The Stages of Reproductive Aging Workshop (STRAW)

Although the menopause transition is primarily thought of as a normal physiological transition, it is a time that encompasses the period of time when women are experiencing changes in the menstrual cycle reflective of endocrine changes. The physiologic processes can be difficult for providers to describe. In 2001, the Stages of Reproductive Aging Workshop (STRAW) developed a standardized approach to menopause terminology.

Please discuss the STRAW and the STRAW +10 definitions and why it is important for providers to have common language when communicating about the stages of menopause.

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The menopause transition is a significant physiological event that affects women during the later stages of their reproductive lives. It is important for medical providers to have a standardized approach to menopause terminology to communicate effectively with their patients. In this answer, we will discuss the STRAW and STRAW +10 definitions and why it is crucial for medical providers to have a common language when communicating about the stages of menopause.


The Stages of Reproductive Aging Workshop (STRAW) developed a standardized approach to menopause terminology, which was created to improve communication between providers regarding the stages of menopause. The STRAW defines the reproductive aging stages in a standard and consistent manner, consisting of three stages. The first stage is defined as the early menopausal transition, which occurs when a woman experiences irregular menstrual cycles. The second stage is the late menopausal transition, which is characterized by an extended period of time with no menstrual cycles. The third stage is post-menopause, which is defined after 12 consecutive months of no menstrual cycles (Santen & Allred, 2016).

In 2012, the STRAW +10 definitions were developed, which provided additional information on the early menopausal transition. It was found that women’s experiences during this stage can vary significantly, and additional criteria were added to the original definition. The updated definition includes menstrual changes, hormonal changes, and physical symptoms such as hot flashes, night sweats, cognitive changes, and vaginal dryness.

It is essential for providers to have a common language when communicating about the stages of menopause because it ensures that they are all providing consistent and accurate information to their patients. With a standardized approach, providers can efficiently communicate with one another and provide a more integrated approach to medical care. Patients can also benefit from a consistent language as they are more likely to understand the changes they are experiencing and better able to manage their health during this transition.


Santen, R. J., & Allred, D. C. (2016). Menopause terminology: The Kronos Early Estrogen Prevention Study (KEEPS) experience. Maturitas, 91, 22-25.

Stages of Reproductive Aging Workshop (STRAW) +10. (2012). Proceedings of the 2010 Stages of Reproductive Aging Workshop + 10: addressing the unfinished agenda of staging reproductive aging. Menopause, 19(4), 387–395.

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