What Is Perimenopause and Menopause? Symptoms, Hormones and What to Expect
Menopause is a natural life stage that every woman will experience, yet it’s often surrounded by confusion and misinformation. Understanding what’s happening in your body can make this transition less daunting and more empowering.
In this guide, we’ll walk through what menopause actually is, the role of perimenopause, what’s happening hormonally, and what you can expect.
What is Menopause?
Menopause is defined as the point in time when a woman has gone 12 consecutive months without a menstrual period. It signals the end of reproductive years and is caused by a decline in ovarian function.
The average age of menopause is 51 years, but it can range from the early 40s to late 50s - or earlier! Factors such as genetics, lifestyle, certain medical treatments, and surgery (like hysterectomy or oophorectomy) can influence timing.
What is Perimenopause?
Perimenopause is the transition period leading up to menopause. It can begin anywhere from your mid-30s to your mid-40s, typically lasting 4–10 years.
During perimenopause, hormone levels - especially estrogen and progesterone - fluctuate unpredictably. This is what causes the symptoms most women associate with “menopause,” even though they technically occur before menopause.
Common symptoms of perimenopause include:
Irregular or heavy periods
Hot flushes and night sweats
Sleep disturbances
Mood swings or increased anxiety
Brain fog or memory issues
Vaginal dryness or discomfort during sex
Weight changes or bloating
What Happens Hormone-Wise?
Your ovaries gradually produce less estrogen and progesterone. This decline affects multiple systems in the body:
Brain: Neurotransmitters like serotonin are influenced, impacting mood and cognition.
Bones: Lower estrogen increases risk of osteoporosis.
Heart & blood vessels: Cardiovascular risk rises after menopause (read my blog on cardiovascular health).
Skin & connective tissue: Collagen production drops, leading to skin and joint changes.
Think of estrogen as a “master regulator” - when it shifts, so does much of your body’s internal balance.
One hormone you may hear your doctor talk about is FSH (Follicle-Stimulating Hormone). As the ovaries become less responsive, FSH levels rise as the body attempts to stimulate ovulation. While a single FSH test isn't always enough to diagnose perimenopause, elevated levels can provide another piece of the puzzle.
Post-Menopause
Once you’ve reached menopause, you’re considered post-menopausal. Some symptoms (like hot flushes) may ease, while others (like vaginal dryness or bone changes) may persist or increase.
This is a time to focus on long-term health, including:
Bone strength (weight-bearing exercise, calcium, vitamin D)
Cardiovascular health (diet, activity, blood pressure management)
Mental wellbeing (stress, sleep, support networks)
Why Understanding Matters
Menopause and perimenopause aren’t illnesses - they’re natural transitions. But they can significantly affect quality of life. Knowing what’s happening helps you:
Recognize symptoms early
Make lifestyle adjustments that support your body
Seek evidence-based treatments if needed (like HRT, supplements, or therapies)
Advocate for yourself in healthcare settings
Key Takeaway
Menopause marks the end of menstrual cycles, while perimenopause is the years of hormonal change leading up to it. Every woman’s journey is unique, but being informed allows you to navigate it with confidence, self-compassion, and proactive health choices.
StrongHer with Meredith
Evidence-based coaching and education to help women navigate perimenopause and menopause with confidence.
The information in this article is intended for educational purposes only and should not replace personalised medical advice. Please consult your healthcare provider regarding your individual circumstances.
