The 4 Phases of Menopause

The menopause is a natural part of every woman's life that brings about many changes (both physical and emotional). The "4 stages of menopause" describe this change in stages.

The menopause, medically called the climacteric, refers to the years before and after menopause - the last menstrual period in a woman's life. This period can be divided into:

1. Premenopause
2. Perimenopause
3. Menopause
4. Postmenopause

Each of the four phases of menopause manifests itself differently. Just as the hormonal changes occur differently in every woman, they begin at different times and also last for different durations. Only those who know the four phases can correctly assign the specific symptoms.

1. Premenopause: The beginning of menopause

The premenopause begins long before the last menstrual period, usually around the age of 40. During this phase, the production of female sex hormones, especially progesterone and estrogen, gradually decreases. The ovaries work less, and fertility declines. The last menstrual period has not yet occurred, but the body is preparing for it. Women in premenopause can still become pregnant.

Symptoms of premenopause:

• irregular, heavy or prolonged periods
• mood swings and irritability
• headaches
• joint pain
• breast tenderness
• water retention
• Digestive problems

On average, the first of the four phases lasts six to seven years before transitioning into perimenopause.

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2. Perimenopause: The transitional phase

Around the average age of 47, perimenopausal changes begin. Perimenopause refers to the years immediately before menopause and the year after. One-third of women experience significant discomfort during this phase, when ovulation becomes less frequent and fewer follicles with fertilizable eggs mature. The second of the four phases is considered the peak of menopause.

Symptoms of perimenopause:

• Hot flashes and sweating
• Menstrual cycle disturbances and absence of periods
• Sleep disturbances, night sweats
• Tiredness
• depressive moods, lack of drive
• dizziness
• hair loss and dry skin
• weight gain
• vaginal dryness and associated loss of libido

Since the timing of the last menstruation can only be determined retrospectively, the perimenopause is considered to be over one year after the last menstrual period.

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3. Menopause: The end of menstruation

The term menopause is often erroneously used synonymously with the climacteric period. The climacteric period, as the name suggests, refers to a period of several years (around menopause), whereas menopause itself stands for the last menstrual period of a woman. This usually occurs at the age of 52. The ovaries have permanently stopped functioning, as medical professionals believe, but only after one year after the last menstrual period.

There are a number of factors that can influence the timing of menopause, such as smoking. Heavy smokers often experience their last menstrual period earlier. The onset of menopause before the age of 45 is referred to as early menopause, a last menstrual period before the age of 40 as premature menopause or in medical terms as premature ovarian insufficiency.

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4. Postmenopause: The time after menopause

Twelve months after the last menstrual period, the last phase of the climacteric period begins, lasting ten to 15 years during which the hormone balance slowly stabilizes again. The production of estrogen and progesterone has now reached its lowest point, whereas the concentration of FSH, the follicle-stimulating hormone, is at a constantly high level.

Symptoms of postmenopause:

• Back and joint pain
• The breasts lose firmness
• Decrease in muscle mass
• Pelvic floor lowering
• The skin is no longer as firm
• Osteoporosis due to lack of estrogen
• Hair loss
• Facial hair growth due to a relative excess of testosterone

Only at this point are the fertile years certainly over and the woman no longer needs to use contraception.

How long does menopause last?

The hormonal changes can encompass a period of 20 years from the beginning to the end of menopause. It is not possible to say exactly when it will be completed, although the end is usually marked between 60 and 65.

Emotionally, however, the duration of menopause varies for every woman. How postmenopausal life feels often depends on the nature and perception of the symptoms. According to a study, women who experience symptoms early can suffer from these symptoms for a longer period. However, one-third develop only mild symptoms.