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Understanding Menopause - Feeling Good in a New Stage of Life The Stages of Menopause The months or years before menopause are called perimenopause. During this time, the ovaries begin to run out of eggs and produce fewer hormones. This can lead to symptoms such as hot flashes and changes in your menstrual cycle. Twelve months after your last period, you've reached menopause. Beyond this point, you are in postmenopause. Perimenopause: When Changes Begin Your estrogen level starts to decrease. Some women have a sudden onset of symptoms. Others notice changes over time. Common symptoms include: Changes in the menstrual cycle. Periods may be closer together for a while. Then they may be further apart. Bleeding also may be heavier or lighter than usual. Hot flashes, night sweats, trouble sleeping, mood swings, breast tenderness, or bloating. Abnormal Bleeding Be sure to call your healthcare provider if you have: Heavy, long, or irregular periods Spotting in the middle of your cycle Bleeding after intercourse These symptoms may be caused by health problems that need treatment. Postmenopause: After Your Periods End Your estrogen level is now very low. You no longer ovulate and your periods have stopped. You are likely to have symptoms. They may include: Changes in the texture of your skin and hair. Vaginal dryness, hot flashes, night sweats, trouble sleeping, and mood swings. Surgical Menopause Menopause can occur after a hysterectomy (removal of the uterus) if the ovaries are also removed. Estrogen and progesterone levels decrease quickly. This may cause sudden and severe symptoms.

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