# 4 Phases of Perimenopause ##### Menstrual Cycle Awareness for Perimenopause --- ![[Pasted image 20261024192122.png]] --- ## TL;DR - Perimenopause is a sequence of events: four phases plus menopause. - Early on, your cycle may still be regular but shorter. Later, it can become more irregular and the gaps between periods can get longer. - Oestrogen can fluctuate wildly while progesterone falls as ovulation becomes less frequent. - The timings are only rough ideas because everybody is different. - Menopause is reached when you’ve had no period for 12 months. --- ## Transcript So we’re going to look at the four phases of perimenopause. So perimenopause is a sequence of events. OK, so remember I said that in the beginning, it’s a sequence of events and there are four phases plus menopause. And this is according to Professor Prior. Actually, these timings I’m going to go through with you, they’re adapted again from Lara Briden’s work. I think this was from her Hormone Repair Manual, and she’s taken the information from Professor Prior. So it’s worth going back to that old research and look at that. If we look at the four phases, phase one is very early perimenopause. OK, so this is where our menstrual cycle is still regular, but maybe it’s shortening a little bit. OK, so it might shorten to around about 21 to 26 days, ish. So you are still ovulating, but your menstrual cycle again starts to shorten. So pretty much that first image that I showed you of your menstrual cycle and your inner seasons, that’s where you’re at. You might be having shorter cycles. And if you’re having shorter cycles, then it means you’re having a shorter follicular phase. OK, a shorter inner spring and summer because your luteal phase, your autumn always remains the same. OK. The reason it stays the same is the corpus luteum I mentioned earlier. When we ovulate, the egg comes from the sac. That sac becomes the corpus luteum, which produces progesterone. That corpus luteum will survive around about two weeks, around about 14 days. OK, and that is why your luteal phase is always the same length. If your menstrual cycle changes in length, it’s the follicular phase—your inner spring and summer—that changes. If you’re having a longer cycle, that’s what changes, not the autumn or the luteal phase. Again, for this, if you’re in this phase. This is where we might have more oestrogen. So again, if you think back to the other chart, we’ve got a bigger push of oestrogen. It’s like our bodies are giving one final push to procreate. So with more oestrogen, there’s risk of heavier periods. Unfortunately, we might have more pain, migraines, sleep disturbances. I think the big thing with phase one is that you just know something has changed, even if you can’t put your finger on it. Things just feel different. You feel different. So, yeah, it could be a number of other things, but also it could be phase one of perimenopause. This very, very early phase of perimenopause lasts between two and five years, roughly. Again, everybody’s different, but these are rough ideas. From there, we’ve then got phase two. So phase two is the early menopause transition. So from the onset of irregular periods, you know, it’s when your menstrual cycle becomes more irregular and varies by more than seven days. The chart says “skipping periods”, but I don’t think that’s completely accurate. So it just changes in length. It varies in length, so it becomes more irregular. You may know you’re in this phase when your menstrual cycle varies by more than seven days. OK. So this is where you have low progesterone because you’re not ovulating as much. We’re also producing less progesterone. You have high and fluctuating oestrogen. Again, that’s, you know, that one last push. Because we don’t have as much progesterone to keep oestrogen in check, oestrogen can fluctuate wildly. But the key thing is that oestrogen isn’t just high; it can be low too. It’s wild. It’s a roller coaster. So when oestrogen drops, it drops even lower. OK. And when it’s high, it is even higher. So everything just becomes more extreme. So this is where you might get hot flushes, night sweats, you know, the typical sort of perimenopause symptoms that you start to think about. You may not get these, but this is what can sometimes happen at this time. And this lasts roughly around about two to three years. Again, differs for everybody. But this is an idea of how long it could be for you. So phase three. So this is the late menopause transition. So this is from when your menstrual cycle is more than 60 days long. OK, so this is where the menstrual cycle, this is where you’re skipping periods, really, because they’re becoming longer than 60 days. So this is when you might start to get other symptoms like hot flashes, again, night sweats, fatigue, all the symptoms pretty much. This is when you know you’re in the late menopause transition. You know, if you’re still having periods, but again, it’s longer than 60 days, you might still have a few heavy periods as well. And this phase can last around about, again, two to three years, roughly. And then we’ve got phase four. Phase four is late perimenopause: the 12 months after your final period. You’re in the waiting room to see whether your last period really was your last period. You know, you might suspect, you know, you might go past that 60 days and then it carries on 120 days and you’re suspecting that you’ve had your last period and you’re waiting 12 months to achieve menopause. Remember, menopause is a single-day event. So when you’ve hit 12 months of no periods, you’re menopausal. OK, that is when you’re menopausal. So this is where you actually have lower oestrogen. OK, so this is the point where you might have symptoms. You could have a few symptoms because we’ve got lower oestrogen. And it’s not as fluctuating as it was before. But you could have another period, which means that your symptoms might go up again. And the younger that you are, the more likely you are to have another period. OK, and then you’ll have to start counting all over again. Unfortunately, I’ve got a few friends, a few clients that have been through this. And, you know, they’re sitting there waiting at nine or 10 months. They’re thinking, “Yes, I’m nearly there. I’m nearly reaching menopause.” Then, just a few weeks before the 12-month mark, they have a period and think, “Oh, fuck’s sake, no.” Then they’ve got to go through this phase again and wait another 12 months to reach menopause. Menopause is reached when you’ve not had a period for 12 months. That’s when you are menopausal and begin the next stage of life. OK, it’s time to celebrate, you know, because chances are most symptoms should resolve around that time. It’s like the calm after the storm. Perimenopause is the storm. Menopause is your calm after the storm. So, again, most symptoms should resolve. This only applies to natural menopause. So I’m not talking about primary ovarian insufficiency or medical or surgical menopause. I’m talking about natural menopause. So you can see that perimenopause is a transition. And it takes you from regular menstrual cycles to menopause. So it’s like the opposite of puberty. It is a transition physically, psychologically, socially, spiritually. It is a transition and one that can take years.