Perimenopause
Perimenopause vs menopause: which stage am I in?
Quick answer
Perimenopause is the transition, when hormones fluctuate and periods start to change, often for several years. Menopause is a single point: 12 months after your last period. Postmenopause is everything after that. Most women reach menopause between 45 and 55. Your periods are the main clue to your stage: cycles that vary by a week or more suggest early perimenopause, gaps of 60 days or more suggest late perimenopause, and a full year without a period means you have reached menopause.
What might be happening
Researchers use a framework called STRAW+10 to describe reproductive ageing. In the early menopause transition, cycle length starts to vary, with a persistent difference of seven days or more between consecutive cycles. In the late transition, there are gaps of 60 days or more between periods, and this late stage typically lasts one to three years. Symptoms such as hot flashes are most likely in the late transition.
Menopause itself is defined after the event: once you have gone 12 months without a period, the date of your last period is your menopause. NICE guidance uses this definition, and also notes that diagnosis is harder if you use hormonal contraception or treatment that changes bleeding, because periods no longer reflect what the ovaries are doing.
Postmenopause follows. Some symptoms, such as hot flashes, can continue for a few years, and others, such as vaginal dryness, can appear or persist. Bone and heart health become more important to look after. Any bleeding after 12 months without a period should always be checked by a doctor.
What to notice
- The date of every period, so you can see cycle length changing.
- Gaps between periods, especially any of 60 days or more.
- Hot flashes and night sweats, and how often they happen.
- The date of your last period, and whether you reach 12 months without one.
- Any hormonal contraception or treatment that affects bleeding.
- Vaginal dryness or bladder changes, which become more common in the later stages.
Period dates alone tell you a lot about your stage. Adding symptoms gives a doctor the full picture.
Related patterns
Typical signs at each stage:
- early perimenopause: cycles shortening or varying, PMS changing, sleep and mood shifts
- late perimenopause: skipped periods, longer gaps, hot flashes and night sweats
- menopause: 12 months since your last period
- postmenopause: hot flashes easing for many, with vaginal dryness and bladder changes becoming more common
Everyone’s path is different, and some women move through the stages with few symptoms while others have many.
Notice the pattern
Knowing your stage helps make sense of what you are feeling, and it matters for decisions such as contraception and treatment options.
A simple record of period dates over a year, with notes on hot flashes and sleep, is usually all that is needed to place yourself, and it is exactly what a doctor will ask about.
When to get support
Speak to a doctor if:
- you have any bleeding after 12 months without a period
- your periods stop or change before 45
- periods are very heavy, or you bleed between periods or after sex
- symptoms are affecting your daily life at any stage
A doctor can also advise when it is safe to stop contraception, which depends on your age and the date of your last period.