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What’s perimenopause – and are you starting it? The signs to spot
Written byMedico Digital
Reviewed byDr Shazia Malik
You're sweating in bed, feeling foggy and... when did you last get your period? Could it be perimenopause? We'll help you understand the symptoms
Summary
1What's perimenopause?
Perimenopause is when your periods haven’t completely stopped, but they’re becoming less regular…
2When does perimenopause start?
While the average age for perimenopause to start is between 40 and 54, some women may experience it earlier or later…
3Signs and symptoms
From irregular periods to brain fog and trouble sleeping, let’s get into the specifics…
Have your periods become less regular? Are you finding it harder to concentrate or waking up in the night feeling hot and sweaty? You could be going through perimenopause.1
Let’s find out more about this stage of life, explore how it’s different from menopause, uncover the symptoms you might experience and discover how you can take care of your mind and body during this time.
What's perimenopause?
Perimenopause is when your periods haven’t completely stopped, but they’re becoming less regular.1,2
The word ‘perimenopause’ literally means ‘around menopause’ and is the natural transitional period leading up to your actual menopause when your ovaries eventually stop working, marking the end of your reproductive years. It’s easy to mix up with menopause, so let’s clear things up.1
Menopause is the time in a woman’s life when periods stop (permanently) as a result of the reduction and loss of ‘ovarian reproductive function’. You technically reach menopause when you’ve gone 12 months without a period, while perimenopause is the transition leading up to it – when your body is going through a whirlwind of changes.1
During perimenopause, your ovaries begin winding down and oestrogen levels decline as your body transitions toward no longer being able to reproduce.2 This shift can lead to some of the classic signs of perimenopause (more on this later).
Perimenopause can be divided into two stages: early and late.1,2 In early perimenopause, periods stay mostly regular with just a few interruptions.2 But as time goes on and you enter the late stage, your periods become more erratic until they eventually stop, marking the transition into menopause.2
Knowing you’re experiencing perimenopause can make a big difference in how you approach the changes in your body.3 This can help you accept what you’re going through and find ways to manage your symptoms.3
But at what age should you expect those first symptoms of perimenopause to appear?
When does perimenopause start and how long does it last?
Every woman is unique and so is the journey towards menopause.1,2 While the average age for perimenopause to start is between 40 and 54, some people may experience it earlier or later.1,4
So, what's the reason for this variation?
A whole host of things can affect when perimenopause begins. Some key factors that may increase your chances of entering this stage early include:4-6
- starting your period at an early age (younger than 11)
- having a low body mass index (BMI)
- smoking
- your mother experiencing early perimenopause
- never giving birth
- surgical removal of your ovaries
- some treatments if you suffer from cancer
- occasionally surgery for ovarian conditions can deplete your egg supply
While many factors that affect perimenopause are within your control, genetics are thought to influence the age at which menopause begins in around half of us.4
You may also be wondering how long perimenopause lasts. It usually spans five to 10 years, though one study found that perimenopause typically lasts about four years,7 while another estimated the average duration to be around seven years.1,2
When does perimenopause end?
Perimenopause officially ends when you haven’t had a period for 12 months – this marks the start of menopause.1 From that point on, you’re considered postmenopausal.1
Going more than 60 days in the last year without a period is one of the signs that perimenopause is nearing its end and that you’re in the late stage of this transition.1
Even after reaching menopause, some women continue to experience symptoms (although irregular periods are no longer one of them).1 So, what do these symptoms actually look like?
Common signs and symptoms of perimenopause
We’ve mentioned that menopause and perimenopause symptoms can be similar, but let’s get into the specifics.
Your body is gearing up for a big change.
As your hormones start to fluctuate during perimenopause, your periods might become a little more unpredictable.1,2 They might show up less often, last longer or shorter and vary in how heavy they are.1,2,8
In early perimenopause, your cycle length may only change slightly. But as you move into the later stage, gaps of 60 days or more between periods can become the new normal.1
Waking up at night soaked with sweat or experiencing sudden waves of heat spreading across your body? You’re not alone – around 60–80% of women experience night sweats and hot flushes during the menopausal transition.9
These are known as vasomotor symptoms (the technical term for night sweats and hot flushes), and they’re thought to be triggered by the drop in oestrogen, which affects your brain chemicals (called neurotransmitters).10
Shifts in mood are common throughout perimenopause, with many women experiencing increased anxiety or even depression.1 In fact, perimenopausal women are two to four times more likely to go through a serious episode of depression.1
But it’s not just mood that might feel off – some women also experience brain fog, often showing up as forgetfulness or trouble concentrating.11
Perimenopause can come with a whole host of other physical symptoms, including:1,2
- fatigue and poor sleep
- low libido (sex drive)
- vaginal dryness
- urinary incontinence
Some women also worry about the impact of perimenopause on their appearance, like weight gain, visible ageing and hair thinning.3
But here’s the good news: there are plenty of things you can do to support your body and mind throughout this transition.12-14
Lifestyle and wellness during perimenopause
While perimenopause symptoms won’t disappear overnight, a few lifestyle tweaks can make a difference in how you feel during this stage.12-14
Women who stay active may experience milder perimenopause symptoms than those who are less active.12 Sounds like a good reason to pencil in that yoga class or head out for a daily walk.
Exercising can also help manage weight gain, which can happen during this stage.12
A healthy, balanced diet can help support your body as you approach menopause.13
The Association of UK Dietitians recommends eating:13
- at least five portions of fruit and vegetables a day
- plenty of fibre-rich cereal foods like muesli, shredded wheat and bran flakes
- two daily servings of calcium-rich foods such as cheese, milk and green leafy vegetables
Avoiding processed foods, along with reducing sugar intake and white carbs can be very helpful in balancing hormones, sleep and general wellbeing. Reducing alcohol intake is also often very helpful in managing hot flushes, fatigue and weight fluctuations.13
Getting enough vitamin D and calcium is especially important, as they help counteract some of the bone loss that can happen when your oestrogen levels drop.2,13
Try to up your intake of heart-friendly foods like oily fish, plain nuts, peas and beans.13
Looking after your mental wellbeing can go a long way in easing perimenopause symptoms.14 Relaxing activities like meditation or yoga are one way to do this, but don’t be afraid to try a few things and see what works for you.14
This is often a transitional period in women’s lives for a whole host of reasons – so focusing on your external causes of stress and how to reduce them, as well as looking at ways of balancing your work and life can be enormously beneficial in how you experience the years leading up to and after the menopause.
If your perimenopause symptoms are affecting your daily life, it might be a good idea to talk to your GP.14 They’ll be able to advise you on the different ways you can manage your symptoms, including whether hormone replacement therapy (HRT) might be right for you.
The final say
Everyone experiences perimenopause differently. Whether your symptoms are barely noticeable or seriously disruptive, there are plenty of things you can do to feel more like yourself again.
And we’ve got plenty more info to browse, from navigating sleep troubles during menopause to our readers’ surprising upsides of perimenopause…
Disclaimer
This article provides informational advice and is not a substitute for medical care. Curated by experts for accuracy, we take great care to ensure the information is up-to-date and relevant. However, you should always consult your GP or healthcare professional before using supplements or alternative products, particularly if you have medical conditions or are under supervision.
1. Cunningham AC, et al. Perimenopause symptoms, severity, and healthcare seeking in women in the US. NPJ Womens Health. 2025;3(12):1–8. https://doi.org/10.1038/s44294-025-00061-3
2. McCarthy M, Raval AP. The peri-menopause in a woman’s life: A systemic inflammatory phase that enables later neurodegenerative disease. J Neuroinflammation. 2020;17(1):317. https://doi.org/10.1186/s12974-020-01998-9
3. Sakson-Obada O, Wycisk J. The body self and the frequency, intensity and acceptance of menopausal symptoms. Prz Menopauzalny. 2015;14(2):82–9. https://doi.org/10.5114/pm.2015.52150
4. Ceylan B, Özerdoğan N. Factors affecting age of onset of menopause and determination of quality of life in menopause. Turk J Obstet Gynecol. 2015;12(1):43–9. https://doi.org/10.4274/tjod.79836
5. Mishra GD, et al. Early menarche, nulliparity and the risk for premature and early natural menopause. Hum Reprod. 2017;32(3):679–86. https://doi.org/10.1093/humrep/dew350
6. Szegda KL, et al. Adult adiposity and risk of early menopause. Hum Reprod. 2017;32(12):2522–31. https://doi.org/10.1093/humrep/dex304
7. Delamater L, Santoro N. Management of the perimenopause. Clin Obstet Gynecol. 2018;61(3):419–32. https://doi.org/10.1097/GRF.0000000000000389
8. Dreisler E, et al. Perimenopausal abnormal uterine bleeding. Maturitas. 2024;184(8):107944. https://doi.org/10.1016/j.maturitas.2024.107944
9. Jaeger M de B, et al. Negative affect symptoms, anxiety sensitivity, and vasomotor symptoms during perimenopause. Braz J Psychiatr. 2021;43(3):277–84. https://doi.org/10.1590/1516-4446-2020-0871.
10. Lugo T, Tetrokalashvili M. Hot flashes. Treasure Island (FL): StatPearls Publishing; 2025. Available from: http://www.ncbi.nlm.nih.gov/books/NBK539827/
11. Maki PM, Jaff NG. Brain fog in menopause: A health-care professional’s guide for decision-making and counseling on cognition. Climacteric. 2022;25(6):570–8. https://doi.org/10.1080/13697137.2022.2122792
12. Dąbrowska-Galas M, et al. High physical activity level may reduce menopausal symptoms. Medicina (Kaunas). 2019;55(8):466. https://doi.org/10.3390/medicina55080466
13. BDA. Menopause and diet [Internet]. [cited 2025 Mar 28]. Available from: https://www.bda.uk.com/resource/menopause-diet.html
14. NHS. Menopause - Things you can do [Internet]. [cited 2025 Mar 28]. Available from: https://www.nhs.uk/conditions/menopause/things-you-can-do/
