The Three Stages of Menopause

The menopausal transition is a gradual process that takes place over several years, typically between 45 and 55 years of age. This period is marked by progressive hormonal changes that cause a variety of physical and emotional symptoms.

Like most women, you may not be sure if you are actually going through perimenopause or menopause.

As you enter your 40s and 50s, you may start to notice changes in your health and wellbeing. These changes aren’t always recognised as being linked to menopause. Changing levels of the hormones—oestrogen, progesterone and testosterone—can encourage a range of symptoms. Some of these are classic menopause symptoms, but others can be more surprising. If you have any of these symptoms and you’re in the ballpark age for menopause, then you could be in that phase of your life.

It’s important to note that not all women experience the same type and intensity of menopause symptoms:

• 20% of women have no symptoms (lucky ladies)
• 60% experience mild to moderate symptoms
• 20% have symptoms so severe that they significantly interfere with daily life

Stage One: Perimenopause
The first stage of the menopausal transition is perimenopause, which can begin several years before actual menopause. This phase can last from a few months up to TEN years before menopause. Yes, you heard me right!

Perimenopause facts:
• The transition or lead-up to menopause
• Lasts an average of 4-6 years, but can be as short as one year or as long as 10 years
• Periods start to ‘wind down’ and become less regular
• Periods can be lighter or heavier, last for longer or finish earlier than they used to
• Menopause symptoms often gradually begin during this time

Perimenopause is often a time of great emotional upheaval for women. It’s simply hormone chaos! There’s a good reason why it’s referred to as the “second puberty”! Before you hit actual menopause, you go through a stage called perimenopause, which is when many women experience the most symptoms.

The fluctuations in hormones can lead to common symptoms such as:
• Anxiety
• Cravings, especially for sugar!
• Dry skin, hair and eyes
• Feeling overly emotional
• Feeling tired or unmotivated
• Hair loss
• Hot flashes
• Irregular periods
• Mood swings
• Night sweats
• Bloating
• Trouble sleeping
• Weight gain, especially around the belly!

Stage Two: Menopause
The second stage of the menopausal transition is menopause itself, which occurs when a woman has not had a period for 12 consecutive months. By this point, the ovaries have stopped producing eggs, and female hormone levels are at their lowest. The symptoms of perimenopause may intensify during this time, with more frequent and intense hot flashes, vaginal dryness, and urinary problems. Women may also face physical changes, such as weight gain, loss of muscle mass and a decrease in bone density, which expose them to an increased risk of osteoporosis.

Menopause facts:
• When you have your final menstrual period—you only know that you have had your final menstrual period if you have had no periods for 12 months
• Most women reach menopause between 45 – 55 years of age
• The average age for women in Australia to reach menopause is 51 – 52 years
• Menopause sometimes occurs earlier than expected as a result of cancer treatment, surgery or unknown causes
• It marks the end of your reproductive years

Stage Three: Postmenopause
Finally, the last stage of the menopausal transition is postmenopause, which begins a year after the last menstrual period and continues until the end of life. During this phase, menopause-related symptoms may gradually diminish, although some women continue to experience hot flashes and vaginal dryness for several years. Postmenopause is also a time when women may face new health challenges, such as cardiovascular diseases and osteoporosis, due to the decrease in hormonal protection.

Post-menopause facts:
• A woman can still experience menopause symptoms in postmenopause—this varies for each woman

Now, let’s have a look at what some of the most common menopause symptoms are:

1. Hot flushes and night sweats
Each woman experiences hot flushes differently. Some women can have hot flushes that are mild and quick, while others can have one a day or more than 20 a day.

Hot flushes generally start in the chest area and spread to the upper chest, then the neck and to the face, but they can also spread over the entire body. They have been described as a burning, overheating sensation with reddening of the skin and different degrees of sweating. A hot flush can last between 5 – 30 minutes (sometimes longer).

A lot of women experience night sweats, too, which can be disruptive for sleep. It’s thought that fluctuating hormone levels affect your body’s ability to regulate temperature, which fools it into thinking that it needs to cool down.

There is no single trigger for hot flushes. Common triggers include caffeine, alcohol, smoking, hot drinks, spicy foods and stress. Keep a journal. Figure out what your trigger is and avoid it if you can, to eliminate those hot flashes (yes, relief is possible!).

2. Sleep disturbances
Sleep problems can occur during times of hormonal change, like menopause. These include issues such as insomnia, where you find it difficult to fall asleep and stay asleep. Menopause symptoms, particularly hot flushes and night sweats, can disturb sleep and set off insomnia. Night sweats might change your usual pattern of sleep, and your body learns this new pattern, so the broken sleep pattern becomes the new norm.

3. Mood changes
A sudden and chronic dip in your mood can be another sign of menopause. Hormone changes are thought to affect levels of neurotransmitters such as serotonin (a contributor to feelings of well-being and happiness), which negatively affects your mood.

During menopause, you can experience:
• Crying spells
• Sadness
• Irritability
• Anger
• Panic
• Anxiety
• Depression
• Lethargy

4. Weight gain
Unfortunately, weight gain during this time of your life is common. But it’s not unbeatable. You might see fat gather around your belly area during menopause — yes, the dreaded muffin top! Your body goes through metabolic changes, so the old methods that used to keep you trim and in shape might not work as well or at all.

One reason is that during this time, your metabolism decreases, making it easier to gain weight. Another reason is that hormones contribute to the decrease of lean body mass, so this means that you lose muscle mass. Muscles help to burn calories while you work out as well as when you’re resting, so losing muscle mass means that you are burning less fat.

Combine that with lifestyle changes such as sitting more and moving less, and it’s a perfect recipe for weight gain!

So, if you have some or all of these symptoms, then you have more than likely begun your menopause journey. But don’t despair, as there are some lifestyle changes that you can make to decrease the severity of your symptoms.

Don’t let your culture dictate to you how you should feel during menopause. Menopause is your opportunity to take this new energy and use it for yourself. For years, you have been nurturing and looking after everyone else. Now that your hormones have changed, you have an opportunity to look inwards and start focusing on yourself and what your needs are.

If you would like to find out more about how you can age well and deal with your menopause symptoms, our Menopause Insights Manual has it all.