Menopause, Perimenopause and Post-Menopause: What Actually Changes?
One of the most confusing things about menopause is the language around it.
Many women are told they are “in menopause”, “through menopause”, or “post-menopause” … often without anyone explaining what that actually means for their body or their health.
And when symptoms continue after periods stop, it can leave women wondering: Shouldn’t I be past this by now?
The truth is that menopause isn’t a single event. It’s a long transition, and each stage comes with different physiological changes and different support needs.
Understanding this can be incredibly reassuring… especially if you’re post-menopause and still don’t feel quite like yourself.
The three stages of menopause (in plain English)
Perimenopause
Perimenopause is the stage leading up to your final period. It can last several years and often begins in your 40s… sometimes earlier.
During this time:
oestrogen and progesterone fluctuate unpredictably
periods may change in length, flow or regularity
symptoms such as anxiety, low mood, poor sleep, brain fog and fatigue often appear
This is the stage many women associate most strongly with “menopause symptoms”, but it’s only part of the picture.
Menopause
Menopause itself is a single point in time defined as 12 months after your last period.
It’s not a long phase, and it doesn’t describe how you feel… it simply marks the end of reproductive cycles.
This is where a lot of confusion comes from.
Women are often told:
“You’re menopausal now so things should settle.”
But what actually follows is post-menopause.
Post-menopause
Post-menopause refers to the years… often decades… after menopause.
Hormones don’t “return to normal”.
They settle at a new, lower baseline, and that shift affects the whole body.
Post-menopause changes can influence:
energy levels
muscle mass and metabolism
bone health
blood sugar balance
sleep quality
stress tolerance
mood and confidence
So if you’re post-menopause and still experiencing symptoms, this doesn’t mean something has gone wrong… it means your body is adapting to a different hormonal environment.
Why symptoms can continue (or appear) after menopause
Many women expect symptoms to fade once periods stop. For some they do… but for many others, new challenges show up or existing ones linger.
This often happens because:
oestrogen plays a role in energy production, muscle maintenance and stress regulation
when oestrogen and progesterone drop they impact on the cycles of other hormones
lower hormone levels change how the body responds to food, exercise and stress
long-term stress, undereating or over-exercise can become harder to tolerate
This is why advice that focuses only on “balancing hormones” often falls short after menopause.
Post-menopause support needs to be broader, steadier and more personalised.
Why what used to work may no longer help
A common frustration I hear is:
“I’m doing all the right things… but my body isn’t responding anymore.”
After menopause, the body often needs:
more consistent nourishment rather than restriction
better blood sugar stability rather than skipped meals
gentler, supportive movement rather than pushing harder
intentional stress support rather than just coping
This isn’t about willpower… It’s about physiology.
Post-menopause health isn’t about going back, it’s about learning how to move forward in a body that has changed.
Why understanding the stages actually helps
When women understand where they are on the menopause journey, a few important things happen:
self-blame starts to ease
symptoms make more sense
health choices become calmer and more intentional
support feels justified rather than indulgent
Many of the women I work with are post-menopause and say:
“I wish I’d known this sooner.”
This understanding is often the turning point.
A gentle reminder
Menopause isn’t something you pass through and leave behind.
It’s a transition that reshapes your body and post-menopause is a stage that still deserves care, nourishment and support.
If you’re still navigating changes, you’re not behind.
You’re simply in a phase that isn’t talked about enough.
This can be the most exciting chapter of you life if you embrace the changes.
Lesley xx