Tell a woman that menopause “only lasts one day,” and you may have to duck.

It’s true, though: technically, “menopause” is the one-year anniversary of a person’s last period, and it only lasts one day.

Perimenopause (the time of hormone fluctuation leading up to menopause) and post-menopause last a whole lot longer, and the entire transition can take up to 20 years in some cases.

In common discourse, the term “menopause” has really come to mean the length of the transition, but there’s a danger is using the terms too loosely.

Do any research at all into menopause, and you’ll find all over the Internet that “the average age of menopause in the United States is 51.” So what happens to a 45-year-old woman who starts experiencing heart palpitations, interrupted sleep, or increased anxiety and depression that can come with hormonal fluctuations?

Believing herself too young for anything menopause-related, she thinks, “Something is wrong with me!” At Gennev, we’re heard story after story of women, terrified, going to the ER thinking they’re having a heart attack, only to be sent home confused, embarrassed, and frequently with a prescription for antidepressants.

While we would always advise women who are experiencing frightening changes in their bodies to seek medical attention, we think many women would find the transition a whole lot easier if they had more information heading in to it.



The stages of menopause

So let’s talk about the stages and what women may experience. However, it’s important to note from the outset that every woman’s experience of peri/menopause is as unique as she is, so your journey may follow a different map from your best friend’s or even your sister’s.


Perimenopause defines the stage of life where a woman’s hormones begin to fluctuate differently than the more predictable rises and falls of her normal cycle. Estrogen levels rise and fall unevenly, and the changes begin.

Despite all sorts of sources across the Internet claiming perimenopause typically lasts “about 4 years,” anything up to 10 years is closer to the truth. Many women enter perimenopause in their early to mid-40s, but the changes can start in a woman’s mid-30s.

In perimenopause, you may notice:

  • Periods become irregular. This is often the first sign that the transition has begun. Periods are lighter, shorter, farther between, or heavier, longer, and more frequent, or any and all of these at different times. Because your body may be producing less progesterone, the uterine lining (which is regulated by progesterone) might get thicker, meaning heavier periods. (Help for wonky periods.)
  • Interrupted sleep. Sleep gets more challenging during this time. Some women find it harder to fall asleep, others to stay asleep. And the onset of hot flashes and night sweats can make a good night’s sleep even harder to come by. (Get better sleep.)
  • Hot flashes. Though we commonly associate these with menopause, hot flashes are actually the most common symptom reported by women in perimenopause. (Help for hot flashes.)
  • Mood. As estrogen ebbs and flows, mood can change with it. Anxiety, depression, and rage are all fairly common. It’s important to be aware and attentive to emotional issues, as depression during perimenopause can reach dangerous levels. (More information on anxiety, depression, and rage.)
  • Decreased fertility. While it is still possible to get pregnant during perimenopause (in fact, it’s the time of highest accidental pregnancy, outside the teen years, so don’t give up using birth control just yet), conceiving is generally much more difficult once perimenopause has begun. (Considering IVF?)
  • PMS gets even uglier. Yeah, sorry. Breast tenderness, mood, cramps, all can get worse: think of it as nature’s way of helping you truly appreciate the end of periods when it finally happens. (Killer cramps? Here’s help.)
  • Brain fog and memory issues. Estrogen is a “master regulator” of the brain, so as levels decrease, you may experience perimenopause brain fog, confusion, inability to concentrate, or memory loss. These are generally temporary as your brain adjusts to the new level of hormones. (Increase concentration.)

Many women find low-dose birth control pills or a hormonal IUD like the Mirena can help control many of the symptoms of perimenopause.


Congratulations! You’ve gone a full 12 months without a period.

While some women may see menopause as an ending – to reproduction, to youth, to sexuality – at Gennev, we see menopause as a beginning to the second chapter of life.

Menopause, in our definition, is an invitation: to take extremely good care of yourself, to try out new things, to indulge your wants and desires, to embrace your sexuality and beauty, and to give a whole lot less importance to others’ opinions of you.

Yes, the symptoms of menopause can be troubling, but there’s no need to let them diminish your quality of life as you step into…


Thanks to longer life expectancies, many women nowadays can expect to live a third (even up to a half!) of their life in menopause.

And this second chapter of life can be rich, fulfilling, active, and vibrant. You just may have to work a little harder to protect your health and quality of life.

In post-menopause, things to be thinking about (and actually, if you’re not there yet, start thinking about them now!):

  • Osteoporosis. If you’ve been diagnosed with osteoporosis or osteopenia, consider taking up some gentle strength training and weight-bearing exercise. Not only can that help with bone density, having a stronger core can help you avoid falling and potentially breaking a bone. HRT (hormone replacement therapy) can also help battle bone loss. (More on osteoporosis exercise and osteoporosis medications.)
  • Heart disease. The #1 killer of women, about 10 years past menopause, a woman’s risk of heart disease equals a man’s of the same age. And her risk of dying is higher, in part because we’re less able to recognize the symptoms of heart attack in a woman. Educate yourself, eat well, exercise, know your risk. (Learn how to have a healthier heart.)
  • Alzheimer’s and dementia. Women suffer from Alzheimer’s at a higher rate than men. Nutrition may help protect your brain, as may HRT if used correctly, so talk with your doctor or ours about how to minimize your risk of developing Alzheimer’s. (Learn how to “eat for retirement.”)

Twenty years may seem like a prison sentence, but it doesn’t have to be. There’s help for symptoms at every stage, and you’d be surprised at how much better common-sense healthy behaviors can make you feel (eating well, prioritizing sleep, minimizing stress, exercising, hydrating, NOT SMOKING).

At Gennev, we’re committed to helping every woman understand her body better, and you can help us do that. We’d like to invite you to share Gennev with the women you care about, especially younger women. Think about it: how prepared were you? Would it have helped if someone had told 40-year-old you about what was happening or coming soon? If you have shared your knowledge, how did you do it? We’d love to know. Hit us up in our community forums, on our Facebook page, or in Midlife & Menopause Solutions, our closed Facebook group.



Shannon Perry

May 15, 2019
Director of Programming & Media

Medically Reviewed By

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