Perimenopause and Menopause 101

The Basics

Menopause is a biological occurrence in a woman’s life that signals the end of her reproductive years. It marks the end of menstruation (monthly periods) where a woman has had no menstrual bleeding for 12 consecutive months.
The age at which menopause is reached varies according to each individual woman and her circumstances. Most women are between the ages of 45 and 55, with the average age of menopause occurring at 51. However, some women can reach menopause before or after this age.


Reaching menopause between 41 and 45 years of age is called early menopause, while premature menopause occurs before the age of 40. Premature menopause affects up to 1% of women, usually resulting from premature ovarian insufficiency, or medical or surgical intervention, such as removal of the ovaries, required radiation therapy and chemotherapy.


Natural menopause occurs when the body’s secretion of oestrogen and progesterone is reduced after the ovaries have stopped ovulating due to the depletion of eggs. This prevents the lining of the uterus from building up and subsequently shedding (menstruation).


With the increase in life expectancy, the average Australian woman who reaches menopause at 50 years of age could
experience approximately another 30 years of postmenopausal life. As women spend a large part of their lives in a postmenopausal state, looking after your health during this transition is vital.

What is Perimenopause?

Perimenopause is the time leading into menopause when a woman’s hormones begin to change in preparation for
menopause. As a woman’s egg numbers diminish, the ovaries slow down their production of the hormones, oestrogen
and progesterone. During this time, you may notice some changes in your menstrual cycle, such as:

  • Irregularity in length – your periods may become longer or shorter
  • Unpredictable menstrual flow – bleeding may become heavier or lighter
  • Late periods – or you may skip one or more periods

Perimenopause is a process of hormonal change that can be as short as a few months or as long as 10 years – lasting around four years on average. Despite potentially feeling like your hormones are bouncing around erratically during this time (like puberty number 2!), a series of hormonal events are taking place through this process. Oestrogen is high in relation to progesterone, but both will eventually decline.
Over the course of perimenopause, hormones eventually fall to a point where the ovaries no longer produce eggs, your
periods stop, and menopause is reached. The later phase of perimenopause is termed as being in the “waiting room” – waiting to see if your last period was, in fact, your last.
Perimenopause and the early years of menopause are important for long-term health. It is during this sensitive state
of physiological change and instability that underlying health conditions can be revealed, and there is increased risk of small health issues amplifying into bigger ones later in life, if left unaddressed. Making positive changes during this period could have long-term health benefits that future you will thank you for.

THE 4 PHASES OF PERIMENOPAUSE LEADING TO MENOPAUSE

1. Very early perimenopause: Cycles are still regular but show signs of change
2. Early menopause transition: From the onset of irregular periods with cycles varying in length
3. Late menopause transition: From the onset of skipped periods starting with the first cycle of more than sixty days
4. Late perimenopause: The twelve months from the final period

Menopause: Reached one year after your last period