changes related to menopause.
• Metabolism Changes — Women often see a decrease in their metabolism during menopause due to reduced estrogen levels.
• Sexual Drive Changes — Estrogen is one of the primary sex hormones. When the levels change, so does your sex drive. And, yes, sex could be painful. Just a heads up!

The most important thing to note is that you should no longer have vaginal bleeding once you hit this stop of the journey. So, if you do have vaginal bleeding after more than one year of no menstrual periods due to menopause, then you’ll want to notify your doctor ASAP. 

It’s a Wrap!

Noticing changes in your body are vital to caring for your health. Whip out a notebook and start tracking your changes. Over time, you may realize that the symptoms you’re feeling could be a part of a bigger picture: The Big M.

While your healthcare provider can run a few tests to see whether or not you’re going through menopause, tracking on your own will help you do the following:

• Create a baseline that will help you know what to expect on your menopausal journey.
• See patterns in your symptoms that paint a bigger picture of what you’re experiencing.
• Identify which stage of menopause you are in based on how your symptoms progress.
• Understand what might be causing the symptoms.
• Teach yourself how to best manage the symptoms.
• Figure out ways to set yourself up for success so that you can overcome the symptoms.
• Establish awareness so that you can be in control of your body.

Watch your menstrual cycle and track your symptoms (hot flashes, irregular periods, memory problems, sleep issues, weight gain, etc.). You will learn so much about your body in a short amount of time. Your changes will all start to make sense as you prepare to embark on the menopausal journey (aka your FDM: final developmental milestone). Once your journey is over, it’s time to throw a Farewell Aunt Flo Party and say ✌️  to your periods forever!

Sources

• https://www.webmd.com/menopause/guide/menopause-information#:~:text=have%20any%20ASAP.-,Are%20There%20Any%20Tests%20for%20Menopause%3F,for%20an%20entire%2012%20months
• https://www.nia.nih.gov/health/what-menopause
• https://www.healthline.com/health/menopause#symptoms
• https://www.mayoclinic.org/diseases-conditions/menopause/symptoms-causes/syc-20353397
• https://hellocaria.com/articles/why-track-your-menopause-symptoms/
• https://gennev.com/education/menopause-specialist-near-me

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