What to Expect During Every Stage of Menopause

Going through menopause is a major milestone—but you may not be aware of how or when your monthly visitor will vanish. For many women, the various stages of menopause (which include perimenopause, menopause, and postmenopause) are a mystery until they actually happen.

“Every woman will go through the stages a little differently,” says gynaecologist Dr Mary O’Toole. That said, there are certain things you can expect throughout each stage as your oestrogen levels decrease and your period finally becomes a thing of the past. Here’s what lies ahead:

Perimenopause

This is the period leading up to menopause where oestrogen and progesterone start to decrease, explains Dr O’Toole. It can begin as early as your mid-40s and usually lasts for around four years. “It’s difficult to pinpoint the onset, but irregular menstrual cycles may be the initial sign,” says Dr O’Toole. You can still get pregnant during this time, so it’s important to use contraception if you’re not looking to conceive.

What to expect

With oestrogen fluctuating, your periods may get longer or shorter, according to the Mayo Clinic. You may also notice your period is heavier than usual, or it could be lighter. “Along with menstrual cycle changes, there may be emotional and psychological changes including anxiety, depression, brain fog, and forgetfulness,” says Dr O’Toole.

Menopause

A woman is officially in menopause when she hasn’t had her period for 12 months, notes Dr O’Toole. Between ages 40-50, oestrogen production has drastically decreased and your ovaries have stopped releasing eggs, which means you no longer have periods.

What to expect

“There’s a spectrum of symptoms that vary with each woman,” says Dr O’Toole. Hot flushes are definitely common and they can vary in frequency and duration. “They may affect sleep and be a source of chronic sleep deprivation, fatigue, or brain fog,” says Dr O’Toole. “Other symptoms that may be present are vaginal dryness, decreased libido, anxiety, depression, and weight gain.”

Postmenopause

As the name implies, postmenopause is the time period after menopause occurs. 

What to expect

“Symptoms like hot flushes may gradually diminish,” says Dr O’Toole. “But you may experience vaginal issues like dryness or irritation; some women may also find that intercourse is more painful.”

Additionally, postmenopausal women have an increased risk of osteoporosis and heart disease because of the decline in oestrogen, which impacts the way the body uses calcium and maintains cholesterol levels in the blood.

You may also notice changes to your skin after menopause, says dermatologist Cynthia Bailey. Postmenopausal skin tends to be more delicate, tearing and bruising more easily. It may also be drier and more prone to conditions like eczema.