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Many women only realize in hindsight that they are going through menopause, sometimes after years of symptoms they had not yet identified as such.
Cycles becoming longer, increasingly restless nights, irritability setting in for no apparent reason: these signs often appear several years before periods stop permanently.
What is commonly referred to as "menopause" is a natural biological transition in women, linked to age and the hormonal changes that come with it.
Menopause actually involves three distinct biological stages, which can span more than a decade.
Each stage has its own hormonal mechanisms, characteristic symptoms and specific health considerations. Identifying them is useful and important for choosing the right approach at the right time.
Understanding these stages is the first step toward adapting to them.
What is menopause and what are its 3 stages?
Menopause is the permanent and natural end of menstruation, mainly caused by a decline in the production of female hormones: estrogens.
This occurs as a result of the depletion of the ovarian follicular reserve, meaning the number of egg cells each woman is born with, which gradually decreases throughout her life.
Menopause is diagnosed retrospectively after twelve consecutive months without a period [1].
The transition toward this point never happens overnight. It follows a three-stage biological process that medical societies clearly distinguish [1].
Stage 1: Perimenopause
Perimenopause is the first stage of the menopausal transition.
It is also sometimes referred to as premenopause.
The ovaries continue to produce hormones, but irregularly. These erratic fluctuations in estrogen and progesterone trigger the first symptoms even before periods stop [2].
It begins on average between the ages of 40 and 50 and lasts four to five years, sometimes longer [2].
Stage 2: Menopause
Menopause is confirmed retrospectively after twelve consecutive months without menstruation [1].
This is when estrogen production stabilizes at a low level and symptoms often reach their greatest intensity:
- Hot flashes
- Night sweats
- Nervousness, anxiety
It occurs at around age 51 on average in Europe. It can occur before age 45, in which case it is referred to as early menopause. If it occurs before age 40, it is considered a medical condition known as premature ovarian insufficiency (POI) [1].
Stage 3: Postmenopause
Postmenopause refers to the entire period following confirmed menopause.
It can last for several decades.
Acute symptoms such as hot flashes tend to gradually subside. However, significant effects on bone health and cardiovascular health can develop silently, without immediate warning signs [3].
Other age-related physiological changes also occur:
- Reduced absorption of micronutrients
- Loss of muscle mass
- Increased abdominal fat storage.
Key takeaway: The menopausal transition lasts an average of ten to fifteen years, from perimenopause to established postmenopause. Identifying your current stage can help you choose the right approach at the right time.
Perimenopause: symptoms, duration and first solutions
Perimenopause is often the least easily identified stage.
Its symptoms can resemble those caused by other factors such as overwork, stress or temporary depression.
In this case, however, they have a specific hormonal origin, and recognizing them makes it possible to adopt an appropriate approach.
What are the symptoms of perimenopause?
Periods become less predictable. This is the first sign.
The ovaries begin producing estrogen irregularly. These hormonal peaks and drops destabilize the thermoregulatory center of the hypothalamus, the region of the brain that regulates body temperature. This is what causes the first hot flashes and night sweats, even before periods stop [4].
Inserm reports that 87% of menopausal women experience at least one bothersome symptom during this transition. Between 20% and 25% experience symptoms that significantly affect their quality of life [3].
Psychological symptoms also have a specific neurobiological basis.
Estradiol, the main form of estrogen, directly modulates the brain's serotonergic and dopaminergic pathways, which regulate mood and cognition [5]. Fluctuations in estradiol disrupt these systems even before levels remain consistently low.
Common symptoms at this stage include:
- Sleep disturbances (difficulty falling asleep, nighttime awakenings)
- Irritability, anxiety, mood swings
- Brain fog, difficulty concentrating
- Decreased libido
- Early signs of vaginal dryness
Expert opinion: Perimenopause symptoms are often dismissed or attributed to another cause, delaying appropriate care. A simple hormone test measuring FSH and estradiol can help confirm entry into this stage when the first doubts arise.
How long does perimenopause last?
Perimenopause is a long and highly variable stage that can last from two to 10 years!
Its duration is influenced by several biological factors. Smoking is associated with earlier menopause because it affects ovarian function. It can bring the process forward by one to two years.
However, the main reason for individual differences is genetic and therefore innate [6].
Around 50% of women enter menopause at the same age as their mother [6].
Science fact: The French parliamentary report on menopause, submitted in April 2025 by MP Stéphanie Rist, estimates that 17.2 million women aged 45 and over are affected by this transition, with 500,000 additional women entering menopause each year [7].
Menopause: the central stage
Menopause itself is often experienced as a significant milestone.
It can be gradual when perimenopause has been long, or more abrupt when the hormonal transition occurs quickly.
In all cases, this is the stage when estrogen deficiency is most pronounced and when symptoms generally reach their greatest intensity.
What are the symptoms of menopause?
Hot flashes become more intense. They are the most characteristic symptom of menopause.
The sustained decline in estradiol disinhibits KNDy neurons (kisspeptin, neurokinin B, dynorphin) in the hypothalamus. These neurons, normally regulated by estrogen, trigger sudden cutaneous vasodilation perceived as an intense wave of heat, followed by sweating and chills [4].
Hot flashes affect 60% to 80% of women during menopause. They can persist for an average of six to seven years, and sometimes for up to ten years [9].
Sleep disturbances worsen. Progesterone, whose natural sedative properties act through GABA-A receptors in the brain, has almost entirely disappeared at this stage. The brain therefore loses important support for falling asleep and maintaining deep sleep quality [1].
Vaginal dryness and urinary symptoms develop. Prolonged estradiol deficiency causes atrophy of the vaginal and urethral tissues, which become thinner, more fragile and lose tone. This is known as genitourinary syndrome of menopause (GSM). Unlike hot flashes, these symptoms worsen over time if left untreated [1].
Key takeaway: Menopause symptoms are not limited to hot flashes. Sleep disturbances, genitourinary syndrome and psychological symptoms are all part of the same clinical picture and are linked to the same estradiol deficiency.
How long does menopause last?
Technically, menopause is a specific point in time, confirmed after twelve months without a period. However, the symptoms associated with it can persist much longer.
Estradiol deficiency progressively disrupts several physiological systems at the same time. This process does not stop at a specific point. It gradually stabilizes over several years.
Menopause symptoms last an average of six to seven years after periods stop. In some women, they can persist for up to ten years [9].
Postmenopause: a new long-term physiological state
Postmenopause is the long-term physiological state of the body after menopause and continues for the rest of a woman's life.
Postmenopausal symptoms include those associated with aging, with specific effects in women influenced by low estrogen levels.
What are the characteristic changes during postmenopause?
The characteristic effects of aging shared by both women and men are, of course, also present:
- Reduced absorption of micronutrients
- Loss of muscle mass
- Loss of bone density, etc.
They require ongoing attention to support healthy longevity, but some changes are more specifically related to low estrogen production. The main ones include:
Genitourinary syndrome of menopause continues to progress. Prolonged estradiol deficiency maintains atrophy of the vaginal and urethral tissues. This process is cumulative and irreversible without treatment [1].
Cognitive symptoms may persist or become more pronounced. Estrogen deficiency affects the function of hippocampal neurons involved in memory and reasoning.
Abdominal fat storage: declining estrogen levels alter fat metabolism and shift fat storage toward the abdomen (as in men!).
Expert opinion: Postmenopause is the stage when prevention becomes particularly important for preserving healthy longevity. An annual check-up including bone density testing, a lipid profile and blood pressure measurement is the minimum needed to anticipate silent risks.
How long does postmenopause last?
Postmenopause does not end. It refers to the entire period of life after confirmed menopause.
For a woman who enters menopause at age 51 and lives to age 85, this represents more than thirty years with stable but low estrogen levels.
How can you identify the stages of menopause?
Identifying your stage of menopause is not always easy. There is no single, foolproof sign. However, biological and clinical indicators can help determine which stage you are in.
During perimenopause, your menstrual cycles change before stopping completely. Vasomotor symptoms (hot flashes) or psychological symptoms may appear while you are still having periods, even if they are irregular.
A medical consultation can include hormone blood tests measuring FSH and estradiol to help guide the diagnosis. High FSH combined with low estradiol indicates that the transition is underway [6].
Menopause is confirmed after twelve consecutive months without a period. Before this point, you are technically still in perimenopause, even if your symptoms are intense.
Postmenopause begins automatically after this first full year without menstruation. Bone and cardiovascular health then become key priorities.
One important practical point: during perimenopause, pregnancy is still possible until your periods have been completely absent for twelve consecutive months [2].
Appropriate contraception therefore remains necessary if you wish to avoid pregnancy, even if you are experiencing significant menopausal symptoms.
→ Read our article: Menopause — symptoms, causes and hormone-free solutions
What you need to know about the 3 stages of menopause
Menopause is not a single event. It is a gradual, natural and inevitable biological process linked to age and hormonal changes.
It begins before periods stop and continues throughout the rest of life.
Understanding its three stages helps explain why the same symptoms can occur at different times, with different levels of intensity, and require different approaches.
This can help you choose the right approach at the right time.
For the first two stages, perimenopause and menopause, at Argalys we have formulated a Menopause supplement specifically designed to support you through this transition.
Without phytohormones or direct hormonal effects, our formula combines Activ'Inside® saffron, L-theanine, magnesium bisglycinate, fenugreek and vitamins B6, B12, D3 and E. It simultaneously targets hot flashes, sleep disturbances, nervous system balance and bone health.
References
[1] MSD Manuals Professional. Menopause. Revised July 2023, modified January 2024. doi:10.1097/GME.0000000000002187
[2] Ameli.fr / Assurance Maladie. Périménopause (préménopause) : symptômes et contraception. Updated 2025. Sources: GEMVI 2025; CNGOF/GEMVi, Gynécologie Obstétrique Fertilité et Sénologie. 2021;49(5):305-499.
[3] Fondation pour la Recherche Médicale (FRM). Ménopause : quel impact sur votre santé à long terme ? Source: GEMVi; Inserm. Available at: frm.org
[4] Rance NE, et al. Neurokinin B signalling and the regulation of body temperature. Prog Brain Res. 2010;182:301-17.
[5] Davezac M et al. The different natural estrogens promote endothelial healing through distinct cell targets. JCI Insight. 2023;8:e161284. doi:10.1172/jci.insight.161284
[6] Medecindirect.fr. Préménopause : signes, symptômes et gestion de cette transition hormonale. Updated April 2026.
[7] Mission parlementaire sur la ménopause. La ménopause en France : 25 propositions pour enfin trouver le chemin de l'action. Report submitted on April 9, 2025 by MP Stéphanie Rist.
[8] CNGOF et GEMVi. Les Femmes Ménopausées : Recommandations pour la Pratique Clinique. Gynécologie Obstétrique Fertilité et Sénologie. 2021;49(5):305-499. Updated 2024: Anti-Age Magazine, February 2026.
[9] Study of Women's Health Across the Nation (SWAN). Longitudinal study conducted since 1994, U.S. universities.
[10] EPI-PHARE (GIS ANSM-Cnam). Étude sur l'utilisation du traitement hormonal de la ménopause (THM) en France entre 2012 et 2025. Assurance Maladie, 2026. Available at: assurance-maladie.ameli.fr
[11] VIDAL. Recommandations ménopause. Updated April 2026. Available at: vidal.fr
[12] MSD Manuals Professional, op. cit. [1]
[13] Inserm. Ménopause. Dossier d'information. Available at: inserm.fr
