What are the stages of menopause?
Menopause is not a single day; it is a point in the middle of a journey that stretches over years. Three words are used to describe that journey: premenopause, perimenopause and postmenopause. Because the words look so alike, they are easy to mix up. You may even hear them used one way at the doctor’s office and another way online.
The framework scientists use most is a staging system called STRAW+10. An international working group updated it in 2011. The system divides a woman’s reproductive life into stages by looking at her period pattern. Hormone tests are only supporting criteria (Harlow et al., 2012).
At the center sits menopause itself. Menopause is your final period, but you can only tell it was the last one once 12 months have passed without another (NHS, What are menopause and perimenopause). In Türkiye the average age at menopause is 47–49, according to the Turkish Ministry of Health’s Public Health Directorate (HSGM). According to the NHS, menopause usually happens between 45 and 55. These ages are averages; it is your period pattern and your symptoms, not your age, that show your stage. Below we walk through each stage in turn, in plain language.
What is premenopause, and why is the word used in two ways?
Literally, premenopause means “before menopause.” That is exactly where the confusion comes from: everything before menopause can fall under it.
CeMCOR, a menstrual cycle research center in Canada, defines premenopause as the time from your first period until perimenopause. The same center points out that before the idea of perimenopause took hold, the word was used for every woman who still had periods (CeMCOR, Premenopause).
So two uses live side by side:
- Narrow meaning: The reproductive years when periods are regular and transition symptoms have not yet started.
- Everyday meaning: Sometimes used to mean “approaching menopause,” or as a synonym for perimenopause.
When you see the word “premenopausal” in an article or a lab report, it most often means “has not yet reached menopause.” If you are not sure, you can ask your clinician which meaning they intend.
What is perimenopause, and how long does it last?
Perimenopause is the time “around” menopause. According to STRAW+10, perimenopause opens when the transition begins and closes 12 months after your final period (Harlow et al., 2012). We cover it in detail in what is perimenopause.
STRAW+10 splits this time into two parts:
- Early transition: Cycle length becomes variable. A difference of 7 days or more between consecutive cycles becomes persistent.
- Late transition: Gaps of 60 days or longer without a period begin. This stage is estimated to last 1–3 years on average. Vasomotor symptoms such as hot flashes are more likely in this stage.
How long it lasts varies from person to person. The Office on Women’s Health says perimenopause lasts about 4 years on average and sometimes up to 10 years. The NHS writes that symptoms usually last 7–9 years, sometimes longer (NHS, Menopause: symptoms). We also look at timing by age in menopause age and duration.
It is also worth remembering that pregnancy is still possible during perimenopause (Office on Women’s Health).
What is postmenopause, and how long does the time after menopause last?
Postmenopause covers all the years after your final period. STRAW+10 divides it in two (Harlow et al., 2012):
- Early postmenopause: Roughly the first 5–8 years after the final period. For the first 2 years, FSH (follicle-stimulating hormone) keeps rising and estradiol (the main form of estrogen) keeps falling; then both settle. Vasomotor symptoms can continue during this time.
- Late postmenopause: Hormone changes slow down. Genital and urinary symptoms such as vaginal dryness can become more noticeable.
There are no periods in this stage, and pregnancy is not expected to happen naturally. The Office on Women’s Health stresses that any vaginal bleeding after menopause should be checked right away.
Postmenopause is not an “ending”; it is a new phase that asks you to pay attention to different areas of your health. Falling estrogen levels can speed up bone loss (NHS, Menopause: symptoms). The Office on Women’s Health notes that bone loss and genital symptoms can progress during this time. We cover bones in bone health and menopause; heart and blood vessel health is another area to keep an eye on with your clinician during these years.
Stages of menopause at a glance
| Stage | Period pattern | Typical symptoms | Duration |
|---|---|---|---|
| Premenopause (reproductive years) | Regular | No transition symptoms | From first period until the transition |
| Early perimenopause | Cycles differ by 7+ days | Period changes, sleep and mood | Varies from person to person |
| Late perimenopause | Gaps of 60+ days without a period | Hot flashes, night sweats | 1–3 years on average |
| Early postmenopause | No periods | Vasomotor symptoms may continue | About 5–8 years |
| Late postmenopause | No periods | Genital and urinary symptoms | The rest of your life |
What might you feel in each stage of menopause?
The stages move forward not by the calendar but by the signals your body gives. The menopause and perimenopause symptoms listed by the NHS cover a wide range: irregular periods, hot flashes and night sweats, sleep problems, mood changes, forgetfulness and trouble concentrating, vaginal dryness, urinary symptoms, joint and muscle aches, headaches and heart palpitations (NHS, Menopause: symptoms).
Which of these symptoms you get, when, and how strongly varies from person to person. Some women notice only a change in their period pattern in early perimenopause. Some wake up drenched in sweat during the late transition. For others, the hardest part is sleepless nights or unexpected flashes of anger.
These changes can affect not only your body but also your relationships, your work and how you see yourself. Knowing which stage you are in helps you see that what you are going through has an explanation, and makes it easier to talk about it with your partner, your family or your clinician. The NHS advises seeing a GP (family doctor) if you have menopause symptoms and want to learn about your options.
Do these stages work the same way for everyone?
No. The STRAW+10 criteria can be applied regardless of age, ethnicity, body size or lifestyle, but smoking and body mass index can affect hormone levels and the timing of the stages (Harlow et al., 2012).
Some situations do not fit the model neatly:
- People who have had a hysterectomy or endometrial ablation (a procedure that thins the lining of the uterus): Without periods, they cannot be staged by period criteria.
- People whose ovaries stop working before age 40: STRAW+10 notes that this group does not fit the model easily.
- People treated for cancer and some people with chronic illnesses.
If you are in one of these groups, understanding your stage means looking at your symptoms, and tests if needed, together with your clinician.
How can you track which stage you are in yourself?
Because period pattern is the main measure of the stages, the most valuable information is already in your hands. Things worth noting down:
- The start date of each period and the number of days between periods.
- Any gaps longer than 60 days without a period.
- Changes in hot flashes, night sweats, sleep and mood.
This record lets you rely on observation rather than guesswork when you talk to your clinician about “which stage am I in?” Do not feel you have to fit yourself into a stage; this framework is simply a map that helps you make sense of what you are experiencing.