What is perimenopause?

Perimenopause is the period, sometimes lasting several years, leading up to the time when a woman finally stops having menstrual periods. During this natural process, your body gradually changes as you near the end of your reproductive years in your 40s and 50s. Your menstrual cycle may become irregular, your levels of the hormone estrogen might go up and down, and you may experience hot flashes, vaginal dryness and other signs that you are approaching menopause. You are officially in menopause when you have not had a menstrual period for one full year.

Dr. Elissa M. Gretz-Friedman, MD
OBGYN (Obstetrician & Gynecologist)

Perimenopause is the 4 to 5 years prior to the final menstrual period. It is a time when your hormones begin to fluctuate. It is divided into the early and late perimenopausal transition. The early is when your hormones may just begin to change. The menses may be not exactly 28 days but you may notice that it is +/- 7 days, of not exactly regular. As the number of available eggs in the ovary decreases, your hormones need to work harder to try to get an egg to ovulate. So you may notice symptoms of increased estrogen. Those symptoms may be increased breast tenderness, increased bloating, maybe slightly heavier menses and possibly increased fibroid growth (if you have fibroids). In the late perimenopausal transition, the last year before your period stops, you may miss your period for months at a time. During this time, it is common to experience the symptoms of low estrogen. The most common symptom of low estrogen is the hot flash. Another common symptom is vaginal dryness. Menopause is official when you have gone one entire year with no menstrual period.

Dr. Mehmet Oz, MD
Cardiologist (Heart Specialist)

Perimenopause is a term many doctors use to describe the phase prior to reaching menopause. "Peri" means "about," so you can think of going through perimenopause as approaching full menopause, which is the point when a woman has not had a period for one year.

Perimenopause occurs as a woman's ovaries slow down and gradually stop functioning. Periods become irregular, fertility diminishes, and a woman may experience symptoms such as hot flashes and vaginal dryness during perimenopause.

Mrs. Marjorie Nolan Cohn
Nutrition & Dietetics Specialist

Often defined as two distinct phases, perimenopause, the transition toward menopause and menopause itself actually form part of a gradual and continuous hormonal and metabolic shift that occurs as a woman ages. Just as the hormonal shifts of adolescence are a normal part of life, perimenopause and menopause are also part of the cycle of every adult woman. The onset of perimenopause and eventually menopause itself signal great changes in your physical and emotional life. Though some women experience few symptoms, if you’re like the vast majority, you may have noticed the incremental shifts that come on for months and years before menopause sets in, this is perimenopause. These physical changes are often accompanied by psychological ones as you confront the realities of aging and try to deal with the mood shifts that often come along with hormonal change and hormonal imbalance.

Perimenopause is when the time between periods begins to lengthen. It's typically a one to two-year process.

It means "around the menopause." Perimenopause begins with a change in the length of time from the beginning of one period to the next. Usually it is seven days longer than the "normal" interval between your regular periods. Perimenopause ends 12 months after the last menstrual period.

Perimenopause is the time period leading up to menopause. Menopause is when a woman has gone one year without her period. Prior to that time, periods can become irregular and sometimes lighter or heavier. This is the time when many women will experience hot flashes, night sweats and moodiness. These symptoms are due to a decline in female hormones. The length of perimenopause is different for every woman, it can last anywhere from months to years.

Marcy Holmes, MSN, NP
Nursing Specialist

Perimenopause refers to the years before menopause; hormone fluctuations can occur anywhere from the 2 to 10 years before a woman stops having her period. If you are aged 35 to 55, and you are still having periods but something is different about them, you are probably in perimenopause. The first sign of perimenopause is often a change to your periods in some way: the time between periods, or the number of days your period lasts, or how much you menstruate—any or all of these could be altered.

Perimenopause is a decrease in ovarian function, associated with menopausal symptoms.

Dr. Marina Johnson

For most women, menopause doesn’t abruptly come out of the blue. There is an interim phase called perimenopause when the body begins its transition into menopause. Lasting anywhere from months to years, it signals that a woman’s reproductive years are drawing to a close. Estrogen levels fluctuate and progesterone progressively declines. This imbalance in both hormones triggers symptoms similar to menopause, although they tend to be milder. These include: hot flashes, mood changes, insomnia, depression, fatigue, acne, memory problems and sweats. A common symptom unique to perimenopause is heavy bleeding caused by the imbalance between estrogen and progesterone. Early treatment with progesterone, birth control pills or endometrial ablation can often avoid hysterectomies frequently seen in women in their forties.


For reasons unknown, your ovaries gradually begin to function less efficiently during your mid-to-late 30s. In your late 40s, the process accelerates along with greater hormone fluctuations. This affects ovulation and levels of the hormones estrogen and progesterone. During this transition period, called perimenopause, you may experience irregular menstrual cycles and unpredictable episodes of menstrual bleeding. By your early to mid-50s, your periods will likely end.

Most women can tell if they are approaching menopause because their menstrual periods start changing. The "menopause transition" is a term used to describe this time, as is perimenopause.

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Important: This content reflects information from various individuals and organizations and may offer alternative or opposing points of view. It should not be used for medical advice, diagnosis or treatment. As always, you should consult with your healthcare provider about your specific health needs.