It literally takes women a lifetime to get through menopause. The stages begin with menstruation and end with death. Menopause means "pause of menses or the absence of periods. According to the website, Womenshealth.gov, there are four stages of menopause: premenopause; perimenopause, menopause and postmenopause
The first stage, premenopause, as well as the last stage, postmenopause, last the longest. By dividing menopause into separate stages, it is easier to identify and address the health issues and symptoms unique to each.
Premenopause
This first stage lasts from the onset of menstruation to the last normal period. It is during her reproductive years that menopause may be the furthest thing from a woman's mind. For most women, this stage begins at 10 to 16 years of age, when the first period occurs, to the last normal period, which usually occurs in in a woman's 40s or 50s.
It is during this initial stage of menopause that young women can lay the foundation for good health in later years through good nutrition and exercise.
Perimenopause
This stage is often the most stressful time for women. The menstrual cycle may become irregular before it ceases completely. Menstrual flow may become lighter or heavier. Each missed period raises questions about whether a woman is pregnant or entering menopause.
This stage, which lasts from 2 to 10 years, is often characterized by irregular menstruation with occasional missed periods. Until menses stop completely, it is still possible to become pregnant. Hormone levels fluctuate, which often leads to menopausal symptoms such as hot flashes; night sweats and insomnia. Low estrogen levels may cause vaginal dryness and irritation.
While changes in the menstrual pattern are common during this time, women should maintain a dialogue with their doctor because frequent or heavy bleeding needs to be evaluated further.
Menopause
Menopause occurs when a woman does not have her period for 12 months. This is actually the shortest stage and the only one with a defined length. If a woman skips several menses and then they return, the clock starts again. It is retrospective. Women do not know they are in menopause until 1 year without a period passes. Only then can they look back and realize they are in menopause. This can be a time of mixed emotions for many women as the childbearing years are over, children are grown and retirement beckons.
Postmenopause
Postmenopause begins 12 months after the last period and lasts until death. With women's increased life expectancy, the postmenopausal stage is a relatively new stage of life. A woman's life expectancy has increased from 48 years in 1900, to 80 years in 2005, according to the U.S. Centers for Disease Control and Prevention's publication: Health, United States, 2008. The majority of women did not live to the postmenopausal years in the early 1900s. Today they often enjoy an active lifestyle into their 70s and 80s.
Generally by this stage, most menopausal symptoms have ceased. Vaginal atrophy, which is due to low, rather than fluctuating, estrogen levels, may persist. Postmenopausal women with low estrogen may be at increased risk for osteoporosis and should consume adequate calcium and vitamin D and have a screening test for low bone density.
