What you’ll learn
In this guide, you’ll learn about the three stages of menopause: perimenopause, menopause, and postmenopause. We’ll discuss how each affects your body, mood, and overall health. We’ll also cover treatment options, lifestyle tips, and how QuickMD can help you access expert care and personalized guidance whenever you need it.
Menopause is a natural part of life. It marks the end of your menstrual cycle and the time when you can no longer become pregnant. Many people call it “the change of life,” and while it’s a normal transition, it can still bring new experiences for your body and mind.
There are three main stages in the menopause journey: Perimenopause, menopause, and postmenopause. Each stage comes with its own physical, emotional, and hormonal changes.
Factors like your genetics, overall health, and lifestyle choices can influence when you start menopause and how long each phase lasts.
Knowing what to expect can help you feel more in control. Understanding the changes ahead means that you can prepare for symptoms, make supportive choices, and take steps to protect your overall well-being.
What are the stages of menopause?
If you’re approaching your 40s, you may already be wondering: Am I in menopause? How will I know? What are the stages of menopause?
Let’s walk through each stage of menopause and the symptoms that can come with it.
Stage 1: Perimenopause
The menopause transition starts with perimenopause. This phase typically begins in your mid-to-late 40s. However, it can start earlier or later depending on your body and circumstances.
During perimenopause, your ovaries begin producing less estrogen and progesterone. These hormonal shifts don’t happen steadily. Your levels can fluctuate unpredictably, which is why symptoms can often come and go or change in intensity from month to month.
These hormonal shifts can lead to a variety of symptoms, including:
- Irregular periods
- Changes in mood
- Hot flashes
- Night sweats
- Periods that are heavier or lighter than usual
- Insomnia
- Urinary urgency
- Vaginal dryness or low libido
Some women only experience mild changes. Others may feel bigger changes in their cycle and how they feel from day to day.
Emotionally, you might feel more irritable or anxious during perimenopause. Mood swings and even depressive symptoms can surface, especially if you’re also dealing with poor sleep or stress from life changes. A recent study published in the Journal of Affective Disorders found that women in perimenopause are 40% more likely to experience depression than women at any other stage of life. These mood fluctuations are linked to a drop in estrogen, which influences serotonin and other mood-regulating chemicals in the brain. This leads to increasing feelings of anxiety and irritability in perimenopausal women. The encouraging news is that lifestyle adjustments, treatment options, and support networks can significantly improve how you feel.
Perimenopause can last anywhere from a few months to several years. Paying attention to your cycle, tracking symptoms, and having a conversation with a licensed healthcare provider during this time can help you feel more informed and in control.
Stage 2: Menopause
You officially reach menopause when you’ve gone 12 consecutive months without a period, and there’s no other underlying medical reason for the change. This signals that your ovaries have stopped releasing eggs and that estrogen and progesterone production have dropped to consistently low levels.
On average, menopause happens around age 51, although this can vary based on genetics, health, and lifestyle choices. Some of the most common symptoms of menopause are:
- Mood swings
- Night sweats
- Hot flashes
- Vaginal dryness
- Insomnia
- Bladder problems
- Weight gain
Some women also experience thinning hair, dry skin, slower metabolism, and joint pain. Sleep may remain disrupted, and bladder control issues, such as leaks when laughing or sneezing, can become more noticeable.
Hormonal changes in menopause are more stable than in perimenopause. However, because your body is now operating on a lower flow of estrogen, many of the symptoms of perimenopause continue and intensify during menopause.
Like perimenopause, menopause can bring feelings of sadness, irritability, or anxiety. For some, it can be a time of reflection or emotional transition. Because estrogen helps regulate mood, lower levels may contribute to feeling “off” or not quite yourself emotionally. At the same time, some women experience a sense of clarity or even relief, especially if they’ve struggled with painful periods in the past.
No matter what your experience looks like, menopause is a major transition. Having a support system and trusted provider in your corner can make a big difference.
Stage 3: Postmenopause
After you have officially entered menopause, the postmenopause stage will continue for the rest of your life. Many of the symptoms you’ve been experiencing will ease up. You might find that hot flashes and night sweats gradually fade. Because your hormone levels have now stabilized at a lower level, your body attunes. But that doesn’t mean the transition is over.
Estrogen plays a protective role in helping prevent certain health conditions. As a result, postmenopausal women may be at increased risk for certain conditions, including:
- Osteoporosis
- Heart disease
- Urinary incontinence
Some women also experience vaginal dryness and discomfort during sex due to thinning of the vaginal walls. You might also notice changes in memory, focus, or energy levels.
The good news is these symptoms are often manageable with lifestyle adjustments and support. Eating a balanced diet rich in calcium, staying active, and getting regular screenings are great ways to protect your health in this stage.
Emotionally, some women report improved mood and energy after menopause, especially as their hormone fluctuations stabilize. Others may find themselves adjusting to new roles in life, such as becoming an empty nester, retiring, or finding a change in priorities.
Postmenopausal women can also benefit from staying connected socially and emotionally with loved ones. Additionally, talking with a licensed provider can help you stay ahead of any potential concerns and empower you on your health journey.
Everyone’s menopause experience is different. But knowing what to expect can help you take proactive steps to manage changes and feel your best.
Symptoms across the stages of menopause
Your experience during menopause will be unique. Certain symptoms tend to appear during different stages, while others may be present throughout the transition.
Understanding how your body may change from stage to stage can help you manage your symptoms more effectively.
Here are some of the most common symptoms during each stage:
| Symptoms | Perimenopause | Menopause | Postmenopause |
| Vaginal dryness | X | X | |
| Insomnia | X | X | X |
| Irregular periods | X | X | |
| Hot flashes | X | X | X |
| Night sweats | X | X | X |
| Mood swings | X | X | |
| Thinning hair | X | X | |
| Weight gain | X | X |
Treatment options for every stage of menopause
If you’re struggling with menopausal symptoms, there are several treatment options available. Some are hormone-based, while others offer non-hormonal ways to find relief. Always speak with a healthcare provider before starting any treatment.
Hormone therapy (HT)
- Menopause hormone therapy (MHT): MHT is one of the most effective treatments for menopause symptoms. It involves supplementing estrogen (and sometimes progesterone) to help your body function closer to when you were naturally producing these hormones. MHT is used to ease symptoms like hot flashes, vaginal dryness, and mood swings. Some patients also find that it supports weight management during menopause.
- Estrogen therapy (ET): ET may be recommended for those who no longer have a uterus. It involves estrogen alone and is typically used to reduce menopause symptoms without the need for added progesterone.
- Estrogen progesterone therapy (EPT): If you still have a uterus, a combination of estrogen and progesterone may be suggested. This approach helps lower the risk of endometrial cancer (cancer that forms in the lining of the uterus).
It’s worth noting that hormone therapy has significant benefits, but, like all treatment and medication options, there are still associated risks. Having a conversation with a provider can help you find the best option for you based on your own medical history, family history, and other lifestyle factors.
Non-hormonal treatments
Not everyone chooses hormone therapy. In some cases, not everyone can opt for hormone therapy. No matter what your circumstances, there are non-hormonal options that can help ease the shift into menopause.
- Cognitive behavioral therapy (CBT): CBT can help you manage how menopause symptoms affect your mood and daily quality of life.
- Prescription medications: Certain antidepressants and other prescription medications can assist with mood regulation and reduce hot flashes.
- Hypnotherapy: Some people find relief through guided hypnosis sessions. Hypnotherapy may help you learn how to manage stress and emotional responses to symptoms.
Lifestyle tips for managing menopausal symptoms
Your daily habits can make a big difference in how you feel during each stage of menopause. Small changes can help you manage symptoms and support your body’s overall health.
Perimenopause
During this stage, it’s important to start tracking your menstrual cycle, if you aren’t already. You can use an app or a traditional calendar to keep track. This makes it easier to spot the changes in patterns. Additionally, eating foods that are high in phytoestrogens can help reduce symptoms by balancing hormones naturally. Phytoestrogens are natural compounds found in plants and vegetables that operate similarly to estrogen in the body. Foods like soy, flaxseed, chickpeas, and berries are a great source of these phytoestrogens. Additionally, starting strength-building exercises (such as lifting light weights or body-weight exercises) can help increase bone density to ward off osteoporosis later in menopause.
Menopause
During menopause, developing a routine to sleep better is important since many women experience insomnia during this stage. You might find it helpful to keep your bedroom dark, cool, and quiet to promote better sleep. If you are struggling with hot flashes, try cooling techniques such as wearing breathable clothing, staying hydrated, and keeping a fan running by your bed. Beyond sleeping better, menopause is a great time to prioritize fiber-rich foods, lean protein, and healthy fats to support metabolism and mood.
Postmenopause
In the postmenopausal stage, it’s important to focus on your physical, mental, and emotional well-being. Embrace a heart-healthy diet rich in whole grains, fruits, and vegetables. If you haven’t started exercising, working out with light weights, or body weight exercises like yoga or pilates can help strengthen bone health and may help you feel better. You have a lot of options, so choose what feels best for you. Keep up with mental wellness practices, including meditation or counseling. This can help you keep a pulse on your mental and emotional health during “the change of life.”
When to see a healthcare provider
Menopause is a natural process, but some symptoms are a sign that you should seek medical attention. If you have heavy bleeding after not having a period for a year, have severe mood disturbances, or fracture a bone after a minor injury, talk to a licensed provider. The same applies if you have perimenopausal symptoms before the age of 40.
Any symptom that impacts your daily life or well-being deserves attention.
Frequently asked questions about menopause
Can I get pregnant during menopause?
You can still get pregnant during perimenopause, although it’s less likely. Once you’ve gone 12 months without a period, pregnancy is no longer possible.
Can menopause happen before age 40?
Yes. When menopause starts before age 40, it’s called “premature menopause” or “early menopause.” If you think this may be happening, speak with a healthcare provider.
Can menopause affect my sex life?
Yes. Hormonal changes can lead to vaginal dryness and reduced libido. These factors can affect intimacy. However, treatment options are available to help revive your sex life.
Do men go through menopause?
Not exactly. Men don’t go through menopause in the way women do. They may, however, undergo a gradual decline in testosterone levels with age. This condition is sometimes referred to as andropause.
What age is considered late menopause?
Late menopause refers to menopause that begins at 55 or older. If you’ve reached your 50s without experiencing menopausal symptoms, chat with a healthcare provider to rule out any other causes.
Do you still need pap tests and mammograms after menopause?
Yes. Routine screenings like pap smears and mammograms are still recommended. Depending on your medical history, age, and conversations with your healthcare provider, they may adjust the frequency.
Does menopause cause weight gain?
Yes. Hormonal shifts during menopause can contribute to weight gain, particularly around the waistline. Lifestyle changes and medical support can help manage it.
