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Stages
The stages of menopause begin with perimenopause—a time that involves a gradual shift when your periods become irregular and you may lose the ability to bear children. Menopause, the time when your menstrual periods have fully stopped, is one of the natural stages in every woman's reproductive life.
The childbearing years are between puberty and menopause. The years just before menopause are called perimenopause. The average perimenopause lasts for 6 years and is marked by physical and hormonal changes, including gradually decreasing estrogen and progesterone production.
How hormone levels are affected during perimenopause
During your reproductive years, the hypothalamus area in your brain stimulates the pituitary gland to secrete luteinizing hormone (LH) and follicle-stimulating hormone (FSH). LH and FSH, in turn, stimulate the release of an egg from your ovaries and increase production of estrogen and progesterone. These two sex hormones thicken the lining of your uterus in preparation for receiving and nourishing a fertilized egg. If fertilization does not occur, hormone levels drop, the lining of the uterus breaks down, and menstruation begins.
During perimenopause, hormone function decreases and becomes more erratic. The changing hormone levels cause the onset of menopausal symptoms. Your ovaries become resistant to FSH, and the pituitary releases more of it in an attempt to stimulate release of an egg. Your health care professional may test for blood levels of FSH, as elevated blood levels of FSH are one indicator of perimenopause.
Menopause
You have reached menopause when you are period free for 1 year and have an elevated FSH blood level. During this time you may experience menopause symptoms such as hot flashes and vaginal dryness.
Postmenopause
Postmenopause is the period of time after menopause. This is the stage in a woman's life when she is free of the concerns related to possible pregnancy. It is also the time when the risk for development of postmenopausal osteoporosis or cardiovascular disease is greatest.
Even during postmenopause, your body may still continue to produce small amounts of estrone, a weaker estrogen, produced in fat tissue. The amount of estrone increases with age and with the amount of fat tissue.
