How Menopause Begins and What’s Really Happening in Your Body

Menopause isn’t a sudden switch, it’s a gradual transition that unfolds over several years as the body prepares to leave its reproductive phase behind.

Understanding how menopause starts and what changes occur can help you recognise the early signs and navigate the transition with confidence

A Slow Shift, Not an On/Off Switch

Most women enter menopause between their mid-40s and mid-50s, but the process begins much earlier.

The earliest phase, often called perimenopause or the menopause transition, can start a decade before periods finally stop. During this time, the ovaries gradually produce less oestrogen and progesterone, the hormones that regulate the menstrual cycle and influence many body systems.

At first, hormone levels fluctuate, sometimes widely, before settling into a sustained decline.

This means your cycle may become irregular: periods may be lighter, heavier, closer together or further apart, and ovulation may occur less often.

Hormones and the Body’s Response

As ovarian hormone production falls:

• Oestrogen drops, this affects the hypothalamus (your body’s temperature and sleep regulator), skin elasticity, bone density and mood. 

• Progesterone falls even earlier in the transition, which can lead to irregular bleeding and contribute to sleep or mood changes.

These hormonal shifts explain why menopause symptoms often begin before periods finally stop, sometimes years earlier.

What Happens in the Body

As the transition progresses, many systems feel the effects of changing hormones:

• Temperature & sleep:

Oestrogen helps regulate the hypothalamus, so its decline can trigger hot flushes, night sweats and disrupted sleep.

• Skin, collagen & joints:

Lower hormone levels reduce collagen and elasticity, leading to drier skin, stiffer joints and slower tissue repair.

• Vaginal and urinary tissues:

Oestrogen keeps mucous membranes healthy. Its decline can cause dryness, irritation, discomfort and increased risk of infections.

• Bones & metabolism:

Oestrogen supports bone strength and body composition. Reduced levels can lead to bone loss and changes in how the body stores and uses energy.

When Menopause Actually Begins

Menopause itself is officially reached after 12 consecutive months without a menstrual period. But the transition, often filled with symptoms, starts earlier and can last several years.

Why Awareness Matters

Recognising the early signs helps you separate normal age-related changes from menopause changes.

It also makes it easier to talk with healthcare professionals about symptom support, lifestyle adjustments or treatments that may help you feel your best through the transition. 

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If you would like to read the results of our Menopause at Work study, click here  MenoSupport Suisse 2025 Study. 

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