Transition, perimenopause, and menopause: do you actually know which phase you are in?

I am still having my period, so I am not in menopause yet.

It is a statement I hear regularly from women. And honestly, it is not that strange that there is confusion about this.

The terms transition, perimenopause, and menopause are often used interchangeably. Even in conversations and articles, 'menopause' is regularly used as a catch-all term for the entire period.

But medically speaking, these words mean something different. And that difference is important.

Because if you think that menopause only starts when your period stops, you can miss signals from your body for years.

Changes in your sleep, menstruation, mood, concentration, temperature regulation, or energy can occur much earlier.

That is why we start with the basics.

Menopause is not the transition

The menopause is the broader period during which a woman's body makes the transition from the fertile phase of life to the phase of life after menopause.

Menopause itself is just one moment within that transition: your very last period. And the remarkable thing is that on the day itself , you do not know that it was your last period. Only when you have not menstruated for twelve consecutive months — without another medical cause — can it be determined retrospectively that you have reached natural menopause.

The average age at which women reach natural menopause is around 51. However, the hormonal changes and associated symptoms can begin years before that.

That is exactly why it is so important not to look solely at your age or whether or not you are menstruating.

Premenopause: before the menopausal transition

Premenopause literally means the period before menopause. In practice, the term is sometimes used for all years before the last menstruation, but to understand the different phases, it is more useful to distinguish between premenopause and perimenopause.

During the premenopause, your menstrual cycle still functions according to your usual pattern, and there are no clear signs of the menopausal transition yet. However, this does not mean that every woman should automatically experience hormonal symptoms from the age of forty.

That is an important distinction.

We should not automatically attribute every change in the body of a woman over 40 to menopause. Sleep deprivation, stress, thyroid problems, iron deficiency, lifestyle, and other medical factors can also cause symptoms.

However, as soon as your cycle or other physical and mental patterns start to change, it is wise to take the possibility of perimenopause into account.

Perimenopause: this is where things really start to change

This is the phase that many women miss.

You might still menstruate every month, and yet your body can already be in the midst of a hormonal transition.

Perimenopause usually begins sometime in the forties, although for some women it happens earlier or later. This phase can last several years.

A major misconception is that your estrogen simply continues to drop from that point on. The female body does not work that neatly.

During perimenopause, ovarian function can become more erratic. The production of estrogen and progesterone, among others, changes, and hormone levels can fluctuate significantly. And it is precisely these fluctuations that can affect much more than just your menstruation.Your cycle may become shorter or longer. Your periods may become heavier or lighter.

But you may also experience changes in sleep, mood, concentration, temperature regulation, libido, and energy.

And that is where things often go wrong.

A woman wakes up in the middle of the night and thinks she is sleeping poorly due to stress.

She is having trouble concentrating and thinks she is just juggling too many balls. She feels more emotional and wonders why she suddenly has so little tolerance.

Perhaps work pressure, diet, sleep, and stress indeed play a role.

But the hormonal transition can also be part of the story.

It doesn't have to be an either-or situation.

What does science say?

Scientific and medical guidelines do not describe the menopausal transition as an event that begins suddenly when a woman has her last period.

The internationally used STRAW+10 model divides female reproductive aging into different stages. Changes in the menstrual cycle play an important role in recognizing the menopausal transition.

Organizations such as The American College of Obstetricians and Gynecologists (ACOG) also describe that estrogen levels can vary significantly during perimenopause. As a result, changes in the menstrual cycle and menopausal symptoms can occur even before menstruation stops permanently.

The average age of natural menopause is around 51, but perimenopause can begin years before that.

So that means:

Menstruation does not rule out menopause.

And that is precisely information that I believe every woman should be aware of from around her fortieth birthday.

Menopause: one day you can only pinpoint in hindsight

Then eventually comes the menopause.

Not a phase of years.

Not a collective term for all complaints.

But only one specific moment: your last period.

When you subsequently have not menstruated for twelve consecutive months,

Do you know that that last period was the menopause?

From that moment on, you enter postmenopause.

Postmenopause: a new phase of life

Postmenopause begins after those twelve months without menstruation and then lasts for the rest of your life.

And here too, I want to correct a persistent thought.

Postmenopause does not automatically mean that all symptoms are gone.

For some women, for example, hot flashes and night sweats decrease. For other women, certain symptoms may persist for years. Conversely, symptoms such as vaginal dryness and changes in the urinary tract may persist or become more pronounced. Additionally, the focus on your health changes.

After menopause, estrogen levels remain lower for an extended period. Estrogen plays an important role in maintaining bone mass, among other things. Therefore, the risk of bone loss and ultimately osteoporosis increases around and after menopause.

Cardiovascular health, muscle mass, strength, metabolic health, and lifestyle also deserve extra attention during this phase of life.

For me, that is an essential part of the conversation about menopause.

We shouldn't just help women get through a hot flash or a bad night.

We must give women knowledge that enables them to also invest in the health of the woman they want to be in ten, twenty, and thirty years.

Why I do this work

I am Monique Pols, founder of Victorious Women and a certified Menopause Coaching Specialist. With Victorious Women, I do not want to tell women that they need to 'fix' their hormones or that there is one method that will make their symptoms magically disappear.

My mission is precisely for women to understand what happens in their bodies.

Because I see how many women lose themselves in random advice during this phase of life.

A sleep supplement.

Eat less for belly fat.

More cardio because the weight changes.

Working harder because energy decreases.

But when you try to solve only isolated symptoms without understanding the bigger picture, you miss important information. That is why I work from my Root to Rise Method™ .

First to the ROOT: understanding what is happening, recognizing patterns, and exploring what your body needs.

From there to RISE: building strength, recovery, vitality, and control for your Second Half.

Don't fight against your body.

But learning how to work with it.

What can you do today?

Don't start diagnosing yourself based on one Instagram post.

Start by observing.

Take a look at the past six to twelve months.

Has your period changed?

Do you sleep differently?

Has your energy changed?

Do you often suffer from hot flashes or night sweats?

Do you notice changes in mood, concentration, or libido?

Does your body feel different than a few years ago?

Write down those changes.

Not because every change is automatically caused by the transition, but because patterns give you information.

And when symptoms are new, severe, or concerning, or when you are unsure about the cause, always discuss them with your GP or another qualified healthcare professional.

Do you know which phase you are in?

That is ultimately the question with which I want to conclude this blog.

Not: “ Am I going through menopause?”

But: “What is changing in my body and in which phase might I be?”

Because the sooner you learn to recognize what is happening, the sooner you can make choices that suit your body and your stage of life.

That is why I have the Victorious Check developed. A first step to reflect on the signals you are experiencing and to gain more insight into what is going on with you.

Take the Victorious Check via my website and discover what your body is trying to tell you: https://scan.victoriouswomen.nl

You don't have to wait until your period stops.

You may start understanding right now.

Your Second Half begins with knowledge. And knowledge gives control.

Sources

Harlow SD et al. Executive summary of the Stages of Reproductive Aging Workshop +10: addressing the unfinished agenda of staging reproductive aging. Menopause. 2012.

The American College of Obstetricians and Gynecologists (ACOG). The Menopause Years.

National Institute on Aging. What Is Menopause?

NHS. Menopause and perimenopause.