Free guide

Understanding your menopause journey

Every woman's experience is different, but knowing what is happening at each stage can bring clarity, reassurance and a sense of control. Click through the stages below to explore what is happening in your body and what to look out for.

Pre-menopause
Menopause
Post-menopause
Pre-menopause
Menopause
Post-menopause
Pre-menopause
Typically ages 35–45 · The years leading up to change
Oestrogen
Stable
Progesterone
Stable
FSH
Low

What is happening

  • Your ovarian reserve begins a gradual natural decline
  • Cycles remain mostly regular but subtle hormonal shifts are beginning
  • Progesterone may start to dip in the second half of your cycle
  • FSH begins to rise subtly as the ovaries work harder
  • Your body is still producing hormones well but early signs of change can be present
  • This stage is often overlooked — many women don't realise it has begun

Common symptoms

  • Worsening PMS symptoms
  • Mood shifts or irritability before a period
  • Increased anxiety or feeling overwhelmed
  • Heavier periods than usual
  • Mild breast tenderness
  • Changes in libido
  • Mild fatigue not explained by lifestyle
  • Slight changes in cycle length
  • Difficulty sleeping around your period

When to see your GP

  • Cycles shorter than 21 days or longer than 35
  • Very heavy, prolonged or painful periods
  • Bleeding between periods
  • Mood changes significantly affecting daily life
  • Any concerns you would like to discuss further
Menopause
Typically ages 45–55 · Periods becoming irregular or stopping
Oestrogen
Fluctuating & falling
Progesterone
Declining
FSH
Elevated

What is happening

  • Oestrogen levels fluctuate unpredictably — sometimes surging then dropping sharply
  • Ovulation becomes irregular and eventually stops
  • Periods become unpredictable in frequency, length and flow
  • FSH rises significantly as the body tries to stimulate the ovaries
  • Menopause is confirmed after 12 consecutive months without a period
  • Every system in your body is feeling the effect of falling hormones
  • The average age in the UK for the final period is 51

Common symptoms

  • Hot flushes and night sweats
  • Sleep disruption
  • Mood swings, low mood or depression
  • Anxiety — sometimes appearing for the first time
  • Brain fog and difficulty concentrating
  • Memory lapses
  • Irregular or absent periods
  • Joint aches and stiffness
  • Vaginal dryness or discomfort
  • Reduced libido
  • Heart palpitations
  • Headaches or migraines
  • Bloating and digestive changes
  • Hair thinning or skin changes
  • Weight gain particularly around the middle
  • Increased fatigue

When to see your GP

  • Symptoms significantly affecting your daily life
  • Very heavy or unpredictable bleeding
  • Low mood, anxiety or depression
  • Heart palpitations
  • Bleeding after 12 months without a period
  • Any concerns you would like to discuss further
Post-menopause
12 months after your final period · Your new baseline
Oestrogen
Consistently low
Progesterone
Minimal
FSH
Persistently high

What is happening

  • Hormones settle at a new, consistently low baseline
  • Your body has completed its transition
  • Many acute symptoms ease as the body adapts to stable hormone levels
  • The ovaries are no longer producing oestrogen
  • Small amounts of oestrogen continue to be made by the adrenal glands and fat tissue
  • Long-term health becomes the primary focus at this stage
  • For many women this brings a new sense of clarity and freedom

Ongoing symptoms

  • Vaginal dryness and discomfort
  • Urinary urgency, frequency or recurrent UTIs
  • Joint stiffness and muscle aches
  • Hot flushes — can persist for several years
  • Low mood or emotional flatness
  • Reduced libido
  • Dry skin and hair thinning
  • Memory and cognitive changes
  • Fatigue
  • Weight management becoming more challenging
  • Pelvic floor weakness

When to see your GP

  • Any post-menopausal bleeding — always investigate promptly
  • Ongoing or worsening symptoms affecting daily life
  • Low mood or depression
  • Bladder or pelvic floor concerns
  • Regular health reviews for heart and bone health
  • Any concerns you would like to discuss further