Maybe it was simpler when menopause was called “the change” and no one talked about it above a stage whisper. But then again, maybe not! That was often an era of both embarrassment and ignorance. Today, many women are embracing the positive aspects that this new phase of life can bring even as they are talking frankly with each other and their doctors about how to manage its physical and emotional challenges.

So let’s get our terms right. Don’t be surprised if the words you’ve been using aren’t accurate—many health professionals get confused, too. When a woman starts to get hot flashes, for example, she might think, “I’ve started menopause!” Chances are, she hasn’t. What she has really started is perimenopause. Here’s the timeline…

Perimenopause: This begins when you first experience changes in your menstrual cycle. (The years before this, from puberty on, is sometimes called “premenopause”.) Also called the menopausal transition, perimenopause is triggered when levels of the hormones estrogen and progesterone begin to fluctuate unpredictably, often wildly. There’s no single way that women experience perimenopause, nor any specific length of time that it lasts. But during this time you may notice…

• Cycle changes. Periods become erratic—cycles are longer or shorter, or you skip months altogether.

• Hot flashes. A sudden onrush of heat in your upper body or all over. Your face and neck may flush or redden. (Check out this animation.)

• Sleep problems. Hot flashes can cause night sweats, or you may simply have trouble sleeping through the night.

• Sexual changes. Thanks to hormone fluctuations, you may find you’re less…or more!… interested in sex. Drier, thinner vaginal tissues lead to discomfort during intercourse.

• Mood shifts. Blame those hormones. You may feel crabby or weepy at times or find your mood shifts quickly without an obvious explanation.

Perimenopause ends when you’ve officially reached menopause.

Menopause: While perimenopause is hard to pin down precisely, menopause has an actual definition. It is the moment when you have not had a period at all for 12 consecutive months. Most women don’t know when they’ve reached menopause, though, because it takes a few months after the final period before you realize it was your final period. What’s happened now is that your ovaries slowed or stopped functioning to the point where you can no longer become pregnant. The average age for reaching menopause—remember, that’s a year after your final period—is 51, but again, it can happen earlier or later than that.

Postmenopause: The rest of your life! Although your periods will never return, for many women, symptoms such as hot flashes that began in perimenopause continue well into postmenopause. (These symptoms could be a tip-off to health issues.) Even when your symptoms subside, it’s important to take steps to protect your heart, your bones, your emotions, the quality of your sleep and your sex life.’s the story of menopause. Of course, there’s always more to the story. There’s early menopause, which occurs before age 45—and premature menopause, which happens before age 40, often due to a genetic predisposition or a medical condition. Finally, there’s surgical menopause, which can occur if you have both ovaries removed. To learn more, see Bottom Line’s Menopause Basics.

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