The Stages of Menopause

The word menopause is used in popular culture to refer to the entire process of pre-menopause through post-menopause. Your doctor may be more precise and use one or more of the following terms.


Some people use pre-menopause and perimenopause interchangeably. Some use it to define the time when a woman is just starting to experience irregular periods but is showing no signs of classic menopausal symptoms like hot flashes or vaginal dryness. Others use pre-menopause to refer to a longer span of time prior to perimenopause, perhaps as early as your mid-thirties. If your doctor uses this term, ask how he or she defines it.


Again, different people define this in slightly different ways. Some consider it to be just the transitional time before menstruation stops. Others extend the definition past your final menstrual period for one to two years. While the average timeframe for perimenopause is about four years, it can last up to ten years and still be considered normal. During this time your ovaries gradually stop releasing eggs and producing estrogen and other hormones (progesterone, androgen, testosterone). In the years before your final period, fluctuations of hormones occur and your periods become erratic. At times, estrogen levels may be higher, which may trigger symptoms similar to premenstrual syndrome (PMS). Both before and for a time after your last period, when estrogen levels decrease, you may experience symptoms like hot flashes, vaginal dryness, diminished concentration and mood swings.


Technically, menopause refers to a specific event – the date of your last period. Doctors pinpoint your final period once you haven’t had one in a year. At that point, you no longer have to worry about periods or getting pregnant. In popular culture, the term is used more loosely to mean the entire process – three of the four stages including perimenopause through post-menopause.


Post-menopause begins with your final period and lasts the rest of your life. While the signs of menopause taper off over a year or two, you are at increased risk for longer term health problems related to low estrogen and need to work with your doctor to manage them.

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