The Four Phases of Menopause: Where Are You in the Change

The Four Phases of Menopause Explained: Symptoms, Hormones & What to Expect

If you have ever wondered what is happening inside your body as you move through the Change of Life, you are not alone. Millions of women experience symptoms without fully understanding the phase they are in. They can feel that something is shifting, yet they lack the vocabulary, framework, or context to make sense of the changes.

The Menopause Action Plan™ brings clarity. It outlines four distinct phases, each with its own hormonal patterns, symptoms, timing, and challenges. When a woman understands which phase she is in, her symptoms begin to align with a clear, predictable process.

Below is an explanation of each phase and how hormones behave during the transition. Knowing where you are in this progression is the foundation for creating your personalized Menopause Action Plan.

Phase One: Pre-Menopause

Pre-menopause is the earliest phase, often beginning between ages of thirty-five and forty-five. Menstrual cycles typically remain regular, but the symptoms surrounding them begin to shift.

Common signs include:

• heavier or longer periods
• breast tenderness
• intensified PMS
• mood swings
• irritability
• cyclical headaches
• bloating
• digestive changes
• spotting before or after periods
• sleep disruptions
• anxiety

These changes happen because progesterone declines earlier and faster than estrogen. Estrogen may still fall within normal ranges, but without adequate progesterone to balance it, estrogen becomes dominant. This imbalance drives many early symptoms, even when hormone tests appear normal.

Phase Two: Perimenopause

Perimenopause is the most symptomatic and unpredictable stage. It typically occurs between ages forty and fifty, though timing varies. In this phase, menstrual cycles become inconsistent. Estrogen begins to rise and fall unpredictably while progesterone remains low. This instability influences nearly every system in the body.

Common signs include:

• short or long cycles
• skipped periods
• hot flashes
• night sweats
• anxiety episodes
• sleep disruptions
• brain fog
• weight gain around the waist
• breast swelling or pain
• water retention
• increased irritability
• mood swings
• fibroids or cysts

Perimenopause lasts an average of four to ten years and is often described as the roller coaster of the transition due to unstable hormone production.

Phase Three: Menopause

Menopause officially begins after twelve consecutive months without a menstrual cycle. Hormone levels have declined significantly, and new symptoms often appear.

Common signs include:

• hot flashes
• vaginal dryness
• pain with intercourse
• bladder urgency
• sleep disturbances
• brain fog
• mood shifts
• weight changes
• slower metabolism
• itchy or thinning skin
• hair loss or texture changes

Menopause represents the midpoint of the transition rather than the end.

Phase Four: Post-Menopause

Post-menopause begins two or more years after the final menstrual period. Hormone levels remain low and stable. Symptoms shift from fluctuating to structural or metabolic.

Common signs include:

• skin thinning
• wrinkles
• collagen loss
• declining bone density
• muscle loss
• increased inflammation
• higher cardiovascular risk
• vaginal atrophy
• painful intercourse
• recurrent urinary symptoms
• hair thinning or increased facial hair

Many women also experience adrenal decline in their sixties or seventies, creating symptoms similar to a second menopause. Understanding this phase helps support long-term health and resilience.

Why Understanding These Phases Matters

When you know your phase, your symptoms begin to make sense. Your needs become clearer. Your conversations with providers become more productive. Most importantly, your Menopause Action Plan becomes specific to your body rather than a one-size-fits-all approach.

This knowledge empowers women to navigate the Change of Life with clarity, confidence, and a deeper sense of control.