Enter your email to get updates, tips and exercises to help you experience healing and transformation.

Stages of Menopause: Physical, Spiritual and Psychological Changes

The stages of menopause are full of opportunity for growth and change.  There are three stages of menopause.  Perimenopause (sometimes called premenopause) is the time leading up to menopause, usually from 2 to 10 years.  Menopause itself is a one-day event, even though the word is used to describe the process including perimenopause and the few years immediately after menopause.  You won't know you've reached menopause until after the event, exactly one year after your last period.  Post-menopause lasts the rest of your life.

Peri Menopause

Perimenopause is the time leading up to menopause when your hormones start to change.  This stage often catches women by surprise.  They start having symptoms and they may not realize they are in perimenopause.  This is what happened to me.  I started having migraines for the first time.  I would cry over nothing, but I thought it was related to grief from leaving my marriage.  As it turns out, leaving a marriage also tends to happen more in perimenopause!

I certainly had not given a single thought to the idea of menopause, for myself or anyone else. When I first started having symptoms, my son was only seven years old, and I was focused on being a mother.  

In America, and other countries as well, there is a fairly negative context for menopause.   You grew up to be a mother, and now you can no longer conceive, and you're losing all your feminine hormones, so you don't have much to look forward to unless you add back the estrogen you have lost, is pretty much the story from the medical (male-oriented) perspective.

The truth is that some hormones are decreasing, but others are INCREASING.  Leutinizing Hormone and Follicle-Stimulating Hormone increase during perimenopause and remain high from that point on. We don't really know the reason for that, but it's probably NOT a mistake.

Here are some of the positive changes that occur at perimenopause, from Joan Borysenko, Ph.D. (1996).  

  • an increase in the vividness of dreams
  • an increase in deja vu experiences
  • increased recognition of synchronicities
  • stronger intuition

Passive women grow more assertive as they begin to develop their masculine side.  There may be an increase in sexual desire, as well as increased energy.

Borysenko states, “Herbalist Susun Weed makes the point that all over the world men are sitting in prayer and meditation trying to reach the intuitive state of interdependence that menopausal women are in naturally.”

Many traditional societies appreciate and honor menopausal women for their intuition and wisdom, including Native American, Middle Eastern, Aboriginal and European cultures.

It's amazing to me that I am just now hearing about this, because I only heard about the negative physical symptoms of perimenopause when I started researching it.  Now that I see these positive aspects, I remember that I had many of those positive experiences, but did not know it was associated with perimenopause.

Also from Borysenko, issues that tend to come up now include a sharper focus on the quality of your marriage, if you have one, as children are growing up and moving away, leaving you alone with your partner. The meaning of work also becomes more important, as women begin to get tired of corporate values, especially the competitive nature of the workplace.  And, many women are tired of care-taking, especially those who feel that they have given so much and gotten so little in return.  They want to begin developing their own interests for a change.

These issues often come up during perimenopause, but may last through all the stages of menopause, depending on your individual situation.

Physical issues at perimenopause

Physical symptoms during this time may include headaches or migraines, insomnia, intense emotions, fatigue, changes in menstrual cycles, anxiety, panic attacks, bloating, gas, indigestion, and weight gain.

You may also have episodes of dizziness, hot flashes, night sweats, irritability, changes in sexual desire, dry eyes and dry vagina, memory loss, inability to concentrate, itchy skin, incontinence, sore or aching joints, and changes in body odor, or high blood pressure.  

Or you may have a symptom not mentioned here.  You may sail through the stages of menopause with only one or two mild symptoms.  Or you may be one of the lucky ones, like me, and have darn near every one of these before you're through.

Other health problems that may arise during this time include fibroids, hypothyroidism, and fibromyalgia.  And if you are overweight: metabolic syndrome, Type II diabetes, heart disease, and cancer could be just around the corner.  Concerns about osteoporosis or other diseases of aging also become prevalent now.  

I think that this is when we can first see the end of life, at least that's how it was for me.  It suddenly became clear that certain dreams I had were not going to come true, that it was becoming true in my body that I could no longer do the things I used to, and it was kind of a shock.  

I remember going to a yoga class at my gym one day, and trying to do some of the poses that I had always accomplished easily before, and all of a sudden I couldn't do them anymore.  How did that happen?  And when?


Menopause, as I said, is a one-day event.  Not much to talk about there.


You may have all of the same symptoms mentioned above in perimenopause, or you may not.  I did not have hot flashes until right before menopause.  My periods came like clockwork, every 28 days, until they stopped for four months, then I had one, then went another six months and had my last one.  

It was when my periods first stopped that my flashes came – and boy, did they come.  I would be shaking afterward, they were so intense.  My bloating remained, but insomnia got better.  I had no more panic attacks or episodes of dizziness, but my periodic anxiety remained.  And weight gain happened after menopause for me, along with my blood pressure going through the roof.

So there you have it.  This can be a time of frustration and discomfort, to say the least.  But even though you may find your journey difficult, as I have, I hope that you also benefit from it.  I had never had such poor health, and so I took the opportunity to implement some changes in my diet and exercise habits that I had been meaning to get around to for quite some time.  

And after I left my marriage and ended up in a low-paying, stressful job because I had been out of the workforce raising my son, I decided to go back to school.  I am just about to graduate with my Bachelor of Arts in Business Communication, and am looking forward to getting a master's degree.  I remember asking a couple of my friends before I started back to school if maybe I was too old.  It seems funny now.  I am very optimistic about my future and hope I live a long time so that I can finish all the things I still want to do.

May you make the most of your Change, as well.


Borysenko, J., (1996).  A woman's book of life. New York, N.Y: Riverhead Books.

Weed, S. (2002).  New menopausal years. Woodstock, N.Y: Ashtree Publishing.

> > Stages of Menopause