The Menopause Journey: Navigating Every Stage with Confidence
Did you know that there are different stages of menopause? Early perimenopause, late perimenopause, early postmenopause, late postmenopause…confused yet?! Today, I'm breaking down everything you need to know about the stages of menopause, from the earliest changes to life after the transition.
Key Definitions to Get Started:
Perimenopause: The transitional phase leading to menopause, marked by hormonal fluctuations and changes in menstrual patterns. Perimenopause can last several years and brings a range of symptoms (PMS symptoms can worsen, migraines can occur, moods can change, and much more!).
Natural Menopause: The phase when a woman’s periods permanently cease due to a natural drop in ovarian hormone production. Menopause is officially marked after 12 consecutive months without a period, typically occurring between ages 45 and 55. (Fun fact: even if you've gone 364 days without a period, having one on day 365 means the countdown resets!)
Induced Menopause: This occurs due to medical interventions like surgery (ovary removal) or treatments such as chemotherapy or radiation, which stop ovarian function.
A Closer Look at Each Stage:
Early Perimenopause
Average age: Early to late 40s, but can begin in the 30s to early 50s. Duration varies.
During this time, your ovaries begin a gradual decrease in estrogen production, though not in a straight line – think of it more like a roller coaster ride.
Hormone Changes:
Fluctuating estrogen
Decreasing progesterone
Irregular FSH (Follicle Stimulating Hormone) spikes
Low Anti-Müllerian hormone (AMH) levels
Low Inhibin B levels
Common Symptoms:
Irregular periods (longer or shorter cycles)
Hot flashes (though typically milder than in menopause)
Mood changes
Sleep disturbances
Vaginal dryness
Weight fluctuations
Late Perimenopause
Average duration: Typically around 1-3 years
This phase often feels more intense. You might find yourself thinking, “Something is definitely changing.” Your body is gearing up for the final transition, but menstruation hasn’t fully stopped.
Hormone Changes:
More pronounced estrogen fluctuations
Low progesterone
Rising FSH levels (>25 mIU/mL)
Low AMH levels
Low inhibin B levels
Common Symptoms:
Longer intervals between periods (more than 60 days)
More frequent and intense hot flashes
Night sweats
Heightened mood swings
Shifts in libido
Menopause
The milestone moment
Menopause itself is one significant day—the one-year anniversary of your last menstrual cycle. While the symptoms may have been brewing for years, this day marks the official start of your new phase.
Early Postmenopause
Duration: Can last for several years.
Congratulations, you’ve reached a new chapter. However, the hormonal shifts continue as your body adjusts to lower hormone levels.
Hormone changes:
Low estrogen
Low progesterone
High FSH levels (>25 mIU/mL)
Very low AMH levels
Low inhibin B levels
Common Symptoms:
Worsening hot flashes
More frequent night sweats
Continued mood swings
Shifts in libido
Late Postmenopause
The years beyond. This phase represents the rest of your life after early postmenopause.
Hormone Changes:
Consistently low estrogen and progesterone
Stabilizing FSH levels
Very low AMH levels
Very low Inhibin B levels
Common Experiences:
Fewer and less severe hot flashes (typically decrease over 2-5 years)
Balanced mood
Increased attention needed for vaginal health
Focus on bone and heart health
Living Your Best Menopause Life:
Remember, menopause isn’t just a phase; it’s an evolving journey that varies for each woman. The most important part is recognizing and embracing these changes. Partner with your menopause provider to address symptoms and improve your quality of life, ensuring you navigate each stage with confidence and well-being.
Understanding your body’s rhythms during menopause empowers you to live your best, healthiest life—no matter the phase.
Stay tuned for my next post about evidence-based treatments for managing menopause symptoms!
