What is the difference between perimenopause, menopause, and postmenopause, when do they begin, and why is the most confusing phase often goes unrecognized?
“I guess I’m going through menopause.”
Almost every woman around 40–45 says this. The one whose period skipped this month. The one who hasn’t been feeling herself lately. The one who has started getting irritated over seemingly minor reasons.
But the truth is quite different. Menopause is just a specific moment. And the whole story begins long before it.
What is menopause, really?
Menopause is not a process. It has no beginning, no development, or end. According to Western medicine, it is a single day on the calendar marking 12 consecutive months without a menstrual cycle. The entire period from that day onward until the end of a woman’s life is called “postmenopause.”
But the more interesting – and often most overlooked – period is the one before that defining day.
This is the period known as “perimenopause,” which causes the most noticeable discomfort, yet remains the hardest phase of the hormonal transition to recognize. The reasons are simple. Perimenopause:
- has no clear starting point – usually around the 40s, but it can begin much earlier and is not determined by age alone
- is typically a long process lasting on average between 2 and 10 years before the final end of the menstrual cycle
- does not have one or two defining symptoms
- can begin much earlier than expected
Could I be in perimenopause and not know it?
Yes—because of the reasons listed above. Moreover, recent studies show that perimenopausal changes can occur even with a completely regular cycle. This means it is entirely possible to become pregnant while experiencing intense hot flashes and seemingly fully functioning ovaries.
Ovulation can occur even with an irregular cycle or after months without menstruation. In fact, a large percentage of unplanned pregnancies happen during perimenopause.
Because of the confusing signals the body sends, specialists often look for the cause of discomfort elsewhere – lifestyle, depression, psychological conditions, panic attacks, even seasonal fatigue. But just as often, it turns out it’s not stress – it’s hormones. Not oversensitivity, but biology.
In such cases, “pull yourself together” doesn’t help. What’s needed is timely, adequate, and holistic care – and a real understanding of what’s happening in the female body.
When are symptoms the strongest?
When hormones fluctuate the most – during perimenopause, often colloquially called a “second puberty.” The reason is that estrogen doesn’t simply decline – it fluctuates chaotically. One month it may be high, the next it can drop sharply.
These “hormonal swings” lead to:
- hot flashes
- joint pain
- vaginal dryness
- weight gain
- anxiety
- sudden mood changes
- heart palpitations
- sleep problems
…and more than 60 different symptoms that medicine is still classifying and studying, with only a limited number of solutions – many of which are not consistently proven effective.
While your body is desperately trying to adapt to these hormonal fluctuations, you may experience unfamiliar, diverse, and often intense symptoms.
With the onset of postmenopause, these sensations often become more manageable or even disappear. In other words, the difficult part is often before – not after – your period stops.
Unfortunately, the challenge is not only the physical discomfort, but also the fact that this stage of life is often experienced in silence – filled with unanswered questions, conflicting information, contradictory advice, and the feeling of being alone in something overwhelming.
Our mission is to change that. To replace chaos with clarity, doubt with understanding, and isolation with support.
That’s why we created Womeno – a digital solution that combines knowledge, symptom tracking, and access to expert help, so every woman can go through this stage informed and confident.
Learn more about the Womeno app HERE.
How does the body change after menopause?
After 12 consecutive months without a menstrual cycle, you enter postmenopause.
It’s important to know that any vaginal bleeding after this stage is NOT normal and should be discussed with a doctor immediately.
Your heart is one of the first to feel the changes. Low estrogen levels can affect blood vessels and cholesterol levels, increasing the risk of cardiovascular disease.
Another significant effect is the reduction in bone density.
Sounds alarming? Not if you’re well-informed and prepared. Like every phase of life, this one also brings new opportunities—but at this stage, prioritizing your health is essential.
Can I take preventive measures?
You can. But regardless of what measures you take, 100% of women go through the hormonal transition of menopause. Whether sooner or later, the changes will happen.
The paradox of perimenopause is that it often coincides with one of the strongest periods in a woman’s life – when her career is thriving, her children require less constant care, and she finally begins to focus more on herself.
And that’s exactly when the body starts changing in ways that are not always easy to understand.
But with the right information, proper expert care, and emotional support, perimenopause can simply be a more intense phase of life – part of every woman’s journey.
A part that reminds you: “You matter – take care of yourself too.”
We at Womeno also remind you: prevention is not just about avoiding illness – it is the foundation of longevity.
Regular gynecological check-ups and mammograms, physical activity, healthy lifestyle habits, and proper nutrition significantly improve your comfort and health during perimenopause and beyond.
And if you’re unsure which stage of the hormonal transition you’re in, take 5 minutes to complete our MenoTest and find out.
Sources:
North American Menopause Society (NAMS): https://www.menopause.org
NHS (UK) – Menopause: https://www.nhs.uk/conditions/menopause
Cleveland Clinic – Perimenopause: https://my.clevelandclinic.org/health/diseases/21608-perimenopause
Santoro, N. et al. (2015) – The Menopause Transition: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4488609/
Freeman, E.W. et al. – Hormonal changes in the menopausal transition: https://pubmed.ncbi.nlm.nih.gov/25504284/