What changes occur in the menstrual cycle during the menopause transition?

During the menopause transition, one of the most notable changes is that menstrual periods become fewer and further apart. This period, known as perimenopause, is characterized by hormonal fluctuations that can lead to changes in the regularity of the menstrual cycle. Initially, women may experience changes such as irregular cycles, longer or shorter cycle lengths, and changes in flow.

While the luteal phase may shorten and the follicular phase can also vary, the primary and observable change is the decrease in frequency of periods, which aligns with the process of the ovaries gradually reducing hormone production. As the body approaches menopause, ovulation becomes less frequent, leading ultimately to the cessation of menstruation altogether.

The indication that the follicular phase compresses, resulting in more premenstrual symptoms, does not accurately capture the typical experience during this transition. Instead, the variability and irregularity of the cycle, including both the shortening of the follicular phase and alterations in the luteal phase, often lead to fewer menstrual events over time. The key takeaway is that the menstrual cycle changes significantly during the menopause transition, primarily presenting as fewer and irregular periods.