What Are the Stages of Menopause?

Did you know menopause involves multiple stages? No? Welp, you and the other 2 million people in the U.S. entering menopause this year are not alone! I’m here to bring the facts and bust the menopausal myths, so  that you get to relax. Well, as much as anyone can relax during mood swings, hot flashes, and night sweats.

Simply put, menopause is an NBP: A Natural Biological Process (remember that acronym for later!). That’s our acronym for when your ovaries no longer produce eggs, your body produces less estrogen and progesterone, and menstruation becomes less frequent (eventually stopping altogether). See ya later, Aunt Flo!

To arrive at the No-More-Periods Promised Land, your body will go on a little menopausal journey. Or not so little, as it can take between 2-14 years. Every journey begins with a couple of big questions. Ours are: 1) What is menopause? and 2) What are the stages of menopause? Answering these questions will help you know what to expect when you’re expecting (menopause)!

Breaking Down the Stages of Menopause

Three Stages of Menopause

Your body is about to embark on an adventure in three parts. Let’s break ‘em down, The Big Three:

1. Perimenopause — It begins! Your body enters the menopause transition. 

2. Menopause — It’s happening!!! You go 12 consecutive months without menstrual cycles. 

3. Postmenopause — The Denouement. Your menopausal symptoms begin to subside (typically 24 to 36 months after your last period). C’est bon! 

There’s an Opening Act that I want to address: premenopause. According to the fine folks at Healthline, “Premenopause and perimenopause are sometimes used interchangeably, but technically they have different meanings. Premenopause is when you have no symptoms of perimenopause or menopause. You still have menstrual periods — whether they’re regular or irregular periods — and are considered to be in your reproductive years. Some hormonal changes may be occurring, but there are no noticeable changes in your body. On the other hand, during perimenopause, you’ll start to experience symptoms of menopause.”

Now that you’ve been properly introduced to The Big Three and their sidekick, let’s take a deeper dive. What is each of these main stages all about? What symptoms might you experience in each one? If you’re thinking, “Great, you’ve named my symptoms, not how about some relief!” Don’t worry, I’ve got you. This post just overviews the symptoms, but menopause treatment recommendations are just a click away (click here for your virtual quick fix).

Perimenopause (AKA Menopausal Transition) 

At-A-Glance

Perimenopause—meaning “around menopause”—is the first leg of your journey. Although millions of people experience menopause at the same time, no two people experience it the same way, including the age of onset. Remember in the first blog post when I said we’re all delicate, unique flowers? I stand by that, but I’ll add we’re all delicate flowers that can handle a lot more than we think. The average age of onset is 51, but you may notice perimenopausal symptoms as early as your 40s. To complicate things further, some women notice changes as early as their mid-30s. I guess the phrase “around menopause” is pretty accurate, if  “around” includes a whopping 20-year spread! 

Symptoms

During this stage, estrogen levels in your body will rise and fall. As an added bit of drama, they will fall … unevenly. Below are some of the most common perimenopause symptoms. Think of them like Pokemon, where you DON’T want to collect them all, but may anyway! 

• 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. If you have a space of 60 days or more between periods, then you’re most likely going through perimenopause. 
• Hot Flashes: Your body may experience mild or intense hot flashes. The frequency of these hot flashes varies, but the average duration is from 30 seconds-10 minutes. I know! That “average” has a pretty wide gap. If nothing else, perimenopause will keep you on your toes. And hopefully those toes are parked in a bucket of ice to help cool you and your hot flashes down.
• Sleep Issues: If you thought hot flashes were fun during the day, then you’ll LOVE them at night. Night sweats, among other menopausal symptoms, may give you trouble when it comes to sleep. I’m talking about falling or staying asleep, waking up early, getting less sleep overall, and experiencing fatigue during the day. Who wouldn’t experience daytime fatigue when they spent the night feeling like a heating pad that was busy being plugged in/unplugged in 30 second-five minute increments?
• Mood Changes: Hellooooo hormones! Do you remember that song you learned in middle school to help you remember the names of all the US States? I’m thinking of writing one for all the mood-based symptoms of perimenopause. Sing it with me: Irritability, mood swings, increased risk of depression, and anxiety, plus lack of motivation! They can all happen, due to your changing volume of estrogen, progesterone, and testosterone. So, get ready to jump on the hormone roller coaster and go for the ride of your life. 
• Vaginal and Bladder Problems: According to the Mayo Clinic, “When estrogen levels diminish, your vaginal tissue 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.” Perhaps  the sexiest of symptoms, no? That last speculation is according to me, not the Mayo Clinic.
• Bone Loss: Perimenopausal Madams, heed my advice: Protect. Your. Bones! Your declining estrogen levels make it so that you lose bone more quickly than you replace it. This means your bones become more fragile, increasing your risk of osteoporosis.
• Sexual Changes: As David Bowie sang Ch-ch-ch-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. Even though you must “turn and face the strange,” that “strange” is totally normal! 

Again, every woman experiences menopause in unique ways. Your symptoms may be subtle or come on gradually. Some may hit you at different times, some may not ever happen, and—just like your ex-boyfriends and used car salesmen—some may come on stronger than others. Just remember your symptoms may all be under that big beautiful umbrella issue that is menopause—or in this case, perimenopause. 

Menopause

At-A-Glance

The next stop on your journey? That’s right, my friend: 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.” 

In non-medical speak: The Big M Has Begun. 

Symptoms

Before driving into this stage of our journey, let’s make a pit stop and remind ourselves that menopause is an NBP: Natural Biological Process. Remember that acronym from earlier? If so, you’ve earned a glass of wine or bar of chocolate. And, if you forgot, no worries. Brain fog during menopause is real. Have the wine/chocolate anyway. You’re going through The Big M, it’s stressful and you’ve earned it!

The symptoms people experience vary, so what you’re going through will likely be different than what your BFF is going through. The good news?  Other than the ability to share wine and chocolate? You can still EMBRACE and EMPOWER each other. 

Aside from the menstruation changes, as I list the other menopause symptoms below, imagine Kelly Clarkson belting out “What Doesn’t Kill You Makes You Stronger.” The song literally begins “You know the bed feels warmer.” She must have been singing about those hot flashes we mentioned!

Here’s that list:

• Insomnia
• Vaginal dryness 
• Weight gain 
• Depression
• Anxiety 
• Difficulty concentrating 
• Memory problems 
• Reduced libido or sex drive 

 What doesn’t kill you makes you stronger . . .  

• Dry skin, mouth, and eyes 
• Increased urination
• Sore or tender breasts 
• Headaches 

 Stand a little taller 

• Racing heart 
• Urinary tract infections (UTIs) 
• Reduced muscle mass 
• Painful or stiff joints 

Doesn’t mean I’m lonely when I’m alone  

• 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

The list can feel overwhelming, but what doesn’t kill you makes a fighter, right? Keep in mind that plenty of treatment options—natural solutions, over-the-counter options, and prescription medications—are available to make it so your limitations don’t have to limit you during your journey.

And, to paraphrase Kelly: Doesn’t mean I’m lonely ‘cause I’m not alone. You’ve got this, but even when you feel like you don’t, the PauseMeNot community has your back.

Postmenopause

At-A-Glance

You made it to the last stop of your tour—the last leg of your journey: Postmenopause. Whoo-hoo! This stage begins when you hit the year mark from your final period. In other words, No Period For One Year =  Postmenopause. Once that happens, you’ll be referred to as  “postmenopausal” for the rest of your life. There’s no going back, but who’d want to? After all, you’ve survived all those symptoms, came out on the other side stronger, AND no longer need to worry about bleeding through your jeans. CONGRATS! 

Symptoms  

Achieving postmenopause (that’s right, I said “achieving,” because it’s a celebration-worthy life stage!) comes with its positive and negative effects. On one hand, you don’t have to worry about dealing with Aunt Flo ever again. Not just Aunt Flo, but all the baggage she brought with her on her little visits. No more “that time of the month” feeling, no more horrible cramps, crazy mood swings, etc. Bye-bye, PMS! 

What’s more, you no longer have to worry about unplanned pregnancy. Although protecting yourself from STDs is still incredibly important.

But ah yes, I did mention some negatives. Most of us don’t fully appreciate the natural hormone estrogen until it’s gone. With a decrease in estrogen, your body’s major systems can become affected in the following ways:

• Heart/Cardiovascular System — A decrease in estrogen might be a factor in the increase in heart disease among post-menopausal people. 
• Skeletal System — This is directly related to bone loss I mentioned above. A decrease in estrogen means your bones are more prone to weakness and brittleness. PYB, friends: Protect Your Bones!
• Urinary System — Low estrogen levels may cause the urethra lining to thin, resulting in weaker pelvic muscles. This, in turn, may result in bladder leakage and urinary tract infections. 

Additionally, changes in your sexuality and metabolism also may occur. 

Note! Once you get here, you should no longer have vaginal bleeding. If you do have vaginal bleeding after more than one year of no menstrual cycles due to menopause, notify your doctor ASAP. 

It’s a Wrap!  

Let’s review! 

1. Your PMS will go away once and for all. Feel free to do a happy dance to celebrate this future moment! I’m celebrating virtually right along with you.

2. While you are doing the end-of-menstruation electric slide (hello 80s!), remember that while you might experience menopause differently with different symptoms at different times, most women go these major stages of menopause: 

• Perimenopause — when a woman’s body begins the transition 
• Menopause — when a woman has experienced 12 consecutive months without menstrual cycles 
• Postmenopause — when the symptoms begin to subside (typically 24 to 36 months after your last period) 

If you’re wondering what stage of menopause you’re in, then take this quick survey to assess where you’re at. Next, check out the signs and symptoms involved in each phase. Knowledge is power!

Remember! You can take all the tests out there, talk to every professional, and still, no one knows your body better than you. So, start a ‘trackin your symptoms, educate yo self, and follow your gut (unless you think it’s just gas 😉 ) when making decisions. YOU are your best resource!

3. In your lifetime, you’ll go from having periods regularly (or almost regularly) to having irregular periods (perimenopause) to hoping for no periods for an entire year (menopause) to living the rest of your life with no periods (postmenopause). Phew! (Again, if you’re still bleeding after postmenopause, then talk to your doctor.)

4. No matter what stage you’re in, remember that your limitations do not have to limit you. You’ll get through this and be stronger on the other side of your journey! 

Sources

• https://www.aoafamily.com/home/news-topic.php?newsid=317
• https://www.webmd.com/menopause/guide/menopause-information
• http://mayoclinic.org/diseases-conditions/perimenopause/symptoms-causes/syc-20354666
• https://www.nia.nih.gov/health/what-menopause
• https://www.healthline.com/health/menopause#symptoms
• https://healthcare.utah.edu/womenshealth/gynecology/menopause/postmenopause.php
• https://www.womens-health-concern.org/help-and-advice/factsheets/menopause-and-insomnia/
• https://www.hopkinsmedicine.org/health/wellness-and-prevention/did-i-just-have-a-hot-flash-im-44#:~:text=A%3A%20Hot%20flashes%20are%20the,seconds%20to%20about%20five%20minutes

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