The Three Stages of Menopause: A Journey of Understanding and Empowerment
Menopause isn't a singular event that happens overnight—it's a gradual transition that unfolds over several years, often beginning much earlier than many women realise.
Understanding this journey as three distinct yet interconnected stages can transform how we approach this natural life transition, moving from uncertainty to informed preparation and ultimately, to empowered navigation.
When we view menopause through the lens of its three stages, perimenopause, menopause, and post menopause, we create space for both anticipation and acceptance. Each stage brings its own group of changes, challenges, and opportunities for growth. Let's explore this journey together with the evidence-based clarity you deserve.
Stage One: Perimenopause - The Beginning of Change
Perimenopause, literally meaning "around menopause," typically begins in a woman's 40s, though it can start as early as the mid-30s for some. This stage can last anywhere from two to ten years, with research showing that most women have begun perimenopause by age 45–47. Given that the average age of menopause in New Zealand is 51.5 years, the perimenopause period can last nearly seven years in some cases. During this time, your ovaries gradually begin producing less oestrogen, though hormone levels fluctuate considerably—sometimes higher, sometimes lower than previous levels.
The most obvious sign of perimenopause is menstrual irregularity. You might experience cycles that are shorter or longer than usual, heavier or lighter bleeding, or periods that skip months entirely. These changes reflect the underlying hormonal shifts as your reproductive system begins its transition.
Beyond menstrual changes, many women experience what researchers call "vasomotor symptoms". Hot flushes and night sweats affect up to 80% of women during menopause, with symptoms lasting on average 7 to 10 years. Sleep disturbances, mood fluctuations, brain fog, and changes in sexual function are also common during this stage. Research shows that these symptoms result from the brain's hypothalamus adapting to changing oestrogen levels, affecting temperature regulation, sleep cycles, and neurotransmitter balance.
What makes perimenopause particularly challenging is its unpredictability. Hormone levels can swing dramatically from cycle to cycle, creating a sense of not quite knowing what to expect from your body. This variability is completely normal, though it can feel unsettling when you're experiencing it.
Stage Two: Menopause - The Moment of Transition
Menopause is technically defined as the point when you've gone 12 consecutive months without a menstrual period. In New Zealand, the average age of menopause is 51.5 years, though it can occur anytime between the ages of 42 and 56, reflecting the natural variation among women. This milestone represents the end of your reproductive years, as your ovaries have essentially stopped releasing eggs and producing significant amounts of oestrogen and progesterone.
While menopause itself is a single point in time, the period surrounding it - roughly the year before and after this 12-month mark - is when many women experience the most intense symptoms. Hot flashes may peak in frequency and intensity, sleep disruption can become more pronounced, and the emotional landscape may feel particularly complex as your body completes this major transition.
It's during this stage that many women seek medical support, whether through hormone replacement therapy, lifestyle modifications, or alternative approaches. The research is clear that early intervention and support during this critical window can significantly impact both immediate comfort and long-term health outcomes.
The psychological aspect of reaching menopause deserves equal attention to the physical changes. Many women describe this time as requiring a fundamental shift in identity - moving from the possibility of childbearing to a new chapter of life. This transition, while natural, can evoke grief, relief, excitement, or a complex mixture of emotions that varies greatly among individuals.
Stage Three: Post menopause - The New Equilibrium
Post menopause begins once you've completed that 12-month period without menstruation and continues for the rest of your life. During early post menopause (typically the first few years), some women continue to experience menopausal symptoms as their bodies fully adjust to lower hormone levels. However, for many, this stage brings a welcome stabilisation.
The hormonal environment of post menopause is characterised by consistently low levels of oestrogen and progesterone. While this might sound concerning, many women report feeling more emotionally stable and energetic once their bodies adapt to this new hormonal baseline. The unpredictable swings of perimenopause give way to a more predictable, if different, normal.
However, post menopause does bring important health considerations that require attention. The protective effects of oestrogen on bone density, cardiovascular health, and cognitive function diminish, making this a crucial time for preventive care. Research consistently shows that maintaining regular exercise, ensuring adequate calcium and vitamin D intake, and staying socially and intellectually engaged can significantly impact long-term health outcomes.
Many women find post menopause to be a time of renewed focus and energy. Without the monthly hormonal fluctuations and the intensity of the transition period, there's often a sense of clarity and purpose that emerges. This aligns with research suggesting that many women experience increased confidence and assertiveness during this life stage.
Navigating Your Unique Journey
While these three stages provide a helpful framework for understanding menopause, it's essential to remember that every woman's experience is unique. Genetics, lifestyle factors, medical history, and individual sensitivity to hormonal changes all influence how you'll move through this transition.
The key to navigating menopause successfully lies in informed preparation and personalised support. This might include working with healthcare providers who understand menopausal medicine, building a support network of other women sharing similar experiences, and developing lifestyle practices that support your changing body and mind.
Research continues to expand our understanding of menopause, offering new insights into treatment options, the role of nutrition and exercise, and the importance of mental health support during this transition. Staying informed about evidence-based approaches empowers you to make decisions that align with your values and health goals.
References
Santoro, N. et al. (2025). Insights into Perimenopause: A Survey of Perceptions, Opinions on Treatment, and Potential Approaches. Healthcare, 5(1), 4. https://www.mdpi.com/2673-4184/5/1/4
Women's Health Action. (2024). Menopause. https://womens-health.org.nz/health-topics/menopause/
The Menopause Society. (2024). Hot Flashes. Patient Education. https://menopause.org/patient-education/menopause-topics/hot-flashes
Moving Forward with Confidence
Understanding menopause as a three-stage journey rather than a single overwhelming event can transform your relationship with this natural transition. Each stage offers opportunities for growth, self-discovery, and renewed vitality when approached with knowledge, support, and self-compassion.
Your menopausal journey is uniquely yours, worthy of the same attention, care, and respect you would give to any other significant life transition. By understanding what lies ahead and preparing thoughtfully for each stage, you're already taking powerful steps toward not just surviving menopause but thriving through it and beyond.
If you're seeking a more natural and personalised approach to support you through this transition, I’m here to help. Feel free to reach out — I’d love to walk alongside you on your journey.