Context/Objective: To identify menopause transition stages using acceleration or deceleration patterns of follicle stimulating hormone (FSH) rates of change from the late reproductive years to postmenopause.

Setting/Participants: Michigan Bone Health and Metabolism Study cohort of 629 women, aged 24–44 years (in 1992/3), with 5757 annual FSH data points over a 14-year period.

Design/Main Outcome Measures: Relate acceleration/deceleration patterns in FSH rate of change to time to final menstrual period (FMP) and chronological age using non-parametric and piecewise regression modeling.

Results: Four major FSH stages, based on rate of FSH change patterns, were identifiable in relation to the FMP. In FSH stage 1, the rate of FSH change increased modestly up to -7 years prior to the FMP; in FSH stage 2 (-7 to -2 years prior to FMP), there was a major acceleration in FSH rate of change. FSH stage 3 had an acute increase in FSH rate of change (-2 to +1 years around the FMP), with average FSH level of 34 mIU/ml. The fourth, or plateau, FSH stage began at 1 year post-FMP when the average FSH level was 54 mIU/ml. During the years 28–60 years, there were eight epochs defined by significant changes of FSH trajectory accelerations or decelerations and rate of change.

Conclusions: Four menopause transition stages bounding the FMP and eight epochs in chronological aging from age 28 to 60 years were defined by changes of FSH trajectory accelerations/decelerations and rates of change. This timing information, combined with knowledge of FSH levels and menstrual cycle characteristics, can help discern the likely status of women with respect to their reproductive viability and menopause transition stage.