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The three stages of Menopause

You might think fluctuating hormones and mood swings belong to your teenage years. But when you hit menopause, they’re back. And, like puberty, menopause has stages. We tend to use the umbrella term menopause to describe all the changes we experience, but the so-called ‘menopausal transition’ has three stages. They’re called: perimenopause, menopause, and postmenopause. Each stage is different, from irregular periods to your final menstruation to never having to buy another tampon. Make sure you talk to your doctor if the symptoms are affecting your life at any stage.

Why does menopause happen?

Here’s the science. When we are born, our ovaries contain about a million eggs, each wrapped up in cells to make something known as an ovarian follicle.The follicles play an important role in the ovary, not only providing a ‘home’ for the eggs but also manufacturing estrogen and progesterone, the hormones that stimulate ovulation or the growth and shedding of the womb. 

The number of egg-containing follicles we have in our ovaries is called the ovarian reserve.

Are you still with us? Great. As we get older, the number of eggs in our ovaries decreases as each month one (or sometimes even more than one) egg is released (or ovulated). In addition, many more egg-containing follicles die naturally each month, so over time our ovarian reserve falls. This causes our hormone levels to become erratic and reduced, until eventually they are so low they are unable to stimulate ovulation or the growth and shedding of the womb. That’s when menstruation ends permanently. Hurrah! No more periods.

So in summary: the physical and emotional symptoms many women experience during menopause are the result of changes in the body's levels of estrogen and progesterone.

What is perimenopause?

Perimenopause, or the menopause transition, is the time leading up to your final period, and can last four to eight years.1 This sounds like a long time to wait for a ‘final period’. What’s going on during this time?

Well, your estrogen levels fluctuate, which can cause a range of symptoms.

Your periods may become irregular, and your menstrual flow may be lighter or heavier than you are used to. 

You may also begin to notice the onset of some menopause symptoms. Many women experience hot flushes, vaginal dryness, sleeping problems and mood changes. This can be hard to take both physically and emotionally. But – yes, there’s a ‘but’ - there are ways to help manage the physical and emotional challenges associated with menopause.

Don’t pre-empt the next stage of menopause by mourning or celebrating the end of your fertility just yet. It may still be possible to conceive during perimenopause and you should continue to use contraception if you don’t want to become pregnant.

What is menopause?

Menopause is your final menstrual period. It sounds momentous. But it’s hard to mark the occasion with any real gravity because you probably won’t know which period is your last. Perimenopause can be such an irregular time, you’ll only know that you’ve actually gone through menopause when you have not had your period for a whole year. It’s worth tracking your periods, so you can know for sure when your last one occurred.

The average age of menopause for Australian women is 51–52 years.2

What is postmenopause?

Postmenopause is all the time that follows menopause. Yes, it’s the rest of your life.

Symptoms, like hot flushes, usually end within a few years of menopause for most women.

Unfortunately, for some women, symptoms may continue during postmenopause.

The good news is, as we are leading longer and healthier lives, you can look forward to a third or more of your life without periods.

How can you treat the symptoms of menopause?

For some women, the symptoms of menopause can be challenging, to say the least. Talk to your doctor if symptoms are affecting your daily life at any stage of menopause. Your doctor can consider the different symptoms you’re experiencing, your age, and your overall health – and then talk with you about a menopause treatment to suit your individual needs. Also, remember to check back here regularly for helpful articles and practical tips to help you manage your menopause! You can also use our Menopause Symptom Checklist.


©Pfizer 2017. Pfizer Australia Pty Ltd. Pfizer Medical Information: 1800 675 229. Sydney, Australia. PP-DUA-AUS-0124, 09/2017

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  1. The Royal Women's Hospital. The women's health book. (2014). 1st ed. Sydney: Random House Australia.
  2. Jean Hailes for Women's Health. Menopause fact sheet. Available at Accessed 20 May 2017.