The Stages of Menopause and what to expect?


Menopause is defined as the cessation of menstruation and occurs in a woman’s life at around 45 – 50 years of age with the average age of onset being 51. It is a gradual process and rarely happens all at once, except in cases of surgical intervention.

There is no relation between the time of a woman’s first period and her age at menopause. The age at menopause is not influenced by a woman’s race, height, number of children or use of oral contraceptives. Factors influencing the time of menopause include heredity (genetics) and cigarette smoking. Smokers (and former smokers) reach menopause an average of 2 years before women who have never smoked.


A woman generally has a menstrual cycle every 21 – 35 days with an average menstrual cycle being 28 days long. Each menstrual period is typically 3 – 5 days. Perimenopause, or the period of time leading up to menopause, begins to set in between ages 40 – 50 and can last anywhere from 2 – 8 years. This time is characterized by fluctuating levels of estrogen and/or progesterone production which can cause heavy menstrual bleeding, hot flashes, sleep problems, and vaginal dryness.

Gradually, menstrual periods become lighter and more irregular, until they cease altogether. After an entire year of the absence of a menstrual period, menopause has officially been reached. The above mentioned symptoms, such as hot flashes and sleep problems, should improve over time.


While lower levels of estrogen has been linked to lower risk for certain cancers, certain risks are increased during menopause, including:

Bone loss. Low estrogen levels after menopause speed bone loss, increasing the risk of osteoporosis.
Skin changes. Low estrogen leads to low collagen, which is a building block of skin and connective tissue. It’s normal to have thinner, dryer, wrinkled skin after menopause. The vaginal lining and the lower urinary tract also thin and weaken. This condition can make sexual activity difficult. It can also increase the risk of vaginal and urinary tract infections.
Tooth and gum changes. Low estrogen affects connective tissue, which increases the risk of tooth loss and possibly gum disease.
Heart disease. While the reasons aren’t entirely clear, a woman’s risk of heart disease increases after menopause. Since heart disease is the number one killer of women, it is important to consider health risks before making lifestyle and treatment decisions.

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