Different stages of menopause: perimenopause, menopause and postmenopause

Different stages of menopause: perimenopause, menopause and postmenopause

Menopause can be divided into three stages: perimenopause, menopause and postmenopause. The duration of menopause is highly individual, ranging from a few years to around ten years.

Perimenopause is the first stage and beginning of menopause. Generally speaking, it is the time before the last menstruation. During this time, the body prepares for menopause by gradually reducing the production of some hormones. Both oestrogen and progesterone decrease, which can lead to menopausal symptoms such as hot flushes, mood swings and irregular periods. Irregular periods usually occur around three to four years before the last period. The reason for the symptoms of perimenopause is that the number of follicles in the ovaries decreases with age. This causes the surrounding cells to produce less oestrogen, which in turn affects ovulation and menstruation, which becomes more irregular. Perimenopause can begin as early as your 30s, but is most common around your 40s. 

Symptoms during perimenopause
Symptoms that women may experience during perimenopause are wide ranging. Some women only experience occasional symptoms that are very mild, while others may have major problems with a variety of disorders. Common symptoms and problems during perimenopause are:

  • sleeping problems
  • mood swings
  • iron deficiency
  • weight gain
  • night sweats
  • less energy

The second phase is called menopause. This is the time after the last menstruation. It is usually said that you can be sure that you are in menopause when one year has passed since your last period without any intermenstrual bleeding. Intermenstrual bleeding is irregular bleedings that can be darker, heavier or come as a discharge mixed with blood. The average age in for the last menstrual period is about 51 years, but it can occur between 40 and 60 years.

Early menopause
If a woman's last period occurs before the age of 45, it is called early menopause and if it occurs before the age of 40, it is called primary ovarian insufficiency (POI). At the moment, the cause is unknown, but it may be due to underlying autoimmune diseases, specific medications or radiotherapy. Symptoms tend to be the same as for those who experience menopause at a later age but can be intense. If you experience early menopause, it is recommended that you seek medical care.

Postmenopause is the final phase of menopause and is a permanent state in which the hormones in the body are at a low level. These levels continue to decline throughout life, although not as drastically as during menopause, which stabilises hormone levels and can be said to be the end of menopause, menopause is almost over. This means that many of the symptoms experienced during menopause become milder or disappear. However, some symptoms may persist. Some of the most common symptoms are:

  • dry mucous membranes
  • unwanted weight gain
  • osteoporosis

Menopause test
If you suspect you are going through the menopause, you can do a test for FSH, either as a blood or urine test. The hypophysis in the brain produces FSH (follicle stimulating hormone), which starts the process of the follicles turning into eggs. When there is only a small amount of follicles left, more FSH is produced in an attempt to kick-start egg production. These tests measure the level of FSH in the blood or urine to see if it is increased.

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