A guide to the stages of menopause and the symptoms you may experience at each stage.
Late Reproductive Stage (Late 30s–Early 40s)
This stage is currently not widely recognised in medicine, and many women may not realise they are in it (which can be confusing). Both the North American Menopause Society and the Australian Menopause Society refer to a study suggesting women may experience some menopausal symptoms several years before menopause. Menstrual cycles may appear normal or show only subtle changes, but women can experience disturbing symptoms such as:
Symptoms:
Sleep disruption
Breast pain
Vaginal dryness
Urinary incontinence
Nocturia (frequent night time urination)
Memory changes
Mood changes
Pain before periods
Perimenopause (Mid-40s, variable duration)
Also known as the Menopause Transition (MT), this period usually occurs in the mid-40s, though it can start earlier or later. Medically, it is diagnosable when menstrual cycles become irregular by plus or minus at least seven days, often alongside symptoms such as hot flushes, sleep disturbances, and low mood. Hormone levels fluctuate widely during this phase: oestrogen rises and falls erratically before gradually declining, while progesterone, testosterone, and other hormones also decrease. This phase can last from a few months to ten years, with the North American Menopause Society and the Australian Menopause Society suggesting an average duration of four to eight years.
Common symptoms:
Hot flushes
Night sweats
Sleep disturbance
Anxiety
Fatigue
Low mood
Brain fog / memory issues
Concentration loss
Less desire to look after others
Irritability
Headaches / migraines
Change of libido
Overwhelm
Heavy / light bleeds
Achy joints
Vaginal dryness
Increased PMT
Rage
Weight gain, especially around the middle
Blood sugar dysregulation
Less common symptoms:
Dry / itchy skin
Hair loss
Sore breasts
Digestive issues, including nausea (especially in the morning)
Higher rate of injury and slow recovery
Gum issues
Dizziness / vertigo
Bladder weakness
Allergies
Changing body odour
Palpitations
Panic attacks
Urinary infections
Electric shocks
Burning tongue
Tinnitus
Tingling extremities
Brittle nails
Postmenopause (Average age 52)
Postmenopause is the term used to describe everything that comes after menopause for the rest of a woman's life. The levels of oestrogen are no longer in a state of fluctuation in this phase, so symptoms usually stabilise (though for many women they can continue).
Symptoms:
Some women find that symptoms decrease and disappear, and some find that they continue for a time, or may even linger for many years. For most women, it is a calmer time post-menopause, sometimes calmer than before.
These are all possible symptoms, and every woman’s experience is different. You may notice some, all, or none of them — each body responds uniquely to this transition.
Late Reproductive Stage (Late 30s–Early 40s)
This stage is currently not widely recognised in medicine, and many women may not realise they are in it (which can be confusing). Both the North American Menopause Society and the Australian Menopause Society refer to a study suggesting women may experience some menopausal symptoms several years before menopause. Menstrual cycles may appear normal or show only subtle changes, but women can experience disturbing symptoms such as:
Symptoms:
Sleep disruption
Breast pain
Vaginal dryness
Urinary incontinence
Nocturia (frequent night time urination)
Memory changes
Mood changes
Pain before periods
Perimenopause (Mid-40s, variable duration)
Also known as the Menopause Transition (MT), this period usually occurs in the mid-40s, though it can start earlier or later. Medically, it is diagnosable when menstrual cycles become irregular by plus or minus at least seven days, often alongside symptoms such as hot flushes, sleep disturbances, and low mood. Hormone levels fluctuate widely during this phase: oestrogen rises and falls erratically before gradually declining, while progesterone, testosterone, and other hormones also decrease. This phase can last from a few months to ten years, with the North American Menopause Society and the Australian Menopause Society suggesting an average duration of four to eight years.
Common symptoms:
Hot flushes
Night sweats
Sleep disturbance
Anxiety
Fatigue
Low mood
Brain fog / memory issues
Concentration loss
Less desire to look after others
Irritability
Headaches / migraines
Change of libido
Overwhelm
Heavy / light bleeds
Achy joints
Vaginal dryness
Increased PMT
Rage
Weight gain, especially around the middle
Blood sugar dysregulation
Less common symptoms:
Dry / itchy skin
Hair loss
Sore breasts
Digestive issues, including nausea (especially in the morning)
Higher rate of injury and slow recovery
Gum issues
Dizziness / vertigo
Bladder weakness
Allergies
Changing body odour
Palpitations
Panic attacks
Urinary infections
Electric shocks
Burning tongue
Tinnitus
Tingling extremities
Brittle nails
Postmenopause (Average age 52)
Postmenopause is the term used to describe everything that comes after menopause for the rest of a woman's life. The levels of oestrogen are no longer in a state of fluctuation in this phase, so symptoms usually stabilise (though for many women they can continue).
Symptoms:
Some women find that symptoms decrease and disappear, and some find that they continue for a time, or may even linger for many years. For most women, it is a calmer time post-menopause, sometimes calmer than before.
These are all possible symptoms, and every woman’s experience is different. You may notice some, all, or none of them — each body responds uniquely to this transition.