The 3 phases of menopause and their effects
The phases of menopause mark a natural stage in every woman’s life, during which hormone levels shift and fertility gradually comes to an end. Yet few women feel truly prepared for it. Mood swings, hot flashes, and sleep disturbances are just a few of the possible symptoms. But what exactly happens in the different phases of the body? This blog explains the three phases of menopause, the associated physical and hormonal changes, and measures that can help relieve symptoms.
Table of Contents
- Why do women go through menopause?
- When does menopause begin?
- The 3 phases of menopause and the timing of menopause
- Tips for navigating the phases of menopause
- Summary
Why do women go through menopause?
Women enter menopause because their hormone levels change. As women age, the function of the ovaries gradually declines, leading to a decrease in the production of the sex hormones estrogen and progesterone. This hormonal shift causes the gradual end of fertility and ultimately leads to menopause—the point at which a woman has not had a menstrual period for 12 consecutive months. This process is a natural part of aging, as the number of eggs in the ovaries is limited and eventually depleted. The hormonal changes can lead to various symptoms such as hot flashes, sleep disturbances, or mood swings (NHS, 2022).
When does menopause begin?
The onset of the phases of menopause varies individually and depends on genetic, hormonal, and health-related factors. Typically, the first hormonal changes begin between the ages of 40 and 45, although they can start earlier or later. Certain medical procedures, such as the removal of the ovaries or cancer treatments, can also induce early menopause (MedlinePlus, 2024).
The 3 phases of menopause and the timing of menopause
The phases of menopause occur gradually and can span several years. Each of these phases involves hormonal changes that may affect the body and mind. Menopause itself is not a prolonged phase but rather a specific point in time—the day on which a woman has not had her period for 12 months.
1. Premenopause: The time before menopause
Premenopause often begins in the late 30s or early 40s, when the production of estrogen and progesterone begins to fluctuate. The menstrual cycle remains regular, but early changes may appear:
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Lighter or heavier periods
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Breast tenderness
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Initial mood swings
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Sleep problems
2. Perimenopause: The actual transition phase
Perimenopause usually begins in a woman’s 40s and can last several years. Estrogen levels fluctuate significantly, leading to pronounced symptoms:
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Irregular cycles (longer or shorter intervals, heavier or lighter bleeding)
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Hot flashes and night sweats
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Sleep disturbances and fatigue
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Mood swings, irritability, and depressive moods
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Weight gain and slowed metabolism
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Joint and muscle pain
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Changes in libido (increase or decrease in sexual desire)
This phase ends with menopause.
Menopause: The time of the last menstrual period
Menopause is not a phase, but a specific point in time—the day on which a woman has not had a period for 12 months. At this point, the ovaries have nearly stopped producing hormones. Many symptoms of perimenopause persist or intensify:
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Vaginal dryness and pain during intercourse
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Increased bone loss (higher risk of osteoporosis)
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Elevated risk of cardiovascular disease due to the loss of estrogen’s protective effects
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Concentration problems (“brain fog”)
3. Postmenopause: The time after menopause
Postmenopause begins after menopause and lasts for the rest of a woman’s life. Some symptoms decrease, but the continued estrogen deficiency can have long-term effects:
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Fewer hot flashes, but persistent sleep issues
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Increased risk of osteoporosis and bone fractures
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Bladder weakness and frequent urinary tract infections
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Changes in fat metabolism (increased cardiovascular risk)
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Continued skin and hair changes
These three phases of menopause are experienced differently by each woman, but they are a natural part of life. A healthy lifestyle, physical activity, and medical support when needed can help relieve symptoms and improve well-being (MedlinePlus, 2024; Cleveland Clinic, 2024).
Tips for navigating the phases of menopause
Menopause is a unique experience for every woman—while some experience few symptoms, others struggle with hot flashes, sleep problems, or mood swings. Regardless of the phase, there are general strategies that can ease the transition: a nutrient-rich diet, regular physical activity, good sleep, and stress management are key to physical and emotional well-being.
Since each phase of menopause brings different needs, the table below provides specific tips tailored to each stage.
| Phase | Phase-specific tips |
|---|---|
| Premenopause – initial hormonal changes, cycle still regular |
Monitor your cycle: Irregularities or heavier periods can be early signs. Improve sleep quality: A consistent bedtime routine can help with initial sleep issues. Schedule regular check-ups: Get hormone levels and nutrient status checked. |
| Perimenopause – significant hormonal fluctuations, noticeable symptoms |
Prevent hot flashes: Reduce spicy foods, alcohol, and caffeine. Balance mood swings: Magnesium and B vitamins can support emotional stability. Support bladder health: Drink enough water and practice pelvic floor exercises. |
| Menopause – symptoms often at their strongest |
Address vaginal dryness: Use lubricants or non-hormonal moisturizers. Support bone health: Ensure adequate calcium, vitamin D, and include strength training. Reduce cardiovascular risk: Monitor cholesterol and blood pressure regularly. |
| Postmenopause – symptoms may subside, but long-term effects remain |
Prevent osteoporosis: Align diet and exercise with bone health needs. Avoid urinary tract infections: Practice gentle intimate hygiene and stay hydrated. Support skin and hair: Omega-3 fatty acids, vitamin B12, and moisturizing care help maintain skin and hair. |
Sources: Mayo Clinic, 2024; NHS, 2022
When should you seek medical advice?
While many women manage the phases of menopause well through lifestyle adjustments, severe symptoms can significantly affect quality of life. In such cases, consulting a doctor may be beneficial. For persistent or distressing symptoms, hormone replacement therapy (HRT) may be considered. This can be administered in the form of pills, patches, gels, or creams to help balance estrogen and progesterone levels (Cleveland Clinic, 2024).
Test your hormone levels and nutrient status
If you want to learn more about your own hormone balance, a menopause blood test or women’s hormone test can help you check key values. These tests measure hormones such as estrogen, progesterone, and others that fluctuate throughout the phases of menopause—helping you better understand which phase you're currently in.
Summary
The phases of menopause include premenopause, perimenopause, and postmenopause, while menopause itself marks the point of a woman’s final menstrual period. As estrogen and progesterone levels decline, symptoms such as hot flashes, sleep disturbances, and mood swings may occur. In the long term, the risk of osteoporosis and cardiovascular disease also increases. A healthy lifestyle, regular physical activity, and medical check-ups can help relieve symptoms. For more severe complaints, hormone replacement therapy (HRT) may be considered.
