top of page

What stage of hormone transition are you in?

Updated: Apr 21, 2023

The 5 Stages of Hormone Transition

It’s true that when everything goes smoothly, we don’t necessarily want to think about menopause and it seems so far away. I would have liked to better understand all this earlier and not only learn to understand my body and manage my hormones from my mid thirties…

I feel like many women don’t know much about their body and hormones and I wanted to document for you the different stages of hormone transition a woman experiences throughout her life. This should help you better understand your symptoms and prepare for what’s to come, because as we say in German: "Wissen ist Macht!". Meaning that the more you know about your body and your symptoms, the better you can act to support your body and minimize your symptoms!

The 5 Stages of Hormone Transition in Women

Stage 1: Puberty (Age 8-18/20)

This is when a girl becomes a woman: the ovaries begin to produce estrogen and progesterone, which trigger the first period, breast growth and body hair.

Symptoms: mood swings, skin disorders, hormonal migraines, depression, anxiety, irregular periods

Stage 2: Premenopause (Age 18/20-35)

During the reproductive years, hormone levels are most stable and fluctuate over the menstrual cycle, with estrogen and progesterone rising and falling in response to ovulation.

These are the good times when women should not experience symptoms of hormone imbalance. They have a healthy sex drive, good energy, great skin, no trouble sleeping

Stage 3: Perimenopause (Age 35-50)

Stage 3 of hormone transition is called perimenopause and perimenopause itself actually goes through 2 phases.

The first phase can start as early as your mid-thirties and you might only notice very subtle changes in your cycle. The slowly falling progesterone levels can lead to increased PMS symptoms in the days before the period starts or during the period to mood swings, migraines, sleep disorders or increased menstrual cramps. The intensity and duration of your period can change, the same goes for the length of your menstrual cycle.

The second phase of perimenopause is when things get really nasty for most. It begins on average from the age of 47 and usually lasts about 3 years. In this phase you will feel the most physical changes, because now the estrogen levels are also falling more and more. The brain registers the falling hormone levels and tries all to stimulate the ovaries (that are about to retire) to produce hormones. This can be clearly seen in the blood from the FSH value (follicle stimulating hormone), which increases significantly towards the end of the second phase. This struggle between your brain and ovaries can often cause estrogen levels to rise really high, only to then rapidly fall again in the second half of the cycle (hello hormonal migraines!). This hormonal rollercoaster ride is what causes the typical menopausal symptoms: irregular periods with heavy & frequent bleeding and then absence of period for a couple of months, brain fog, mood swings, skin disorders, hormonal migraines, depression, anxiety, sleep issues, weight gain, hot flashes, night sweats, low libido.

In late perimenopause we are moving more and more towards menopause. In this phase, the intervals between menstrual bleeding become significantly longer, until menstruation ultimately stops altogether.

Stage 4: Menopause (Age 52)

You are in menopause when you’ve not had your period for 12 consecutive months. Your ovaries are done producing hormones. A small amount of sex hormones is still produced in your adrenal glands and fat tissue. It is said that 50 % of women have their last menstrual period at the age of 52. However, this is just an average age and it is different for every woman.

Symptoms: increased brain fog and memory issues while the brain gets used to lower levels of estrogen. Depression, high blood pressure, bone loss, sleep issues, weight gain, hormonal migraines due to low estrogen.

How severe your symptoms of menopause really are in the end also depends on your genetics, diet and lifestyle. You cannot change your genetics of course, but you can influence them for a more positive outcome. “Your gene loads the gun, but the enzyme pulls the trigger” and how your enzymes work is something you can influence with diet, lifestyle, stress management and working on your emotional state.

There are women who hardly suffer from any symptoms during menopause or others who only have very little symptoms. Unfortunately, that’s not the majority.

It is important that you pay particular attention to your body during this phase and support it so that it can get through the hormonal change as well as possible.

Menopause despite hysterectomy?

In most women who have had a hysterectomy, the ovaries remain intact and continue to produce hormones, such as estrogen and progesterone. Therefore, even if your uterus had to be removed, the typical menopausal symptoms can occur. In most cases, however, the age shifts somewhat and women without a uterus often enter menopause earlier.

In the case of a total hysterectomy (including the ovaries), menopause begins immediately after the operation – regardless of age. In this case, women often experience significantly more severe symptoms because the drop in hormones is very extreme.

Stage 5: Postmenopause

In the last phase of menopause, the sex hormones reach their lowest level. Due to the low hormone levels, many women in postmenopause have symptoms such as hot flashes, vaginal dryness, sleep disorders, depression, weight gain, incontinence or muscle and joint pain.

In this phase of life, your hormones first have to level off and stabilize again to a new normal state. Although some women are still struggling with symptoms in the final phase of menopause, most women are feeling much better once turbulent years of the hormone roller coaster ride are over.

Many women continue to experience symptoms though and also for your heart and bone health you may want to consider bioidentical hormone therapy. This will help ease symptoms, protect your heart and bones and also prevent vaginal atrophy or dryness which leads to chronic UTIs or incontinence.

Also, the underlying causes that triggered your symptoms in perimenopause and menopause will likely not have gone away if they haven’t been addressed:

  • Increased cortisol and insulin levels

  • Imbalanced microbiome

  • Impaired absorption due to low digestive function

  • Lack of nutrients and exercise

  • Exposure to toxins and pollution


In conclusion, how much you suffer during your hormone transition depends on your genetics, diet and lifestyle. Even if you have a genetic predisposition for hormone imbalance, you can influence how your genes express by adapting the right diet and lifestyle.


  • In general, you want to eat a nutrient-dense and whole foods diet with plenty of veggies, especially the brassica family and sulfur-rich veggies

  • Eat plenty of animal protein to make sure you keep your muscle mass, but also your hormones functioning well as long as possible

  • Eat plenty of cholesterol and Omega 3 fatty acids that are the base for your hormone production and managing inflammation levels

  • Drink plenty of water with added minerals

  • Improve your digestion and balance your microbiome to make sure you absorb your nutrients

Get my blood sugar and hormone balancing cookbook for more guidance on how to implement a hormone balancing diet.


Recent Posts

See All


bottom of page