Medically reviewed in March 2022
Between mood swings and weight fluctuations, perimenopausal symptoms can make you feel like a teenager again—and not necessarily in a good way. Hormonal changes on the often-long road to menopause may be causing changes in the way you feel and in the way your body behaves. Here is everything you need to know about this very normal stage called perimenopause.
Menopause versus perimenopause
Contrary to popular belief, menopause is not that time of your life when your menstrual cycle slows down and your periods begin to dwindle. The true definition of menopause is the point when you've gone 12 consecutive months without your period. The hormone-based transition leading up to menopause is called perimenopause. For some women, it can last a few months, and for others, it can continue for 13 years, explains Margery Gass, MD, executive director of the North American Menopause Society.
Perimenopause can begin in your 30s
For some women, perimenopause may strike sooner than you think. "Despite the fact that we consider the normal range of menopause to be age 41 to 55, perimenopause can start in a woman's early 30s—and it's normal! A lot of women are caught off-guard by that," Gass says.
Unfortunately, there's no test or crystal ball that can tell you when or if you're approaching perimenopause, says Judith Volkar, physician at the Cleveland Clinic Center for Specialized Women's Health. The most predictive factor of perimenopause is the age your mom was when she went through the change.
Some research suggests women who smoke are likely to hit menopause sooner. One study found that women who smoked heavily over a long period of time had nearly double the risk of early menopause compared to other women. However, quitting smoking more than 10 years before menopause helped extinguish that risk.
Signs of perimenopause
According to Gass, the first sign of perimenopause is menstrual cycle irregularity—marked by periods that can show up an entire week early or late. As you progress into late perimenopause, your menstrual cycles become longer, and you may go as long as 60 days without a period. "It's during this time that women will start to have some symptoms, such as hot flashes, but only during that time of the month," Volkar says.
In addition to hot flashes, you may be bothered by other perimenopausal symptoms, like fatigue, irritability or weight gain. The biggest perimenopause complaint Volkar hears is emotional instability. "When you have a sullen teenager, you say, 'Oh, it's their hormones.' Well, you have a lot of that same feeling when you're perimenopausal, because you can have such wild hormonal fluctuations from day to day," she explains. The result can be that you get weepy or angry over things that wouldn't normally bother you.
Can I get pregnant during perimenopause?
Many women wonder if they can get pregnant once signs of perimenopause begin. The answer is yes. It's possible to get pregnant as long as you're still menstruating. "It's not that common," Volkar says, "but it can happen."
