What are the Stages of the Menopause?

The word menopause comes from the Greek words Mens (month or monthly cycle) and pausis (end, stop). The menopause is a normal and natural part of a woman’s life cycle. The menopause is a gradual decline in ovarian function. It is marked by a fluctuation in hormone levels, especially a drop in oestrogen and eventually progesterone.

The menopause is divided into three phases:

1. Premenopause. Before a woman’s final period she may experience several years, her hormone levels drop or vary. This can cause a number of different changes including irregular menstruation.
2. Perimenopause. This is the transition period leading up to a woman’s final menstruation, lasting around four to eight years. Although the changes are dramatically reduced, at this time it is still possible to become pregnant. Oestrogen levels will fluctuate even more, and a number of common symptoms may appear, including very irregular periods, hot flushes, vaginal dryness and mood changes.
3. Postmenopause. A woman is postmenopausal a year after her final flow, when her ovaries are inactive. The average age for this to happen in the UK is 51, this, of course, varies, but it is normally between the ages of 45 and 55. Hormone levels will still drop and fluctuate for a while, which means that some symptoms experienced during the perimenopause may continue. After the menopause a woman is likely to go through physical changes some of which are obvious (such as a different body shape) and others less obvious (including an increased risk of osteoporosis and heart disease.

It’s impossible to predict exactly when you’ll hit menopause: the age your mother was when she went through it and the date you started your periods are relevant, but there is a cocktail of lifestyle factors that can also influence the timing. These include smoking, alcohol intake, Body Mass Index (BMI), and physical activity levels, and whether you have children or not (more than one pregnancy may delay menopause). Studies show smokers can go through menopause significantly earlier and have a twofold increase of early menopause before the age of 45, compared to women who have never smoked.

Around one per cent of women will go through the menopause prematurely before the age of 40. Women who have had a hysterectomy (removal of their womb) will go straight into menopause. Another cause of menopause is chemotherapy for cancer.

The body is pre-programmed to enter menopause in mid-life, just as it is to trigger puberty. As a result, levels of the sex hormones oestrogen, progesterone, and testosterone (all produced in the ovaries as part of the reproductive cycle) fluctuate and then decline as eggs are no longer released.