Skip to main content

Stages of menopause: What to expect for each stage

Premenopause, perimenopause, menopause or postmenopause? No matter where you are, here’s what to expect and ideas for how to prepare.

Published: May 23, 2024 |4 minutes to read

Written by: Melanie Mannarino

A person with long, naturally gray hair stands at their worktable and looks out the window on a sunny day.

Even in a world where most health topics are openly discussed, there’s still plenty of mystery around menopause. Many people don’t know when it starts, how long it lasts and what going through it feels like. So, let’s pull back the curtain.

Simply put, menopause is a milestone in a person’s fertility. It marks that 12 months have gone by since a person’s last menstrual period. When a person is postmenopausal, this means that they can no longer become pregnant naturally.

You might have heard different terms related to menopause: premenopause, perimenopause, menopause itself and postmenopause. These are the various stages of menopause, and it’s helpful to understand each.

Here, we define and explain each phase, and highlight a few symptoms to be aware of along the way.

In this article:

The premenopausal stage

While many people use the terms “premenopause” and “perimenopause” interchangeably, they actually refer to two distinct times. Premenopause has nothing to do with the menopause years specifically.1

During this chapter of a person’s life, ovarian function is typically strong and menstrual cycles are generally predictable, going with the general ebb and flow pattern of hormones. As such, premenopausal people are more likely to get pregnant than people in other stages of fertility, says Lisa Larkin, MD, president of The Menopause Society and a board-certified internist.2

Perimenopause

Perimenopause is the stage leading up to menopause and often starts when a person is in their mid-to-late forties.3 However, some people experience it earlier and some experience it later. For people assigned female at birth, perimenopause symptoms can start as young as 35, according to Stephanie Faubion, MD, director of the Mayo Clinic Center for Women’s Health and medical director of The Menopause Society.4

During perimenopause, previously regular hormonal levels can spike and dip as the ovaries start to slow down. Eventually, ovaries stop producing eggs and releasing hormones that support fertility.

These changes not only affect the menstrual cycle, but physical and mental health too. People may experience some or all of the classic symptoms that have long been associated with menopause, including hot flashes, mood changes, trouble sleeping and vaginal dryness.5

Read the linked article for a more complete overview of perimenopause and menopause symptoms.

Perimenopause is a sign that fertility is waning. It is still possible to get pregnant at this stage as long as you’re still getting your period — even if it’s irregular. (Click through for more on perimenopause.)

Menopause

More of a milestone than a stage, menopause signifies that it’s been 12 months since a person’s last menstrual cycle, so they are no longer in the perimenopause phase.

The average age of menopause in the United States is 516 or 52,7 though some may reach it in their 40s or 60s.8 Menopause occurring before the age of 40 is called premature menopause and happens in about 1% of individuals.

During menopause, the body’s estrogen production has decreased significantly:9 “You’re no longer bleeding, you’re no longer fertile,” Dr. Larkin explains.10 (Read more about menopause.)

Postmenopause

Once a person has reached the menopause milestone, they enter their postmenopausal stage.11 This post-fertile stage will continue for the rest of their life.12

For some, “it doesn’t feel different — you’re just not having periods,”13 Dr. Faubion says.

As far as symptoms are concerned, some will continue experiencing the same or others they had during perimenopause. These may include hot flashes and night sweats, but some will likely get milder or go away completely.14

It's important to know that the risk of certain conditions, including heart disease and osteoporosis, increases after menopause.15

Empowering yourself

Menopause is a natural life transition. Arming yourself with knowledge about what to expect can help make it easier to accept and manage.

Talk to your health care provider about any questions or concerns you may have — and let them know if you’re experiencing any symptoms.

“With the average life expectancy for women at 79.1,16 women are spending 30 or 40 years in their postmenopausal stage,” Dr. Larkin says.17 Being aware of your body and the changes that are taking place can go a long way toward living a life you love during those decades.

Your health care provider may also talk to you about certain strategies for supporting relief, such as certain prescription medications or over-the-counter products:

  • Calcium and vitamin D supplements (when recommended by your doctor), which can support bone health.18
  • Cooling eye pads, cold packs and cooling gel sheets, which may offer some relief support from hot flashes and night sweats.
  • Facial moisturizers formulated for dry skin, which can help restore moisture balance.
  • Vaginal lubricants, which can help replace moisture loss from menopause.19

This content is for informational purposes only and is not medical advice. Consult your health care provider before taking any vitamins or supplements and prior to beginning or changing any health care practices.