What the Stage of Menopause Look Like

Hot flushes are talked about the most when we bring up menopause.

But this isn’t usually the first symptom - While physical symptoms become more obvious closer to your final period, the transition often starts more quietly.

Slight changes in your cycle or mood, subtle shifts that blood tests miss.. but you feel them.

If you’ve been wondering “Is this normal?” or thinking “Why does no one talk about this?”, you’re not alone. If you’re feeling off lately, emotionally drained, physically different, or just not yourself, most women feel something during the first stages of the menopause transition. For some, it’s subtle. For others, it’s life-disrupting. But it’s real, and it’s happening.

This is an article I hope will be shared widely, because raising awareness of what to expect could spare the next generation of women from silently suffering like so many before us.

Let’s normalise these conversations, remove the shame, and make sure our daughters and their daughters feel prepared - not blindsided when this chapter arrives.

85% of women experience physical and psychological symptoms during menopause. One in three report them as severe.

Let’s put that into perspective: If you were sitting at a dinner table with nine girlfriends, chances are eight of you would be feeling something ... hot flushes, mood swings, sleep disruption, anxiety, or just a sense that things feel off. And three of you? You’d be flat-out struggling.

The truth is: every woman’s experience is different. Culture, genetics, and ethnicity all play a role. But when we zoom out and look at the bigger picture, both from research and real women's stories, some very clear patterns are starting to emerge from stage to stage.

Let’s break them down in a way that actually makes sense.

1. Late Premenopause

Time Frame: Variable
Period: Slight changes (e.g. one day shorter, heavier bleeding)
Physical: FSH starts to fluctuate in the early follicular phase, but blood tests might not pick it up
Psychological: Nervousness peaks. Depression and anxiety become more noticeable. Quality of life scores drop.

Common Experience:
This is when you know something feels off. You go to the doctor, get a blood test, and they tell you you're fine. “You’re probably just stressed.”

You leave feeling unseen, dismissed, and unsure whether to trust yourself. That sense of dread creeps in: What if something is seriously wrong and no one’s catching it?

Most women in this phase feel like they’re falling apart quietly, with nothing to show for it. And that’s a lonely place to be.

2. Early Perimenopause

Time Frame: Variable
Period: Now swings 7+ days in either direction, often heavier
Physical: Estrogen fluctuates wildly. FSH starts to rise, but may still be missed in bloodwork. Symptoms come from estrogen dominance and sluggish detox pathways.

Symptoms: Headaches peak. Skin gets itchy. Heart palpitations. Fatigue deepens.

Psychological: Anxiety and depression linger. Perceived stress is at its highest. This is where you find yourself yelling at your kids for things you might’ve previously let slide. You might wake up one morning, look at your partner, and feel an inexplicable wave of irritation—or even rage. Especially in the days leading up to your period, your brain starts sending the message: “I can’t stand them.” You’re not alone, and you’re not losing it—your hormones are shifting fast, and your nervous system is struggling to keep up.

Common Experience:
Some doctors start recognising perimenopause here, and HRT may be discussed. But dosage, delivery, and outcomes vary.

Your relationships may be suffering more here, when your nervous system is stuck in a constant fight-or-flight mode, everything starts to feel like a battle. You’re stretched thin, feeling invisible for all the things you do for your family, and it's hard not to let that frustration spill over. The pressure builds until one day you explode over something small, and then feel guilty for losing it. This stage often feels like you're constantly giving, but no one sees how much you're holding, physically, emotionally, and hormonally. Many women are offered antidepressants instead of hormone support.

If this is your experience: please seek out a health provider trained in women’s health. You deserve to be heard and treated holistically.

3. Late Perimenopause

Time Frame: 1–3 years
Period: You start missing cycles entirely (60+ days between bleeds)
Physical: Estrogen continues to decline but may still spike. Progesterone is low. FSH begins to rise.

Symptoms: Hot flushes and insomnia peak. Brain fog, low libido, and inconsistent energy become common. Symptoms are unpredictable.

Psychological: Depression and anxiety may ease for some, but persist for others—especially for women who experienced these symptoms before the transition. The persistence is often worsened by poor sleep quality and the physical toll of night sweats, leaving many women in a state of chronic exhaustion. It's not just tiredness from a long day—it's a bone-deep fatigue that lingers even after rest, clouding thinking and making daily life feel heavier than it should. The emotional load becomes harder to carry when your body isn’t getting the recovery it needs.

Common Experience:
Every month feels like a new body. You’re unsure whether to expect calm or chaos. But there’s often relief in knowing this is part of the process.

4. Early Postmenopause

Time Frame: 5–8 years after your final period
Period: Officially done (12 months without a period)
Physical: FSH is still high. Estrogen and progesterone continue to fluctuate, just less dramatically.

Symptoms: Nervousness fades, but insomnia, sexual complaints, fatigue, and hot flushes may continue.

Psychological: Mood tends to stabilise, but some report lingering melancholy.

Common Experience:
You may start to feel like yourself again - just a slightly different version. Some women feel relief, others feel grief. Both are valid. And then there’s the frustration: you thought you were finally through the worst of it, having gone years without a period, but the physical symptoms, like hot flushes, sleep disruptions, and unpredictable energy ... continue to linger. It can feel like an unfair aftershock, draining your motivation and making you question whether you’re really past the transition at all. You’re not imagining it.

This phase may still hold challenges, but now, you’re equipped with more awareness, and that matters

5. Late Postmenopause

Time Frame: Remainder of life
Period: If you bleed here, see a doctor.

Physical: Urogenital issues increase (e.g. UTIs, vaginal dryness), as do musculoskeletal pains.

Psychological: Mood is generally similar to premenopause.

Common Experience:
This is where bone health, strength, mobility, and prevention really matter. With lower hormone levels and natural aging, our bodies are more vulnerable to pain, stiffness, and loss of function. But this isn’t a time to stop—this is when movement matters most. Adopting a mindset like the Japanese concept of 'ikigai' or purposeful living can help: don’t focus on what you can’t do anymore, focus on what you can do—and keep doing it. How you move, eat, and sleep now lays the foundation for your freedom, strength, and independence at 80 and beyond.

Factors That Influence Your Menopause Experience

There are some things you can’t control. But there are many you can influence, and several you do control. And the key to navigating menopause with more ease often lies in knowing the difference.

Stoic philosophy, cognitive behavioural therapy (CBT), and even the Serenity Prayer all echo the same core wisdom: focus your energy on what you can do. When you're clear about what’s in your power, your mindset shifts, from helplessness to empowerment. I

n the midst of hormonal chaos, this clarity can anchor you. It won’t take the storm away, but it can give you the tools to ride it with more confidence and less fear. Start with what’s controllable.

Then, look to influence what you can. Let the rest go.

Can’t Control:

• Genetics
  
  
• Ethnicity
  
  
• Age of onset
  
  

Can Influence:

• Muscle mass
  
  
• Resilience and stress response
  
  
• Sleep quality
  
  
• Relationship satisfaction
  
  
• Mindset and self-efficacy
  
  

Can Control:

• Diet
  
  
• Exercise
  
  
• Alcohol and smoking habits
  
  
• Stress toolkit
  
  
• Daily rhythms and recovery practices
  
  

I personally love knowing where I do have power. But I also give myself grace.

Some months will hit harder.

That doesn’t mean you’ve failed, it just means you’re human.

Steps Forward

👉 Think you are entering into it and want to set yourself (lifestyle) up with the best way not only get through it but healthily aging... put your name down on my course that will teach you all this and more...GO HERE

ONE MORE THING>>>>

Here’s one thing that’s often overlooked- but it matters: how you perceive menopause can directly affect how you experience it.

If you’re resisting aging or feel embarrassed every time a hot flush hits, it’s going to be harder. But if you can laugh at the sweat running down your back, embrace the change, and see this transition as an evolution, not a downfall, it genuinely shifts the way your body and mind respond.

Menopause is physical, yes. But it’s also emotional and mental.

Like I say in the stages above, you are the phoenix rising. And while we celebrate the phoenix, we forget the part where she was reduced to ashes first. That burning is uncomfortable. But it’s also what makes the rise so powerful.

What you’re experiencing might be messy and uncomfortable, but the tools that support you remain consistent:

• Eat well (start with my [1.2.3 Meal Download])
  
  
• Prioritise sleep
  
  
• Move in ways that build or protect muscle
  
  
• Build resilience, yes, it’s a skill
  
  

As Lisa Mosconi has found, our brain changes during this transition, this is your time to embrace that change and sculpt the brain you want. Let go of the old you and welcome in the new.

For the 40+ Women feeling off and tired of feeling stuck in a body that is no longer playing by the old rules - Check out my soon to be launched RISE: Stronger in Midlife Program

Reference:

https://pubmed.ncbi.nlm.nih.gov/40526070/ 

https://pmc.ncbi.nlm.nih.gov/articles/PMC3340903/ 

https://www.sciencedirect.com/science/article/abs/pii/S1521693422000426