Menopause is often talked about as though it is one stage of life.
In reality, the menopause transition happens over a number of years and understanding where you are within it can help make sense of changes that might otherwise seem confusing or completely unrelated.
The three terms you will hear most often are perimenopause, menopause and postmenopause.
Although we often use “menopause” to describe the entire transition, medically, menopause actually refers to the final menstrual period and is confirmed retrospectively after 12 consecutive months without another period.
Here’s what each stage means.
What are the stages of menopause?
The menopause transition can broadly be understood as:
Perimenopause: The transitional period when menstrual cycles or menopausal symptoms begin to change, continuing until 12 months after the final menstrual period.
Menopause: The final menstrual period, confirmed retrospectively once 12 consecutive months have passed without another period, provided there is no other medical explanation.
Postmenopause: The stage of life beginning once menopause has been confirmed, 12 months after the final menstrual period.
The experience is different for every woman. There is no universal age at which symptoms begin, no standard collection of symptoms and no single timeline everyone follows.
What is perimenopause?
Perimenopause means “around menopause” and describes the transition beginning when menstrual cycles or menopausal symptoms start to change and continuing until 12 months after the final menstrual period.
During this time, ovarian function changes and levels of hormones including oestrogen and progesterone fluctuate.
For many women, one of the first noticeable signs is a change in their menstrual cycle. Periods might become shorter or longer, lighter or heavier or begin arriving at different intervals.
But changes to periods are only part of the picture.
Women can also experience hot flushes, night sweats, disrupted sleep, mood changes, brain fog, headaches, changes in libido, vaginal and urinary symptoms and changes to their skin and hair.
When does perimenopause start?
Perimenopause most commonly begins during the 40s, although some women experience changes earlier.
This is one reason the beginning of perimenopause can be difficult to recognise.
If periods are still occurring and menopause feels like something that belongs much later in life, symptoms such as poor sleep, changes in mood or suddenly unfamiliar skin might not immediately be connected with hormonal change.
How long does perimenopause last?
There is no fixed duration.
Perimenopause commonly lasts several years and both its length and intensity vary considerably between women.
As the transition progresses, menstrual cycles often become increasingly irregular until the final menstrual period occurs.
What is menopause?
Menopause refers to a woman’s final menstrual period.
Because there is no way of knowing at the time whether a particular period will be the last, natural menopause is diagnosed retrospectively once 12 consecutive months have passed without another menstrual period, provided there is no other medical explanation.
This distinction is important because menopause is technically a point in time rather than a stage lasting several years.
Natural menopause most commonly occurs between the ages of 45 and 55, with the average age in Australia around 51.
Menopause can also occur following surgery that removes both ovaries or as a result of certain medical treatments. These experiences can be quite different from natural menopause because the hormonal change can occur much more abruptly.
What is postmenopause?
Postmenopause is the stage of life beginning once menopause has been confirmed, 12 months after the final menstrual period.
And postmenopause isn't a temporary phase.
It continues for the rest of a woman’s life.
Some symptoms experienced during perimenopause can improve or disappear after menopause, while others can continue. Longer term health considerations also become increasingly important as the effects of lower oestrogen levels become relevant.
This is why menopause healthcare shouldn't end when periods do.
Is menopause the same for every woman?
Not remotely.
Some women move through the transition with relatively few symptoms.
Others experience symptoms that significantly affect their sleep, work, relationships, confidence or quality of life.
The symptoms themselves can also be remarkably varied.
While hot flushes have become almost synonymous with menopause, not every woman experiences them. For another woman, the most disruptive change might be insomnia, anxiety, brain fog, joint discomfort, vaginal dryness or changes in her skin.
There is no single “correct” menopause experience.
Understanding that variability is important because women can sometimes dismiss what they are experiencing simply because it doesn't resemble the version of menopause they expected.
What happens to your skin through the stages of menopause?
Skin changes are one part of menopause that can be overlooked.
Oestrogen influences numerous aspects of skin biology. As hormone levels fluctuate during perimenopause and oestrogen levels ultimately decline, women can notice changes in hydration, collagen, elasticity, skin thickness and the way their skin looks and feels.
Skin that behaved predictably for decades can suddenly feel unfamiliar.
It might become drier.
Products that were previously comfortable might begin to feel irritating.
Some women notice increased sensitivity or visible redness, while others become more aware of changes in firmness or texture.
But there is another biological system involved that has received considerably less attention.
The skin microbiome.
Does menopause change the skin microbiome?
Research has identified differences in the facial skin microbiome associated with menopausal status.
The skin microbiome is the community of microorganisms that lives on the skin. These microorganisms interact with the skin and play an important role in normal skin function.
A 2024 study examining the facial skin microbiome before and after menopause found differences in microbial diversity and composition between premenopausal and postmenopausal women, including greater bacterial diversity and lower relative abundance of Cutibacterium in the postmenopausal group.
The researchers considered chronological ageing as a potential factor and proposed menopausal status as the principal differentiating factor affecting the microbial profiles they observed, while acknowledging that age could not be completely excluded.
This emerging microbiome-menopause connection adds another dimension to our understanding of why skin can behave differently through menopause.
It also challenges the idea that menopausal skincare should simply be conventional skincare with more moisturiser added.
The biology is more complex than that.
Understanding it is one of the reasons Nu Allumé was created.
When does menopause end?
This is a common question because menopause is often described as something women “go through” and eventually finish.
The symptoms associated with the menopause transition can certainly change over time and some can eventually disappear.
But technically, once menopause has occurred and a woman enters postmenopause, she remains postmenopausal for the rest of her life.
That doesn't mean she will experience menopause symptoms forever.
It simply describes her reproductive stage.
How do I know which stage of menopause I’m in?
For women experiencing natural menopause, menstrual history is one of the most useful indicators.
If your menstrual cycle is changing or you are experiencing menopausal symptoms while periods are still occurring, you may be experiencing perimenopause.
Menopause is confirmed retrospectively once 12 consecutive months have passed without another period. At that point, you are considered postmenopausal.
But it isn't always that straightforward.
Hormonal contraception, hysterectomy, medical treatments and other circumstances can make menstrual patterns less useful or impossible to interpret.
Symptoms associated with menopause can also overlap with other health conditions.
If you're unsure whether changes you're experiencing are related to perimenopause or menopause, particularly if symptoms are new, unusual or affecting your quality of life, speaking with a qualified healthcare professional is important.
Understanding the stages of menopause
Understanding the language around menopause can make the experience a little less mysterious.
Perimenopause is the transition surrounding menopause.
Menopause is the final menstrual period, confirmed retrospectively 12 months later.
Postmenopause is the stage that follows and continues for the rest of a woman’s life.
But those definitions only provide the framework.
Every woman will experience these stages differently.
The more we understand about the biological changes taking place throughout the menopause transition, from hormones and cardiovascular health to brain, bone and skin health, the better equipped women can be to understand their bodies, ask informed questions and make decisions that are right for them.
Menopause isn't one experience.
And it isn't one moment.
It is a significant biological transition that deserves to be understood.
