FOUR STAGES OF MENOPAUSE: The Transition Lane To the next life cycles

four stages of menopause

Although menopause doesn’t set in until you’re between ages 46 to 53, estrogen begins to decline over a 10 to 15-year span beginning any time from your 40’s through the ’50s. The average age is 51. This is your body’s preparation for the day when estrogen levels are so low that menstruation finally stops. Once your period disappears, estrogen continues to drop as you age into your 70’s and 80’s. Medically, a woman is considered menopausal when she has no period for 6 to 12 months after age 45.

The Four Phases of Menopause

Menopause is divided into four phases beginning around 40 years old. The whole process, from your 40’s to your 70’s, is called climacteric.

  1. Peri menopause begins around age 40.
  2. Peri menopause lasts for two to four years when female sex hormones are changing.
  3. Menopause is when menstruation actually ceases.
  4. Post menopause is when your body has adjusted to new hormonal levels.


Changes occur with the four main hormones that orchestrate the menstrual cycle— estrogen, progesterone, follicle stimulating hormone (FSH) and luteinizing hormone (LH). Your ovaries and adrenal glands produce estrogen and progesterone during your fertile years. The adrenal glands make estrogen by converting the male hormone, androstenedione, to estrogen—especially before puberty and once again in mid-life when the ovaries no longer produce sufficient amounts. Fat cells also manufacture estrogen—so if you have more fat cells, you make more estrogen. Research indicates thinner women tend to experience earlier menopause.

Women are born with a limited amount of follicles that eventually become eggs. Each month for 30 to 40 years, women menstruate and the eggs either die or become fertilized. After age 40, fewer follicles mature each month, and the ones that do are less sensitive to hormones. As a result, cycles shorten or become irregular.

By the time a woman reaches her late 40’s or early 50’s, the follicles have degenerated to the point where they produce so little estrogen that conception becomes difficult or impossible. At the same time FSH levels increase in an attempt to bolster diminishing estrogen. (Kind of like kicking a car that doesn’t start. It feels good, but doesn’t help much.) Toward the end of the menopausal change, the follicles’ ability to produce eggs is exhausted, and estrogen level drops until there is not even enough to build up the lining of the uterus to start menstruation and menopause begins.

How Does The Transition Affect You?

After age 40, you may begin to notice subtle changes caused by hormonal alterations, such as drier skin, new wrinkles, frequent urination, depression, and moodiness. At first, you may become aware that your periods are irregular and monthly blood flow is thinner or thicker. You may notice changes in your cervical mucus during ovulation. Eventually, some of the more obvious symptoms may appear hot flashes, night sweats, vaginal dryness, mood swings, headaches, irritability, insomnia, weight changes, and fatigue. Some of these symptoms you may already have experienced as PMS—all are due to hormonal changes.

There are several health problems associated with the decline of estrogen in menopause, such as the increased risk of osteoporosis, cancer, heart attacks, changes in blood vessel walls and stroke. The top two causes of death for post-menopausal women are heart disease and cancer. Medical professionals are beginning to realize, however, that some of these problems can be successfully handled with diet, exercise and healthy living.

Some women sail through menopause and others suffer symptoms for years. The symptoms and intensity vary greatly with each woman. Are you shocked? I mean really, why should your menopause be exactly the same as your best friend’s? Was your menstrual period? I remember that I just hated to know my best friend got her period in seventh grade and mine didn’t arrive until practically the end of the eighth. Of course, maybe her menopause will be first, too!

Replacement Therapies

To use hormonal replacement therapy or not to use, is one of the most important decisions we as women face in our lives. Natural solutions can and should be your first choice. Remember, start simple, if that doesn’t work, then work your way up to more complex therapies.

The risk of disease versus the benefits of ERT, or synthetic estrogen is taken alone, weighs heavily in the minds of many women. Hormonal replacement therapy refers to combination therapy of synthetic estrogen and progestogen, those famous two balancing hormones we all must respect. If you are aware of the risks of HRT and ERT, both short and long-term, you can make a decision that is right for you. Replacement therapy is really a misnomer because it does not actually replace your own natural hormones—your hormones are supposed to decline at this time of your life—But rather, it adds extra hormones that don’t necessarily act the same way as your own estrogen and progesterone do.

Most doctors prescribe synthetic estrogen and/or progestogen for relief of menopausal symptoms in oral form.

(Hormones are broken down too quickly by digestion to make them optimally useful as oral medicines.) I use wild yam in cream form, based on the above principles.

I’ve found it takes anywhere from one day to four months to see results. It depends on your system. Usually, you’ll notice a difference in a few days. Menopausal women apply t for two topical creams for three weeks and stop during menstruation (if they’re still having periods). isn’t helping you, you may also want to search for another. Treatments vary in effectiveness, as do physicians.


There are benefits to ERT and HRT, but there are also risks you need to know. It is estimated that over 80 percent of women seek natural alternatives for hormone replacement therapy because they will not or cannot take estrogen replacement therapy. You are at risk years after you discontinue estrogen therapy. A recent study followed 5,563 postmenopausal women for nine years—one group took estrogen alone (ERT), and the other group was on estrogen and progesterone (HRT). The women taking estrogen alone had a six times higher incidence of endometrial cancer up to five years versus those using HRT. This risk is 15 times greater among long-term users. Women taking estrogen had the highest rate of cancer, followed by women taking no supplementation, with women taking progesterone having the lowest incidence of cancer. Women’ health study found synth

Estrogen does relieve many of the common menopausal symptoms like hot flashes and vaginal dryness and may protect you against heart disease and osteoporosis. However, it could cost you in the long run. Dr Susan Lark states, “Estrogen is not a cure . . .  because the hot flashes may return when replacement therapy is discontinued—the ovaries are not revitalized or regenerated in any way by ERT.” (2)

Some of the common side-effects of estrogen replacement therapy are vaginal bleeding and spotting, menstrual cramps, PMS-like symptoms, no period, vaginal yeast infection, breast tenderness, nausea, vomiting, abdominal cramps and bloating, jaundice, hair loss, facial hair, skin rash, intolerance to contact lenses, headaches including migraines, dizziness, depression, increase or decrease in weight and changes in libido.

ERT may also increase your risk of endometrial and breast cancers, liver and gallbladder disease, elevated blood pressure (which can cause heart attacks or stroke) and blood clotting, especially if you are overweight. In higher doses, ERT can increase your risk of diabetes because it changes glucose levels. If you are already diabetic and taking estrogen, you should have your blood sugar levels monitored carefully.

HRT consists of both estrogen and progesterone. This combination was developed in recent years to help prevent osteoporosis, protect against heart disease and relieve the menopausal symptoms. The side-effects from progestogens sound an awful lot like PMS—water retention, nausea, anxiety, tender breasts, weight gain, vaginal discharge, irregular bleeding, bloating and headaches.

Some British researchers suggest that HRT is addictive, claiming PMS, postpartum depression and menopausal depression are evidence that female hormones alter mood. HRT can promote feelings of well-being and some women on HRT show signs of drug dependency. In light of this, blanket HRT prescriptions for all menopausal women over long periods of time could be dangerous. (3)

Hysterectomy-induced Menopause

A full hysterectomy—removal of your ovaries and usually uterus—produces artificial menopause. There are thousands of hysterectomies performed in the United States every year. After a hysterectomy, a woman goes through emotional, physical and hormonal shock. She can be overcome with emotional problems and symptoms just like PMS—the feelings of depression, a sense of loss, a feeling of unworthiness and even headaches. She may not prepare for the emotional feelings of loss from the removal of her ovaries and uterus, often feeling she is no longer a whole woman. She also can suffer from menopausal symptoms.

The physical changes women experience after a hysterectomy are:

  • For the first six to eight days after surgery, there is an increase in follicle stimulating hormone (FSH) from the pituitary gland—just like during natural menopause.
  • For the next eight to ten days there is an increase in the luteinizing hormone (LH).
  • For 10 to 31 days, the FSH continues to increase to three times its previous amount and the LH doubles, remaining high for many years.
  • For six to twelve months after surgery, the normal cyclical symptoms of PMS prior to the hysterectomy return.