Menopause Transition

The menopause transition is the stage of reproductive aging in which menstrual cycles become persistently more variable as ovarian function changes before the final menstrual period. In the STRAW+10 staging system, the transition is divided into early and late stages using characteristic changes in menstrual-cycle timing, with hormonal changes providing supportive rather than stand-alone criteria .¹

During this period, ovarian follicle activity becomes increasingly irregular and levels of hormones such as follicle-stimulating hormone and estradiol can fluctuate substantially. Ovulation may become less predictable, and symptoms associated with the transition can occur, but symptoms are not required to define the reproductive stage. The final menstrual period can only be identified retrospectively after sufficient time without menstruation .¹

The menopause transition is related to, but not identical with, perimenopause. In common clinical use, perimenopause often includes the menopause transition and an interval after the final menstrual period, whereas the formal transition stages end at that period. Menopause itself refers to the final menstrual period as a biological event, not the entire span of years during which reproductive aging occurs .¹