Most women have heard about and know what menopause is, but many are shocked to find out that it’s just 1 stage out of 4. Yeah, that’s right! There are four stages women go through as we transition through the end of our reproductive years into our older and better years. In this article, we’re going to uncover exactly what those four stages are and what stage you can expect the most symptoms (it’s actually not menopause).
So, What Are The 4 Stages of Menopause?
Menopause is a natural four-stage process that happens as women move through the end of their reproductive period. The first stage is premenopause. Many women experience slightly irregular periods during premenopause, as their hormone levels begin to fluctuate. For some women, premenopause may also be marked by the beginning of troublesome hot flashes.
The second stage is perimenopause, which is marked by significant reproductive and hormonal changes that often lead to a range of different symptoms. The third stage is menopause. During this stage, a woman is no longer having menstrual periods and hasn’t had one in 12 consecutive months.
Last but not least is the final stage, which is postmenopause or late menopause. This stage of your journey, which generally begins eight years after the end of your periods, signifies life after menopause and accounts for approximately ⅓ of a woman’s life. Now, let’s explore what each stage looks like.
First Stage of Menopause: Premenopause
Premenopause is the first stage in the menopause process, although many people combine this stage with perimenopause. But, there is a difference. In premenopause, symptoms tend to be milder than in perimenopause. There may be somewhat irregular periods and some hot flashes, but many women do not experience any noticeable symptoms in this phase. One important thing to remember is that premenopause can happen in your mid-30s. Many women are surprised by this fact.
Second Stage of Menopause: Perimenopause
Perimenopause is the second stage in the menopause process. It can happen at different ages for different women as female reproductive hormones, such as estrogen, begin to drop. Perimenopause often starts in a woman’s 40s or early 50s and can last from two to ten years, depending on the individual. Some women, however, may experience perimenopause symptoms as early as their 30s. And this can be confusing or alarming for some women who are conditioned to believe that menopause starts far later in life.
Perimenopause is generally the part of the menopause journey where women experience the most challenging symptoms. Not every woman will experience each symptom, and the severity of the symptoms will also vary from woman to woman. However, there are treatments available to address many symptoms, including holistic options. We’ll discuss many of the symptoms women can expect below.
#1. Irregular Periods
As women enter perimenopause, their periods may become irregular. Sometimes, these irregular periods may be very light, and other times, they may be heavy. Eventually, in menopause, periods stop entirely.
#2. A Fall in Sex Drive
Many women report a decline in their sexual drive during perimenopause. Sometimes it’s just a direct result of perimenopause and a dip in hormones. Other times it’s a side effect of some medications that women take to address other menopause symptoms.
#3. Vaginal Dryness
As women enter perimenopause, many note that their vagina becomes dry. This can make sex uncomfortable without extra lubrication.
#4. Hot Flashes and Night Sweats
Many women report that hot flashes are one of the most frustrating, and in some cases debilitating, symptoms of perimenopause. This occurs because the body is adapting to changing hormone levels.
#5. Rapid Heartbeat
Some women report experiencing a rapid heartbeat. The science behind this is similar to why some women have hot flashes. A rapid heartbeat can lead to exhaustion.
This is a commonly reported and frustrating symptom of perimenopause. Some women report fatigue independent of other symptoms, whereas others feel their fatigue is a function of other symptoms.
Psychological Symptoms: #7 - #13
Many women report that in addition to physical symptoms, they also have a host of emotional and psychological symptoms, including:
- #7 depression
- #8 mood swings
- #9 irritability
- #10 anxiety
- #11 a sense of doom or dread
- #12 a feeling of brain fog or constant confusion, and
- #13 memory lapses
These symptoms can be upsetting and although we can’t say there is a solution to it, the good news is there are holistic approaches to treat these symptoms.
Many women report that their symptoms become better and more manageable even without medication as they move through perimenopause and their hormones begin to stabilize. Organizations, such as the Anxiety and Depression Association of America, are doing additional research into the psychological impact of perimenopause.
#14. Weight Gain
Many women report weight gain and body shape changes during perimenopause. This can be frustrating for self-image.
In addition to weight gain, some women report being bloated or retaining water.
#16. Bladder Problems
Some women report bladder control issues during perimenopause. These can range from significant challenges to small leakage when they laugh or sneeze.
#17. Sore Bones, Joints, and Tendons
Many women experience aching joints and muscles during perimenopause, and it may signal the start of osteoarthritis.
Skin Issues: #18 - #20
Some women report skin problems are some of their most frustrating perimenopause symptoms. Three common skin symptoms are:
- #18 a sense of skin-crawling
- #19 a buzzing or electric sensation under the skin, and
- #20 skin tingling, particularly in the extremities
#21. An Increase in Allergies
This is a symptom of perimenopause that is not as widely understood, but some women report a sharp increase in their allergy symptoms or entirely new allergies.
#22. Gastrointestinal Distress
GI distress can take many different forms. For some, perimenopause may lead to a spike in diarrhea or nausea and vomiting. For others, it may result in GERD (reflux or heartburn).
#23. Troubling Headaches
Migraine headaches can be a debilitating symptom for some women in perimenopause. Interestingly, however, other women report that their headaches become better as hormone levels change.
Soft Tissue Changes: #24 - #26
The change in hormones during perimenopause and menopause can also affect soft tissues. Some symptoms may include:
- #24 muscle tenderness and/or muscle tension
- #25 breast swelling and tenderness, and
- #26 swollen gums that may bleed more easily
#27. Difficulty Sleeping
This is one of the most frequently reported and challenging perimenopause symptoms. Sleep challenges can be associated with other perimenopause symptoms, or it can be standalone. Sleep challenges can set up a vicious cycle of worsening symptoms.
#28. Worsening Pre-Existing Conditions
This phenomenon is not entirely understood. But, many women with other health conditions note that these health conditions become worse during perimenopause.
#29. Changes in Your Hair and Nails
Many women report losing hair or that their hair has become more brittle. They may also lose hair on body parts, for example, pubic hair. Some women also experience symptom #30, brittle nails.
Additional Symptoms: #31 - #34
Other commonly reported symptoms of perimenopause include:
- #31 dizziness and balance issues,
- #32 body odor changes (a rarely reported symptom),
- #33 a burning tongue and
- #34 osteoporosis: Osteoporosis can have long-term impacts on a woman’s health. However, osteoporosis usually happens in the years following menopause. It is crucial to think about bone health and take proactive strides, such as Vitamin D or calcium supplementation.
Third Stage of Menopause: Menopause
Menopause happens at the end of perimenopause when it has been 12 months since a woman’s last period. It generally occurs in your 40s or 50s, with the average age in the United States being 51. Many women experience a decline in the troublesome symptoms mentioned above when they experience menopause.
Fourth Stage of Menopause: Postmenopause or Late Menopause
Postmenopause or late menopause is the timeframe after menopause has officially happened. Many people refer to it as happening eight years after your last period, when hormone fluctuations and hot flashes have stopped. As life expectancies increase around the world, women are having longer lives after menopause. This means that women and their health providers need to be aware of potential health challenges. For example, the risk of heart disease and stroke may increase after menopause, as women no longer have high levels of protective estrogen in their bodies.
After menopause, it is imperative to make sure that you are making healthy lifestyle choices. Some doctors may suggest using hormone replacement therapy to decrease the risk of these diseases. There are other possible treatments, too, including phytoestrogens and low-dose oral contraceptives. Another issue to consider during the postmenopause period is bone health and preventing breaks, particularly hip fractures, related to osteoporosis.
Today, many women are unaware that there are four stages of menopause, even though this is a process every woman will experience as they age. The menopausal transition can bring with it distress and an overall decreased quality of life, but this isn’t 100% due to the symptoms mentioned above. In fact, one of the main risk factors for distress is negative stereotypes that lead to themes of silence, shame, and stigma related to aging and menopause.
So, what does the above information mean? It means that most women don’t know what the stages of menopause are because there is still so much stigma associated with this very natural part of aging for women. We hope this article alleviated some of the stigmas surrounding menopause and brought some understanding to a very common, natural, and beautiful part of aging.