The Four Phases of Menopause

Menopause marks a significant biological transition for women; defined as 12 months without menstruation in the absence of other causes. This transition affects women both physically and mentally. In fact, 85% of women experience menopausal symptoms that negatively impact daily life.

Contrary to common belief, menopause itself lasts just one day—it signifies the one-year anniversary of a woman's last period. When people discuss "menopause," they're typically referring to the broader transition that includes four distinct phases. In reality, this transition can encompass one-third of a woman's life.

Today in the U.S. alone there are 55 million women experiencing menopause, of which 73% do not receive treatment for their symptoms. There are a wide range of symptoms from hot flashes to depression and anxiety, and they vary with each individual.

Unfortunately, a significant gap exists in the dissemination of critical information about menopause. Nearly 80% of physicians feel uncomfortable discussing the menopause transition, and a mere 20% of OB/GYNs receive specific training on menopause. These are just a few examples highlighting the urgency of addressing this information disparity. The menopause transition is a crucial aspect of women's health that deserves more attention and understanding.

Recognizing the symptoms of the menopausal transition, learning about its effects on your body, and understanding how it may affect you, are key aspects of empowering yourself to take charge of your health during this stage of life. By gaining valuable knowledge about the four phases of menopause, you can navigate this transition with confidence, and make proactive choices for your well-being.

An illustrative graph of the four phases of menopause

 Phase One: Premenopause

Premenopause and perimenopause are often used interchangeably, but in fact, they hold distinct definitions. Premenopause marks the beginning of your transition and occurs around age 35, extending until the onset of perimenopause, usually in your early 40s. During the premenopause phase, there are no perimenopause or menopause symptoms present. Menstruation persists, whether on a regular or irregular basis, and this period is characterized as your reproductive years. Although some hormonal shifts might be happening, there are no noticeable changes in your body.

Phase Two: Perimenopause


Middle-aged woman informing herself about the four phases of menopause.

Perimenopause is the transitional phase before menopause, typically beginning around 42. Perimenopause can start up to ten years before menopause. It is characterized by a decrease in estrogen, the primary female hormone produced by the ovaries. Fluctuations in estrogen levels may shift up and down leading to irregular periods and other symptoms.

Perimenopausal Symptoms and Conditions

Research shows that about four in ten women in perimenopause experience mood-related symptoms, and physical symptoms can accompany these mental shifts. Every woman's journey through perimenopause is unique, and symptoms can vary widely in severity and duration.

During perimenopause, you may start to experience symptoms such as:

  • Irregular periods and periods that can be heavier or lighter than normal
  • Breast tenderness
  • Skin & hair changes
  • Weight gain
  • Hot flashes
  • Mood swings
  • Changes to your sleep patterns
  • Vaginal dryness
  • Changes in sex drive
  • Forgetfulness and concentration difficulties
  • Muscle aches
  • Urinary tract infections

 Phase Three: Menopause

The third phase of the menopause transition is menopause itself. Despite common misconceptions, it is defined as a single day—the day that marks a full year (12 consecutive months) since your last menstrual period, and typically occurs around 51 or 52. 

Menopause Symptoms

Because estrogen levels have dropped you may start to experience a range of symptoms, some of which you may have already been experiencing during perimenopause, such as:

  • Insomnia
  • Fatigue
  • Dry skin
  • Vaginal dryness
  • Mood swings
  • Hot flashes & Night sweats
  • Changes in sex drive
  • Depression & Anxiety

 Phase Four: Postmenopause

Postmenopause, the final stage in your menopause journey, begins when you've completed a full year without a menstrual period. Once you enter postmenopause, you will remain in this phase for the rest of your life.

Postmenopausal Symptoms

During the initial years of postmenopause, you may still experience some symptoms associated with the earlier menopause phases. However, these symptoms will eventually decrease in both frequency and intensity or go away completely. Some women, however, may continue to experience menopausal symptoms for a decade or more after menopause. People in postmenopause may still experience some symptoms associated with the earlier menopause phases, such as:

  • Depression & Anxiety
  • Hot flashes & Night sweats
  • Insomnia
  • Dry skin
  • Hair loss
  • Weight changes
  • Vaginal dryness & Painful sex
  • Changes in sex drive

 Health Risks During the Menopausal Transition

During the menopause transition, it's important to be aware of these potential health risks:

  • Osteoporosis: The decline in bone density can lead to osteoporosis, resulting in more fragile bones that are susceptible to fractures.
  • Cardiovascular Conditions: Hormonal shifts can increase the risk of cardiovascular diseases, including heart disease and stroke.
  • Breast Health Concerns: Changes in hormone levels can affect breast tissue, emphasizing the importance of regular breast health checks.
  • Type 2 Diabetes: Menopause is associated with changes in body fat distribution and a slower metabolism, potentially increasing the risk of developing type 2 diabetes.
  • Thyroid Disorders: Postmenopausal women are at a higher risk of developing thyroid disorders, which can impact metabolism, heart rate, and numerous other bodily functions.
  • Vaginal atrophy: Reduced estrogen levels may lead to vaginal tissue thinning, resulting in vaginal dryness and discomfort during sex. Additionally, decreased estrogen levels may also impact the urinary tract and bladder, potentially causing bladder leaks.

 Preventing and Managing Health Conditions

Staying vigilant about your health during the menopause transition is essential. Continue regular checkups to monitor your overall health, discuss any concerns, and review preventive screenings such as mammograms, Pap smears, and bone density tests. Regular visits can help catch potential problems like heart disease and osteoporosis early. They will also help you and your doctor develop a treatment plan to manage your menopause symptoms.

Treatment Options

Hormone Replacement Therapy (HRT), which involves replacing the hormones which naturally decrease during menopause, may be an option to manage menopausal symptoms. It’s important to discuss the benefits and risks with your healthcare provider to make an informed decision that suits your needs. HRT comes in different forms, including gels, patches, and pessaries.

Additionally, alternative therapies like acupuncture, and mindfulness techniques may offer relief for some women.

 Lifestyle Changes and Recommendations

Implementing some of the following lifestyle changes can help improve not only your overall health during this transition but also your mental strength:

  • Eat a well-balanced diet
  • Stay hydrated
  • Get regular exercise
  • Get sleep
  • Reduce stress
  • Seek support
  • Schedule regular health checkups

 A Word on Skincare

Woman holding the Finlay+Green clean moisturizer

Skin changes during the menopausal transition are very common, and many women report a sudden onset of skin aging several months after menopausal symptoms begin. Estrogen is an essential component of skin function, and lower levels of estrogen have a big impact on the skin. As your hormones plummet you may notice that your skin starts to become dryer, thinner, and itchy.

According to the American Academy of Dermatology, collagen drops 30% in the first five years of menopause, and then approximately another 2% each year for the next 20 years. As a result, skin loses its elasticity and firmness and also becomes more prone to damage, increased wrinkles, and sagging.

As we age, our bodies no longer retain as much moisture. In our youth, we are 60–70% water, but after menopause, women may only be 55%. This is quite a substantial drop, making it very important to stay hydrated.

Menopause skin symptoms:

  • Dry skin
  • Loss of elasticity & firmness
  • Wrinkles
  • Hyperpigmentation
  • Acne
  • Easily irritated skin
  • Wounds heal more slowly

Finding solutions:

It’s important to take care of your skin during menopause. Use a high-quality broad-spectrum SPF30 or above sunscreen, avoid hot baths and showers, stay hydrated, eat a healthy diet, use a mild cleanser, and consider using skincare specifically developed for menopausal skin such as our Finlay+Green clean moisturizer.


In conclusion, the transition through the four phases of menopause calls for prioritizing your personal well-being. It’s important to get regular health check-ups, seek professional guidance regarding treatments, and find comfort in support groups or chats with friends. Maintaining a balanced diet, committing to regular exercise, ensuring sufficient rest, and managing stress are pivotal to navigating this transition smoothly.

It's crucial to comprehend the various physical and emotional shifts that occur during these phases. By adopting a proactive approach, backed by accurate information and strong support, you can help improve your well-being and also the quality of your life. Above all, remember, you are not alone.



NOTE: This blog is intended for informational purposes only and is not a substitute for medical advice. It should not be relied on as health or personal advice. Always seek the guidance of your doctor or other qualified health professional with any questions you may have regarding your health or a medical condition.