menopause women photo

The Stages of Perimenopause

Every woman’s path to menopause is unique. It is impossible to predict with any certainty the exact time it will take you to reach the 12 month mark with no periods – the day you reach menopause.

However, there are general markers that can be observed to gauge approximately where in the transition journey you are, and what is still to come. Hormone tests are generally an unreliable predictor as they vary so much according to where you are in your cycle and transition in general. Symptoms are a much better predictor of menopause transition.

The total time from the start of perimenopause to menopause usually lasts between 5 to 7 seven years (some sources quote 2 to 6 years as it depends when you start relating early symptoms to stage 1).

Often the journey is not smooth and many women believe that they have transitioned from early perimenopause to late menopause, and then frustratingly return to more regular cycles again for a few months.

Perimenopause Symptoms

The most commonly reported perimenopause symptoms are:

– Heavier period flow, possibly with clots
– New or increased period pain
– Sore, swollen or lumpy breasts (that weren’t like this before)
– New or worse migraine headaches
– New or worse premenstrual mood swings
– Night sweats and hot flushes, often worse around your period
– New sleep problems and mid-sleep wakening
– Weight gain without change in food intake or exercise
(see a longer list of symptoms in this post)

The Stages of Perimenopause

Stage 1
Very Early

– Starts approximately 6 to 9 years before menopause and lasts for between 2 to 5 years.
– Age 35 or older with regular periods and a combination of the symptoms in the list above.
– Generally, the younger you enter this stage the longer it will last.
Stage 2 –
Menopause Transition

– Starts approximately 4 years before menopause and lasts for 3 years on average.
– In addition to a combination of the symptoms in the list above, this stage also includes:
Stage 2a – Early Transition
– Periods become irregular and cycles may vary in length by 7 or more days.
Stage 2b – Late Transition
– Periods are skipped completely with cycles of 60 days or longer.
Stage 3
Late Perimenopause

– The 12 months before menopause, starting from the first day of your final period.
– Symptoms usually increase as periods become less frequent.
– You won’t know for sure that you are in stage 3 until it is complete.
– The timer resets if you start to bleed again during the 12 months.

– Occurs 12 months after final period.
– After this day you are postmenopausal.
– Symptoms decrease in postmenopause.

Further reading: