Knowledge is Power: An Expert Explains Understanding The Stages of Menopause

Knowledge is Power: An Expert Explains Understanding The Stages of Menopause

Guest blog by: Teresa Isabel Dias

There’s still a lot of confusion about the terms premenopause, perimenopause, menopause, and postmenopause. It is important for you to understand where you are in your journey through menopause, to know what to expect next, and how best to manage the symptoms and challenges you may experience through this journey. 

Premenopause/Reproductive Years

Between puberty—when ovulation, periods, and fertility start—and perimenopause are the reproductive years, whether or not a woman gets pregnant. The ovaries usually release an egg every month, every 21 to 35 days on average, and if there’s no pregnancy most women have a period regularly every month as well. 


Female sexual hormones—estrogen (the predominant female hormone), progesterone, and testosterone—start fluctuating in perimenopause, indicating the start of changes in ovarian function. Women who previously had regular menstrual periods may start noticing changes, such as shorter intervals between periods, lighter or heavier bleeding, shorter or longer bleeds, spotting between periods, and in some months even no bleeding at all. This is usually the first change women notice in perimenopause, but many women also report hot flashes, fatigue, aches and pains, difficulty sleeping, headaches, dry itchy skin, mood swings, anxiety, depressive feelings, low sexual desire, hair loss, weight changes, body shape changes, palpitations, irritability, foggy brain, bladder problems, dizziness, and others. Perimenopause can start in a woman’s late 30s or early 40s and last 2-6 years. 

Women who are sexually active and don’t wish to get pregnant must use birth control until at least 12 months after the last period because ovulation is unpredictable in perimenopause but may still occur. 


Menopause is the end of ovarian function, the end of ovulation and fertility, and consequently periods stop as well.

How do you know when you are in menopause? Menopause is confirmed when you haven’t had a period for 12 consecutive months. The next day you are in postmenopause! All women go through menopause if they live long enough, and for most women it is a normal and natural event. 

Menopause usually happens between 45 and 55 years of age, and the average age of menopause in North America is 51. Some women may experience early menopause, before 40 years old. 

Induced menopause occurs when a woman undergoes removal of both ovaries and/or chemotherapy and radiation treatments (which damage the ovaries) for certain types of cancer. Women who go through induced menopause at a younger age experience more severe symptoms due to the very sudden drop in estrogen levels, and are at higher risk for diseases related to low estrogen levels, like osteoporosis, dementia, and heart disease. 


These are the years after menopause is confirmed and postmenopause lasts for the rest of the woman’s life. Many women will live past their 80s and will spend one-third of their lives in postmenopause. It’s important to understand the protective effect of estrogen against diseases like stroke and heart attack, osteoporosis, and diabetes to help you make healthy lifestyle choices to ensure healthy aging and prevent disease.

Bio and links

Teresa Isabel Dias a pharmacist with over 25 years of professional experience in community pharmacy and drug information, an author, speaker, and above an educator, and women’s health advocate. In 2013 she became a Certified Menopause Practitioner (NCMP) through the North American Menopause Society (NAMS) and founded MenopausED ( Because many women experience physical, emotional, and mental challenges in midlife due to hormonal changes Teresa provides education and support on symptom management for women at work and at home so that they feel like themselves again and enjoy a vibrant, and productive life. She provides online one-on-one individualized consultations and programs, online workshops, Lunch & Learns in the workplace and for women’s groups, and relevant information about the hormonal changes of midlife through her MenopausED Newsletter-







Thank you so much Theresa for sharing your knowledge and wisdom! 


Please note, comments must be approved before they are published