Stages of Menopause

Menopause is normal and natural – it can be a positive experience, if women are adequately informed, equipped and supported to navigate their unique journeys.

Stages of Menopause

The time leading up to menopause is as different for every woman, as we are from one another, and each woman’s menopause is unique and specific to her

Women’s experience of menopause is strongly influenced by personal, family and social factors and there is evidence that having a positive attitude and being prepared for menopause, can reduce distressing asymptoms and empower you to manage it with greater confidence.

There are an estimated 3 million South African women between the age of 45 and 54 years – who are likely to be in one of the menopause phases each year (source: MAPS 2021 data set, Marketing Research Foundation South Africa).

9 out of 10 South African women have told us that they learnt about menopause through trial and error, rather than education, care or support! (Source: Daliah SA Menopuase Benchmark Report 2022)

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Awareness of what to expect during the different stages of menopause enables a woman to prepare and manage her journey.

We encourage women to pass forward their knowledge and learnings to enable and encourage others to prepare for this important life stage brought about by hormone decline as part of the natural aging process.

How is Menopause Diagnosed?

If you are 45 years old or over, the diagnosis of perimenopause is usually based on the symptoms a woman may experience, as hormones fluctuate so much by the time a woman reaches her mid-40s, hormone blood tests can be inaccurate.

For a woman under 45, a hormone blood test can be taken to test levels of FSH. FSH is tested early in our cycle as it is the first step in the hormonal loop. If levels are high, it can indicate that your menstrual cycle is no longer functioning properly.

Your healthcare practitioner may choose to test other hormone levels, such as testosterone if libido has dropped significantly during perimenopause. This test can be useful in deciding whether testosterone should be prescribed.

The Stages Of Menopause

There are broadly speaking three stages of menopause.

Only 3 in 10 South African women feel they are adequately prepared for the menopause, with sufficient information to guide them. (Source: Daliah SA Menopause Benchmark Report 2022)

Stage 1: Perimenopause meaning “around menopause” or the “menopausal transition (typically starts early-40s)

The menopause transition – or perimenopause – is the period of time leading up to the final menstrual period.

The changes during perimenopause begin subtly and what many women do not know – because we don’t talk about menopause enough – is that menopause symptoms can start between two and fourteen years before a woman’s final period happens. The average time in perimenopause is 4 years, but some women will notice changes in their mid-30s already – remember everyone is different.

Perimenopause can be a devastating time if you don’t understand what is happening to your body, so here are the changes to look out for:

If you have consistent changes in your period – both in length of period, frequency and flow, without the presence of other health issues, you may be in early perimenopause.
If gaps between periods begin lengthening, to about 60 days, you could be in late perimenopause. Your menstrual cycles can continue, and pregnancy can still happen, so continue to take precautions.
Common symptoms can include: breast tenderness; worsening of PMS; irregular periods; changes in period flow.

1 in 2 women start to experience menopause-related symptoms in their early 40’s (source: Daliah SA Menopause Benchmark Report 2022)

Stage 2: Menopause (typically occurs early- to mid-50s)

Menopause occurs usually in a woman’s 50s and is defined by the medical profession as menopause when a period has not occurred for 12 months. Menopause that occurs at 40 or younger is called “premature menopause”; and where there is no medical or surgical reason for this, the medical term is “primary ovarian insufficiency”.

As women get closer to the 12 month anniversary of their last period, the most common symptoms experienced, are: hot flushes; night sweats or cold flushes; vaginal dryness; urinary urgency; insomnia; emotional changes; dry skin, eyes or mouth. Other symptoms can include a racing heart, headaches, joint and muscle aches and pains; changes in libido; difficulty concentrating and memory lapses; weight gain; hair loss or thinning. For a more detailed analysis of each symptom click here.

Did you know that the middle phase called “menopause” lasts only 1 day. It’s the day when a women has gone 12 consecutive months without a period. After that, a woman moves into post-menopause, which lasts a lifetime. And it’s when many symptoms start to disappear or reduce in their severity.

Stage 3: Post-menopause (starts on the day after you have reached menopause, usually in mid to late 50’s)

This time is defined by no periods, low estrogen, and a welcome decline in the symptoms of menopause – however, some symptoms can linger; and women are also more at risk for health conditions such as osteoporosis and heart disease.

The correct information and lifestyle changes, and/or medical interventions are critical for quality of life.

We want to encourage women to prepare for menopause by focusing on the positive aspects too.

Awareness of what to expect during the different life stages of menopause, will enable women to prepare and to seek treatment if they need. It is the lack of awareness and the fact that talking about menopause is still such a taboo, the world over – not only in South Africa – that leads to women suffering needlessly.

For a more detailed analysis of each symptom click here

We’ll keep sharing new tips on how to manage the symptoms associated with menopause. Sign up for the Daliah Digest newsletter, to stay informed, equipped and supported through your journey.

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Disclaimer: This information is for general educational purposes, and should not be used as a substitute for medical advice, diagnosis, or treatment of any health condition or problem.

Stages of Menopause