The phases of the transition explained

Menopause is a natural phase that all women go through. During this period, your ovaries gradually change their function. This leads to the end of your fertile years. Menopause is a period in which your hormone balance changes significantly. But what are all the phases of menopause? And when does menopause actually begin? Read about that and more in this article. 

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The words menopause and menopause are often confused. But they actually mean something different. Menopause is the period around the menopausal transition. Menopause is your very last period. The moment your last cycle ends. Menopause is therefore a point in time, compared to the long-term process that menopause can be.

Menopause is the period during which your menstrual pattern becomes more irregular and in which you experience complaints and symptoms due to hormonal changes. During this period, your body is looking for a new balance.

When the moment of menopause has occurred, you can only really say it in retrospect. Only after you have not had a period for a year can you say that menopause has occurred. The last period does not always mean the end of menopausal symptoms. They can continue to occur for a while after menopause.

During menopause, hormone production in the ovaries gradually decreases. In the years before menopause, the ovaries still produce estrogen and progesterone, but this happens increasingly irregularly. As menopause approaches, the production of these hormones decreases and eventually the function of the ovaries stops completely.

The duration of menopause varies from woman to woman. The average time between the onset of irregular periods and the last period (menopause) is 4 to 5 years. In total, menopause lasts on average between 5 and 10 years. But it can also be longer or shorter.  

The average age at which women have their last period and thus reach menopause is 51 years. The first menopausal symptoms usually begin between the ages of 40 and 55, but the decline in estrogen levels actually begins much earlier. Around the age of 35, you already start producing less of this female hormone.

Genetics play an important role in determining the age at which you enter menopause. For example, the age at which your mother and grandmother entered menopause is a good indicator.

Hormonal contraceptives containing estrogen can sometimes mask the symptoms of menopause. For example, if you use the contraceptive pill. This means you may not realize that you are already in menopause. Taking the pill does not delay menopause.

If you reach menopause before the age of 40, it is called premature menopause. This is also known as Primary Ovarian Insufficiency (POI). This occurs in about 1 in 100 women. 1 in 1,000 women has her last period before the age of 30.

If you enter menopause early, your supply of eggs has been depleted too soon. This can have several possible causes. There are diseases that can play a role, but also treatments, such as the removal of the ovaries.

Menopause can be divided into three phases: 

1. Premenopause
2. Menopause
3. And postmenopause

Premenopause, also known as perimenopause or pre-menopause, is the period from before your last period up to one year after your last period. During this phase, your ovaries become more irregular. This causes changes in your hormone balance and menstrual cycle.

At the beginning of perimenopause, your periods are still fairly regular, but the closer you get to menopause, the more changes occur.

Periods come closer together or further apart.

Bleeding may be heavier or lighter than you are used to.

During the period when your cycle clearly changes, menopausal symptoms such as hot flashes, mood swings, and night sweats also come into play. 

Menopause is the moment your very last period occurs. You only know that menopause has occurred when you have not had a period for a year or longer. Read more about this moment in the article "Menopause explained?"

Have you not had a period for a year? Then your eggs are depleted; no more will mature, and postmenopause begins. Although menopause has already occurred by then, the transition is not yet over. Your body is still looking for a new balance. In postmenopause, you often still experience typical menopausal symptoms such as vaginal dryness and reduced libido. On average, postmenopause lasts about 3 years. 

Menopause is accompanied by various discomforts due to hormonal fluctuations. And although one woman notices more menopausal symptoms than another, there are a number of typical menopausal symptoms and signs:

Hot flashes: you suddenly feel very hot and break out in a sweat.

Night sweats: these are actually hot flashes at night, which can cause you to wake up drenched in sweat.

Vaginal complaints: such as vaginal dryness or irritation.

Poor sleep: not only hot flashes and night sweats keep you awake, but also stress, for example.

Dry skin: due to reduced estrogen production, your skin may become drier.

Sexual changes: such as having less desire for sex or pain during intercourse.

Want to read more about discomfort during menopause and what you can do about it? Read "What to do about menopausal symptoms".

Whether you are in menopause depends not only on your age, but especially on the menopausal symptoms you experience. Menopause begins with noticeable changes in your menstrual cycle due to the decline in hormones. 

In a normal situation, you do not need to see your GP when menopause begins. A blood test is not necessary. In some cases, your GP may do a blood test to determine if you are in menopause: for example, when you think you are entering menopause early.

It is also advisable to consult your GP if you have extremely heavy bleeding, or if you suddenly start bleeding, or have brown or pink discharge, after not having had a period for a year.

If you want to know more about menopause, what vitamins and nutrition your body needs during this phase of life, and which supplements can support you, read the following articles: 

"Vitamins during menopause"

"Nutrition during menopause: What your body needs"

"Which supplements help you during menopause?"

The information provided does not replace the information provided by a GP and cannot be considered medical personal advice.