A.Vogel Talks Menopause: The 3 stages of menopause

Eileen Durward
Ask Eileen

13 March 2017

Read the full video transcript below

Today's topic

Hello, and welcome to my weekly video blog. And today on A.Vogel Talks Menopause, I’m going to be discussing the three stages of the menopause. Now, I get a huge number of women who contact me every week and they’re really not sure what is the menopause, when does it start, what’s going to happen to me, how long is it going to last, how am I going to feel afterwards. So I thought today, that I would just basically go right back to basics and start from the beginning.

The three main stages of the menopause

Now, there are three main stages to the menopause. There’s the perimenopause, there’s the menopause itself, and there’s the post-menopause phase.

At what age does the menopause start?

Now, the average age to start the menopause is 45 to 55. That’s the average age group. A number of women will start later. I mean, I heard somebody a few weeks ago who was still getting regular periods at 58 and wondered when she was going to start, and quite a few women actually start earlier. So this would be between sort of 35 and 45. Now, this earlier age group can be caused by a number of things. It can be hereditary, so it could be, you know, if your mom started early, if your gran started early, your sisters and your auntie started early as well, then there’s a good chance that you will fall roughly into the same age group as well. Not a guarantee though, that’s the only thing, so it’s just a rough estimate if you like.

Other issues can affect the menopause. You can get an early menopause if you smoke, if you are overweight, if you have chronic health issues such as diabetes or rheumatoid arthritis, and it can also be your ethnic origin as well. There are some countries and continents in the world where women will naturally start the menopause that little bit early. Now, there’s also a group of women and we would call it the premature menopause, and this can be some girls in their late teens to early 20s can start the menopause. This is more of a major medical condition, and that’s not something that I’m actually going to be discussing at this particular time.


So, let’s have a look at the three stages of the menopause itself. So we’ve got the peri-menopause. This is the phase leading up to the menopause. This can last about three to five years, it just depends on you as an individual, how this is going to sort of pan out. You can start to feel your hormones changing a number of years before your periods actually start to change. So you can be getting completely normal regular periods, everything just the exact same, and then you suddenly feel as if you’re starting to get some menopause symptoms. You could end up with things like your hot flushes, joint aches, digestive problems, headaches, and stress palpitations as well. And these tend to be some of the common ones that would happen at this particular point.

The problem with these symptoms at this time is that they are not often associated with the menopause. So women, they’ll start to get the stress palpitations and really worry about this or they start to get joint aches or digestive problems, and they will go along to the doctor and get tested, and the thing is, the tests will come back completely clear. And that’s quite a worry because you know that something’s not right, you know something’s going on, but very often the doctor will say, “Well, there’s nothing wrong with you. You just take painkillers or antacid tablets or something like that.” So there’s a lot of symptoms at this particular point that are often not realized that they are part and parcel of the menopause. So, if you are in the peri-menopause, it’s a good idea to just look at your general health at this particular moment in time. And if there is anything going on, maybe have a look and see whether it can be more associated with the menopause rather than anything else at all.

Now, in the peri-menopause, at some point, you will find your periods starting to change. Now, the menopause or the peri-menopause, it’s not a static state. Your hormones just don’t fall gracefully and that’s it. They can go up and down like a yo-yo, and you might find that for six months, you get one set of symptoms and then they disappear, and then you get another set of symptoms. So, during this phase of three to five years, you can actually end up getting a range of different menopause symptoms at different times. You know, if you start off getting hot flushes, that does not mean to say that you’re going to get hot flushes, you know, every single day for the next five years. It doesn’t actually work in that way.

Now, for some women, they may find that their periods start to get closer together, they might start to get a little bit heavier, they might start to get a little bit more prolonged. That normally means, at that point, that your progesterone is forming just that bit quicker than your oestrogen. So these are sort of high oestrogen symptoms. Some women find that their periods start to tail off, they start to get further apart, they get lighter, they start to go missing. You might find you get one period and then they miss for four months, and then get another period, and so on. And this is normally an indication that your oestrogen is falling that little bit quicker than your progesterone is falling. But you can get a combination of both. You can get heavy periods for a year and then they suddenly start to tail off. And then at some point, you will find your periods just stop for good. Now, there are some lucky women that don’t get any sign or any symptoms, their periods just stop and that’s it. That’s the menopausal stage. So, sometimes that does actually happen.

The menopause

So the next phase, once you think to yourself, “Oh, my periods have actually stopped.” The menopause itself, believe it or not, is just the moment in time when your periods just stop for good. Problem is, you don’t know your periods have stopped for good, until you’ve not had one for about two years. Now, there are some schools of thought that say you’ve gone through the menopause when you haven’t had any periods for a year, but we actually find that quite a large number of women can go for a year or more without a period and then get one or two back again. Sometimes, you know, it’s a last fling of their hormones. So, we tend to say, once you have not had any periods for two years, that you’re through the menopause.

Now, this phase, from when your periods have stopped for good until the two years to stop, your hormones are still changing, so you can still get a number of symptoms at this particular point. And some women find that this is when they start to maybe get a little bit worse purely, because your hormones are falling that little bit further. However, the majority of women find that, as you approach the end of the two years, that the body has learnt to rebalance itself and that your symptoms will start to ease off. Now, the only problem here is that the length of time it takes for your symptoms to ease off can be very often linked to your general health, your lifestyle, stress management, and your diet. So this phase is very important where you still need to keep looking after yourself well.


Now, once you’ve got to the two years without a period, you’re then considered post-menopausal. And that’s the point where your hormones will start to level off. It doesn’t get to the point where you have no hormones at all, or that’s very, very rare. You will just end up learning, your body will learn to cope with a lower level of hormones. That’s the point when you can actually start to feel better. You can start to get your old self back, your body can cope, your energy will come back, and there’s no reason at this point post-menopausal, when you can’t actually feel as good, if not better than you did before. Because the great thing is, you’ve got no hormonal ups and downs, there’s far less emotional ups and downs going on as well. So, this phase, the post-menopausal phase, can actually be a really great one. But again, you still need to keep looking after yourself well.

Remember everybody's menopause is unique

So, it’s quite a complex situation and you must all of you remember that, every single one of you is going to have a completely unique menopause. And the information that I gave today is just a general guide. Some women will have really, really long menopauses, other women will have very, very short ones. And the combination of symptoms that you get at any given time, are going to be different to everybody else’s.

See you next time

So I hope you’ve enjoyed today’s topic, and I look forward to seeing you next Monday on A.Vogel Talks Menopause, for my next video blog.


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  • shirley's photo avatar
    shirley — 18.09.2017 20:01
    i had my last period when i was 36, i am now 54 and still experiencing all the symptoms, i was on HRT from 45 to 50 years of age then stopped as i did not feel it was making any difference, has anyone else gone through similar? and if so was there an end to it!!!


    • eileen's photo avatar
      eileen — 19.09.2017 14:25
      Hi Shirley Unfortunately, coming off HRT can trigger withdrawal symptoms that can mimic menopausal ones. You are going from a high hormone level (the HRT) to your own natural level which would have been lower at that point. This sudden hormonal fall could have given you a sort of menopause all over again, albeit an induced one! Like a natural menopause this can take several years for the body to re-adjust and re-balance itself. You may find trying the Menopause Support can help as this is known to gently raise and balance oestrogen. However, other health issues can creep in at this age so it is a good idea to ask your doctor to test you for low iron, low thyroid function, low vitamin D and B12, all of these can cause menopause-like symptoms and it can be difficult to differentiate between this and the menopause. Daily relaxation is really important for this as it helps to strengthen the nervous system and the stronger this is the less likely you are to get symptoms.


  • Anna Marie's photo avatar
    Anna Marie — 04.09.2017 18:22
    Hi my fsh levels show that I'm going through the menopause but as I have the mirena coil inserted I haven't had a period for about 12 years. Should I get the mirena coil out now? I have the typical night sweats and sleeping very badly. Nothing seems to help


    • Eileen's photo avatar
      Eileen — 05.09.2017 13:16
      Hello Anna Marie, What age are you now and what was your main reason for getting the Mirena coil? Thank you


    • Anna Marie 's photo avatar
      Anna Marie — 05.09.2017 15:28
      Hi I'm 51 now and my main reason for getting the mirena coil was as a contraceptive.


    • Eileen's photo avatar
      Eileen — 05.09.2017 15:47
      Hi Thank you for letting me know. The trouble with this type of contraception is that they keep your progesterone levels artificially high. Once you start the approach to the menopause, your oestrogen levels are going to start to fall, but your progesterone level is going to stay up here, and it's the gap between these two that can actually cause problems. So you may be experiencing menopause developments breaking through or side effects of the Mirena coil. You could ask the GP to have it removed in the near future and this might be helpful but if it is for contraception purposes you may need to see what other options are out there (e.g the Barrier method). You could try a calming herbal remedy like Passiflora complex and a magnesium supplement to support your nervous system for now. If I can be of further assistance let me know.


  • Gillian White's photo avatar
    Gillian White — 02.09.2017 06:39
    This is really helpful and I've had symptoms as you discussed. It's reassuring to know that it is the menopause. I'm 55 and my periods have been erratic for about 2yrs but stopped at the end of May. The hot flushes were terrible but I've tried Sage tablets but they didn't do anything and now I'm trying Red Clover tablets and the flushes have reduced significantly which is brilliant. All the info you've supplied is brilliant, so thankyou. Xx


    • eileen's photo avatar
      eileen — 04.09.2017 10:21
      Hi Gillian Great to hear that the Red Clover is helping you!


  • Caroline Whoriskey's photo avatar
    Caroline Whoriskey — 31.08.2017 15:48
    Hi my eriods stopped when i hd a artial hysterectomy (am now 50) my question is how far into menopause am i ? i have all thr mood swings, hot flushed aching bones and the sleepless night for abut 3 yrs.


    • eileen's photo avatar
      eileen — 01.09.2017 10:58
      Hi Caroline It is difficult to tell how far through the menopause you if you don't have missing periods as a guide. As a rough estimate the average length of the menopause is 5 years from when you first notice symptoms until (if you hadn't had the operation) 2 years after your last period. After than you are considered post menopause. However, it can be shorter for some women and longer for others. For your symptoms you may find the Menopause Support helpful and remember to look after yourself well!


  • Susannah Littman's photo avatar
    Susannah Littman — 29.08.2017 20:36
    Hi, I stopped my periods about 6 years ago at age 49. Until recently I didn't appear to have menopausal symptoms but now - all this time later, I am having hot flushes, joint aches, and tiredness. Is this normal to have symptoms so long after periods stopping? Could the shock of bereavement have brought this on?


    • eileen's photo avatar
      eileen — 30.08.2017 15:09
      Hi Susannah It is unlikely that your symptoms are hormone related after all this time. However, we do know that any emotional or physical shock can stress the nervous system enough to trigger menopause-like symptoms such as flushes or sweats. So it is more than likely this is the reason. You may find taking a magnesium supplement and a calming remedy such as Stress Relief Daytime can help to ease this. Also remewmber to drink lots of plain water, flushes can dehydrate you very quickly and dehydration will put further stress on the nervous system making symptoms worse. https://www.avogel.co.uk/herbal-remedies/stress-relief/index.php


  • Sam's photo avatar
    Sam — 28.08.2017 19:34
    Hi - I think I've been in perimenopause for a while and am one of those women who have been diagnosed with anxiety and them cfs (maybe it's both, who knows!). So I've had flushes, moods, itchy skin, losing a bit of hair, weight gain on my middle and now my periods are becoming closer together and lighter... my question is that the article says that periods becoming lighter/closer can be seen sign of higher oestrogen - is Menopause Support still suitable for me (as the soy may mimic oestrogen)? I've started it recently - I'm got a bit nauseous with it, but this seems to have tailed off. Will know more re the effect it has as I approach my next period! Thanks - really helpful series of articles! X


    • eileen's photo avatar
      eileen — 29.08.2017 13:30
      Hi Sam Menopause Support can sometime work in two ways in this type of situation. If the high oestrogen is caused by one of the dominant oestrogens (we have several different kinds) then the gently plant oestrogens from the soya can help to prevent these from causing problems so your symptoms would improve. However, if the symptoms are caused by other oestrogens then it may not help. We tend not to recommend in this situation as we won't know which is what but if you feel it is helping then it is worth trying for a couple of months at least. Do let me know how you get on with it.


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