Women start perimenopause at different ages. Many notice changes in their 40s—irregular periods, hot flashes, mood swings—but for some, the shift begins as early as their mid-30s (nope, that's not a typo).

So, what’s going on? As women age, their ovaries gradually release fewer eggs and produce less estrogen. This stage is defined by erratic, often unpredictable changes in estrogen and progesterone levels.

Your menstrual cycles may become irregular, heavier or lighter, or space out unpredictably. You might also notice symptoms like night sweats, trouble sleeping, vaginal dryness, brain fog, and shifts in mood or energy. Be aware of lesser recognized symptoms like new muscle and joint aches, phantom smells, new food intolerances, hives, vertigo, strange sensations in your legs or extremities, and random bouts of rage.

This stage can feel like hormonal whiplash—but support and treatment options do exist, from lifestyle strategies to medical therapies.

Menopause is officially marked when you’ve gone 12 consecutive months without a menstrual period. Behind the scenes, this means that the ovaries have dramatically reduced hormone production, particularly estrogen.

Menopause means an end to the erratic menstruation symptoms of perimenopause. However, as the body adjusts to consistently low levels of estrogen, symptoms—like hot flashes, vaginal dryness, and changes in sexual function may increase in intensity.

This is also the time when the long-term effects of estrogen loss begin to show up more clearly. Bone density declines, increasing the risk for osteoporosis. Cholesterol levels may shift, raising the risk for heart disease. Skin may become thinner, joints creakier, and memory fuzzier. Understanding what’s happening allows you to make informed choices about your health, whether that means hormone therapy, lifestyle changes, or symptom-targeted relief.

Postmenopause refers to all the years after menopause when estrogen and progesterone levels have reached a new and stable baseline. Even though the hormonal rollercoaster has slowed, some symptoms may still linger.

Hot flashes, vaginal dryness, and sleep issues don’t always stop when periods do. For some women, they persist for years. This is also when vaginal and urinary symptoms (now grouped under a medical term called Genitourinary Syndrome of Menopause, or GSM) can become more bothersome. Tailored treatment, smart nutrition and regular movement can all help you stay strong and vibrant in this next chapter.

The postmenopausal years also bring new considerations. Low estrogen continues to affect bone health, heart function, skin elasticity, metabolism, and even hearing and vision. But it’s not all doom and gloom—many women say this is a time of clarity, confidence, and redefinition.