Phases of menopause: pre, peri (climacteric) and post

Although the term menopause is generally used to designate the end of menstruation, the period is clinically only the last menstrual bleeding. The phases that involve symptoms or the transition to menopause are divided into:



In general, it occurs between 35 and 48 years, but the period still generates debates among specialists who do not always agree with that age.

The rates of estrogen and progesterone begin to change, although not always noticeable.

The most striking feature of pre-menopause is the drop in fertility, which can be reduced to 20% after the age group between 35 and 40 years.

That is, pre-menopause is a phase that can start very early and that few women, in fact, feel the arrival, because it is usually marked by a subtle hormonal reduction, without major symptoms to the body – different from the climacteric, more common and most reported by women.

Perimenopause (climacteric)

Perimenopause, or more popularly known as climacteric, in general, begins between the ages of 45 and 50, and this is the transition phase to menopause ( peri = around). It is also the period when symptoms related to the end of menstruation are more present and accentuated.

For most women, perimenopause begins about 2 years before the last menstruation and extends to 1 years after it.

Estrogen levels before menopause are falling, but quite unevenly. It is even possible that they will rise more than in previous periods.

In this phase, hot flashes (called hot flushes), excessive sweating, irregularity in the menstrual cycle, changes in mood (irritability, anxiety and depression ) begin to manifest themselves with more intensity and, in general, tend to become more and more accentuated until menopause occurs.

In addition, the following may occur:

  • Amenorrhea: absence of menstruation or menstrual irregularities;
  • Vasomotor disorders: heats, chills and night sweats;
  • Sleep disorders;
  • Irritability, anguish and depressive states.

But it is worth mentioning that each organism is unique and that there are different manifestations, including no symptomatic perception for some women.


It is, in fact, the last menstruation. However, it is only after 1 year that it is possible to determine that the bleeding was the menopause. Therefore, it is, in fact, a very punctual event.

A wide margin considers that menopause occurs between 45 and 55 years, but the average for Brazilian women is 51 years.

Approximately 5% of women experience late menopause, which occurs after age 55, and another 5% of women experience early menopause, which occurs before age 45.

Clinically, natural menopause is characterized by amenorrhea (absence of menstruation) for 12 months in women over 45 years old, with hormonal rates of high follicle stimulating hormone and gradually lower estrogen.

But estrogen rates are not always the hallmarks of the period, as the reduction is gradual and not always regular, and it may take a few months to stabilize and show consistently low rates.


Postmenopause ranges from the last menstruation to 65 years old, when the woman reaches old age. However, after menopause, for approximately 1 year, the patient is still in perimenopause, and the phases occur together.

Signs of irritation in the intimate area, dry mucous membranes, infections and urinary incontinence, reduced sexual interest, difficulty in vaginal lubrication, pain and discomfort during sex tend to occur more predominantly in this phase.

It is in this period that late manifestations tend to appear. Between them:

  • Changes in the skin : wrinkles, loss of elasticity and skin resistance;
  • Intimate problems : vaginal dryness, infections, irritation and difficulty lubricating;
  • Urinary dysfunctions : cystitis and urinary incontinence;
  • Neuromental problems : increased risk of Alzheimer’s disease, stroke, deficit in concentration, difficulty concentrating and reduced memory;
  • Cardiovascular diseases : increased risk of acute myocardial infarction;
  • Bone dysfunction : increased risk of osteoporosis.

Find out more about menopause: