Let’s get one thing clear: menopause is a normal and natural stage of life for women. It’s not a disease, a disorder or something that needs to be cured.

Even though menopause is a perfectly natural part of biological ageing, it’s often misunderstood, under-discussed, and for many, still feels like a taboo topic. That needs to change.

According to The Menopause Charity’s 2025 Report, nearly half of women feel informed about menopause. But only 22% of men do. That’s a huge gap, and it highlights just how important it is to keep the conversation going.

The reality is, around half of the world’s population will experience menopause in their lifetime. That’s billions of people experiencing hormonal, physical, and emotional changes that can deeply affect their lives. So, it’s important to raise awareness and talk about it, and shed light on the stages of menopause women go through.

After all, menopause isn’t just a single moment in time. It’s a journey that happens across three distinct stages, each with its own set of changes and challenges.

Whether you’re experiencing menopause yourself, are a health and fitness professional working with female clients, or you’d like to provide better support to the women in your life, understanding the different stages of the menopause is essential.

Let’s break it down.

1. Perimenopause: The hormonal changes begin

Perimenopause means around menopause, and it refers to the years leading up to your final period and reaching menopause. It’s the first of the three stages of menopause, which often starts in your early to mid-40s; though for some, it can begin as early as your 30s.

This stage can last up to a decade, and it’s when the hormones oestrogen and progesterone start fluctuating before they drop to a low level. Progesterone tends to decline steadily, while oestrogen levels spike and crash in erratic patterns. These hormonal ups and downs also make this the most symptomatic stage.

Common signs of perimenopause include:

• Irregular periods
• Heavier or lighter bleeding
• Hot flushes and night sweats
• Weight gain and appetite changes
• Mood swings, anxiety, or low mood
• Increased stress and cortisol levels
• Brain fog or trouble concentrating
• Sleep issues and fatigue
• Vaginal dryness and discomfort during sex
• Reduced libido

The frustrating part of this stage is that many of these symptoms can mimic other health issues like IBS, cystitis, thyroid problems, or depression. As a result, people often get misdiagnosed or dismissed entirely.

When addressed correctly, women can get the support they need to help manage their symptoms. Treatments like Hormone Replacement Therapy (HRT) may be an option, depending on your symptoms and overall health. For many, this provides some relief from symptoms, but it’s not for everyone.

That’s why education matters. We’re working to close this gap through menopause awareness training for health and fitness professionals so they can spot the signs and offer better support to those going through it.

2. Menopause: A moment in time

While menopause is often used to describe the whole journey, it technically refers to a single point in time: the moment when you haven’t had a menstrual period for 12 consecutive months.

The average age for menopause in Western countries is around 51, though it can happen earlier or later depending on factors like genetics, health conditions, and lifestyle.

When you hit this point, levels of oestrogen and progesterone drop to their lowest level, and your reproductive years officially come to an end.

Even though menopause is technically just one day, symptoms like hot flushes, mood changes, or sleep issues can still linger into the next stage.

3. Postmenopause: The years that follow

Once you’ve gone a full year without a period, you’ve officially entered postmenopause—the final stage of the menopause journey. Unlike the first two stages, postmenopause is a lifelong phase that lasts for the rest of your life.

For many women, postmenopause brings some relief as the rollercoaster of hormones you were on comes to a halt as oestrogen and progesterone levels dip and stay low. Thanks to this, symptoms you may have experienced in perimenopause begin to subside.

But this doesn’t mean everything goes back to normal. As your body adjusts to consistently low hormone levels, it can bring about new health concerns, which are:

• Brain health: Some research links lower oestrogen levels with a higher risk of cognitive decline or Alzheimer’s.
• Heart health: Oestrogen helps protect the heart, so the risk of cardiovascular disease increases after menopause.
• Bone health: Lower oestrogen can lead to bone density loss, increasing the risk of osteoporosis.
• Urogenital health: Issues like urinary tract infections, incontinence, and vaginal dryness may persist.

Staying active, eating well, and having a supportive healthcare provider can make a big difference.

Not all menopause happens naturally

While many people go through the three stages of menopause naturally, it can also occur prematurely or be medically induced due to other circumstances. Here are the most common types:

• Natural menopause: This occurs gradually as a result of natural hormonal decline, usually between ages 45–55.
• Surgical menopause: This commonly refers to the surgical removal of both ovaries (often during a hysterectomy), which causes an immediate drop in oestrogen and progesterone.
• Induced menopause: Where treatments for medical conditions like endometriosis and cancer, such as chemotherapy, radiation, or certain hormonal therapies, cause menopause.
• Premature Ovarian Insufficiency (POI): This occurs when the ovaries stop functioning before the age of 40. POI can be caused by genetics, autoimmune diseases, or unknown factors. It affects fertility and often causes the same symptoms as natural menopause, sometimes more severely.

Did you know?

• 1 in 10 women experience early menopause (ages 40–45)
• 3.5 in 100 experience premature menopause (before 40)
• 1 in 1,000 go through menopause before age 30

The bottom line

Menopause is not a one-size-fits-all experience. It affects everyone differently physically, emotionally, and socially. While it’s a natural part of ageing, it’s still under-discussed and often surrounded by misinformation.

Every one of the stages of menopause brings about new challenges. Whether you’re navigating the confusing beginnings of perimenopause, reaching the milestone of menopause, or adjusting to the long-term changes of postmenopause, you’re not alone and you deserve support.

With open communication, better education, and compassionate healthcare, we can ensure that no one feels isolated, dismissed, or misunderstood during this pivotal life stage.

Let’s break the stigma. Let’s educate ourselves and each other.

Want to learn more?

If you’re a health and fitness professional who wants to learn how to better support your clients going through the menopause, we can help. Our Level 3 award in supporting clients through the menopause will give you the knowledge and skills you need to support your clients in as little as 6 weeks.