Phases of menopause

What are the three phases of menopause?

The menopause journey unfolds in three key stages: 1) Perimenopause – hormone levels fluctuate and symptoms begin. 2) Menopause – confirmed after 12 months without a period. 3) Postmenopause – the stage after menopause, where symptoms may change or persist.

What is perimenopause?

Perimenopause can start in your late 30s or 40s. Periods may become irregular. Symptoms like hot flushes, mood swings, brain fog, and sleep disruption often begin. It's the most unpredictable phase and often the most overlooked.

What is menopause?

Menopause is diagnosed after 12 consecutive months without a period. On average, this happens around age 51 in the UK. Hormone levels (especially estrogen) have significantly declined. Some symptoms stabilise, others persist.

What is postmenopause?

This is the long-term phase after menopause. You may still experience symptoms like joint pain, anxiety, low libido or vaginal dryness. Your risk for osteoporosis, heart disease, and cholesterol issues increases which is why long-term support still matters.

Does treatment differ by phase?

Yes. In perimenopause, you may need sequential HRT. In postmenopause, continuous HRT is often used. Vaginal estrogen or testosterone can be added at any stage. Your treatment plan should evolve with you.

The takeaway

Understanding where you are in the menopause journey helps us personalise care so you get the right treatment at the right time.

"You don't just wake up one day in menopause it's a transition. Knowing where you are helps us help you better."