Perimenopause

“Perimenopause usually happens sometime in your 40s.
On average, it lasts 4 to 6 years,
but it can last from one to 10 years”.1

Umbrella

What may the Perimenopause Umbrella include?

Depending on the Source (DotS) this Umbrella may include:

  • Climacteric
  • Late Reproductive Stage (LRS)
  • Menopausal Transition/Transitional Phase
  • Menopause Transition/Transitional Phase
  • Perimenopausal/Peri-menopausal Changes
  • Perimenopause/Peri-menopause
  • The Transition To Menopause
  • Time Leading Up To Menopause

Definition

What is perimenopause?

DotS the definition of perimenopause may vary.

In Menopause: Key Facts the World Health Organization’s definition is:

  • “The menopausal transition can be gradual, usually beginning with changes in the menstrual cycle. Perimenopause refers to the period from when these signs are first observed and ends one year after the final menstrual period”.2

On page four in Menopause Terminology: Glossary of Terms [English] the International Menopause Society’s definition is:

“Perimenopause – the time before; around and just after the actual moment of menopause”.3

In The 2023 Practitioner’s Toolkit for Managing Menopause: Definitions, published online 30 October 2023, the authors’ definition is:

  • “Perimenopause is the time from the onset of cycle irregularity through until 12 months after the final menstrual period”.4

Start

When may perimenopause start?

In Perimenopause: Symptoms & Causes – Overview the (United States) Mayo Clinic elaborate on:

“Women start perimenopause at different ages. You may notice signs of progression toward menopause, such as menstrual irregularity, sometime in your 40s. But some women notice changes as early as their mid-30s”.5

In What Is Menopause? Perimenopause, Menopause and Postmenopause – When Does Perimenopause Happen? the (Australian) Jean Hailes for Women’s Health (JH) also note:

“Perimenopause usually happens sometime in your 40s. On average, it lasts 4 to 6 years, but it can last from one to 10 years”.6

Duration

How long can perimenopause last?

In What Is Menopause? What Is Perimenopause (the Menopausal Transition)? the Australasian Menopause Society elaborate on:

“Some women can experience menopausal symptoms for 5-10 years before their final menstrual period. Age at which a woman’s menopausal symptoms will start or how long they will last, is not able to be predicted”.7

Menopause

When does perimenopause stop and menopause officially start?

In Perimenopause: Symptoms & Causes – Overview the Mayo Clinic explain:

“Once you’ve gone through 12 consecutive months without a menstrual period, you’ve officially reached menopause, and the perimenopause period is over”.8

First Sign

What is usually the first sign of perimenopause?

In Menopause: Symptoms – Common Symptoms of Menopause and Perimenopause: Changes To Your Periods the (United Kingdom) NHS explain:

“The first sign of the perimenopause is usually, but not always, a change in the normal pattern of your periods, for example they become irregular.

Eventually you’ll stop having periods altogether”.9

Physical Symptoms

What may some physical symptoms include?

In Symptoms of Menopause: Physical Symptoms of Menopause the JH explain:

“Physical symptoms may include:

  • Irregular periods
  • Hot flushes
  • Night sweats
  • Joint aches and pains
  • Sore breasts
  • Itchy, crawly or dry skin
  • Exhaustion and fatigue
  • Dry vagina

They may also include:

  • Loss of sex drive (libido)
  • Headache or migraine
  • More intense premenstrual syndrome (PMS)
  • Sleep problems
  • Bloating
  • Urinary problems
  • Weight gain”.10

Emotional Symptoms

What may some emotional symptoms include?

In Symptoms of Menopause: Physical Symptoms of Menopause — Mental and Emotional Symptoms the JH explain:

“Mental and emotional symptoms of menopause may include:

  • Feeling irritable or frustrated
  • Feeling anxious
  • Difficulty concentrating
  • Brain fog
  • Forgetfulness
  • Lowered mood
  • Mood swings
  • Feeling you can’t cope as well as you used to”.11

Common or Not

How common are menopausal symptoms?

On page one in Joint Position Statement By the British Menopause Society, Royal College of Obstetricians and Gynaecologists and Society for Endocrinology on Best Practice Recommendations for the Care of Women Experiencing the Menopause one of the recommendations is:

“The menopause transition can have a significant impact on many women, with more than 75% experiencing menopausal symptoms and a quarter describing their symptoms as severe. A third experience long-term symptoms, which may last as much as 7 years or longer”.12

Hormone Therapy

Can hormone therapy help improve symptoms of menopause?

In Mayo Clinic Q and A: Perimenopause Transitions and Concerns, dated 20 July 2023, the Mayo Clinic note:

“Although it is often a source of concern, hormone therapy also can help improve symptoms of menopause. Estrogen therapy is still the most effective treatment option for relieving hot flashes. Estrogen also helps prevent bone loss. There are also nonhormonal options. It is important to talk to your healthcare team about the risks and benefits of each treatment, and which one is right for you”.13

Health Care Provider

What if I would like help with perimenopause?

If you would like help with perimenopause, it may be in your best interest to choose to talk to your health care provider about this.

In What Is Menopause? When To See Your Doctor the JH explain:

“Talk to your doctor if you are worried about:

  • Irregular periods
  • Heavy bleeding
  • Bleeding after menopause
  • Increased premenstrual syndrome (PMS) symptoms
  • Menopausal symptoms, such as hot flushes, that interfere with your daily life”.14

In Menopause: Diagnosis & Treatment – Treatment the Mayo Clinic elaborate on:

“Before deciding on any form of treatment, talk with your healthcare professional about your choices and the risks and benefits of each. Review your choices yearly. Your needs and the treatment choices may change”.15

Health Topics A-Z

Where may I find Health Topics A-Z related to Perimenopause?

In Health Topics A-Z you may find:

Health Topics A-Z

Links

Where may I find Links related to Perimenopause?

Your Country may have Links similar to:

Perimenopause

Links

This Links List to third party websites is neither comprehensive nor exhaustive. Inclusion on this Links List does not imply endorsement or recommendation. Non-inclusion on this Links List does not imply non-endorsement or non-recommendation. Third party websites are not under the control of Meno Martha International Menopause Directory. Third party websites may contain explicit medical images and/or sexual references. Please read Meno Martha International Menopause Directory’s Links Policy before proceeding to a Link. Please contact Webmaster if you experience a problem with a Link.

New or Updated

  1. 29 Perimenopause Symptoms You May Not Know About
  2. 5 Things You Didn’t Realise You Need To Know About Perimenopause
  3. 8 Common Health Conditions Midlife Women Face
  4. 9 Less Common Perimenopause Symptoms and How To Manage Them
  5. ACOG Explains: Managing Menopause Symptoms [American College of Obstetricians and Gynecologists]
  6. CAMS Menopause Hour: Perimenopause – A Clinical Challenge
  7. Consumer Video and Podcast Series: 2024 Consumer Videos and Podcasts – Cognitive Behavioral Therapy and Menopause
  8. Consumer Video and Podcast Series: 2024 Consumer Videos and Podcasts – Preparing for Your Menopause Health Care Visit
  9. Consumer Video and Podcast Series: 2025 Consumer Videos and Podcasts – Nutrition At Menopause and Why It Is Important
  10. Consumer Video and Podcast Series: 2025 Consumer Videos and Podcasts – Three Symptoms Linked to Cognitive Complaints
  11. Contraception and the Menopause
  12. Deciding About Hormone Therapy Use
  13. Diagnosing Menopause
  14. Diagnostic Tests for Menopause
  15. Does Having Hot Flashes Mean I’ve Started Menopause?
  16. Empowering the Health of Women In Midlife
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  17. Experts Answer Your Menopause Questions In New Video
  18. FAQs: Perimenopausal Bleeding and Bleeding After Menopause
  19. Find A Menopause Practitioner [United States and Other]
  20. Find An AMS Member [Australasian Menopause Society: Australia and New Zealand]
  21. Find Your Nearest BMS Menopause Specialist [British Menopause Society]
  22. First Symptoms of Menopause
  23. Genitourinary Syndrome of Menopause
  24. Genitourinary Syndrome of Menopause
  25. HRT Questions Answered
  26. Handling Hot Flushes and Night Sweats| Dr Louise Newson
  27. Hot Flashes
  28. How To Find Relief for Hot Flashes At Night
  29. How To Talk To Your Doctor About Heavy Periods
  30. How To Talk To Your Doctor About Menopause
    Perimenopause
  31. How To Talk To Your Doctor About Midlife Brain Fog
  32. How To Tell You’re Near the End of Perimenopause
  33. How To Track Your Perimenopause Periods
  34. Joint Position Statement By the British Menopause Society, Royal College of Obstetricians and Gynaecologists and Society for Endocrinology on Best Practice Recommendations for the Care of Women Experiencing the Menopause
  35. Later Years (Around 50 Years and Over): Menopause and Post Menopause Health – Signs and Symptoms of Menopause [+ Video: Talking Menopause With Your GP] [Other Languages and Formats]
  36. Later Years (Around 50 Years and Over): Menopause and Post Menopause Health – Supporting Someone Through the Menopause [+ Video: Men Don’t Need To Know About Menopause] [Other Languages and Formats]
  37. Let’s Talk About Perimenopause
  38. Looking After Yourself Around the Time of Menopause
  39. Managing Menopause Symptoms [+ Video Courtesy: Mayo Clinic News Network]
  40. Mayo Clinic Minute: How Lifestyle Changes May Help Manage Menopause Symptoms [+ Video]
  41. Menopause
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  43. Menopause
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  44. Menopause Checklist Podcast
  45. Menopause Map: Downloadable Resources – My Personal Path Print Tools: Symptom Tracker
  46. Menopause Map: Downloadable Resources – Stages of Menopause: Perimenopause
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  47. Menopause Patient Information [Videos] 2. Talking To Your GP About Menopause
  48. Menopause and Mental Health
  49. Menopause and Sleep
  50. Menopause: Ensuring A Tranquil Transition
  51. Menopause: Identification and Management [NICE Guideline Published: 12 November 2015 Last Updated: 07 November 2024]
  52. Menopause: Identification and Management: NICE Guideline [NG23] Published: 12 November 2015 Last Updated: 07 November 2024
  53. Menopause: Things You Can Do
  54. Menopause: Understanding the Changes and Finding Relief | Dr Susan Davis | The Proof Podcast EP #256
  55. Menopause: Your Choice of Language
  56. Menstrual Calendar
  57. Midlife Weight Gain
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  58. Monitoring Menopause Symptoms [Video]
  59. Mood and the Menopause
  60. Mymenoplan.org [My Menoplan, United States]
  61. Navigating Menopause: Honest Answers To All Your Questions [+ Video: What To Expect in Menopause]
  62. Night Sweats
  63. PerimenopauseNonhormone Treatments for Hot Flashes and Night Sweats
  64. “Not feeling like myself” In Perimenopause — What Does It Mean? Observations From the Women Living Better Survey
  65. Perimenopausal and Postmenopausal Bleeding
  66. Perimenopause
  67. Perimenopause
  68. Perimenopause
  69. Perimenopause Usually Begins In Your 40s. How Do You Know If It Has Started?
  70. Perimenopause and Menopause Checklist: Translated Checklists
  71. Perimenopause and Menopause Symptom Checklist
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  72. Perimenopause, Menopause and … Weightlifting? Expert Explains Value for Bone Health
  73. Promoting Good Mental Health Over the Menopause Transition
  74. Severe Mental Illness and the Perimenopause
  75. Supplements: What Works, What Doesn’t and the Truth About Menowashing
  76. Surprising Menopause Symptoms Q&A | Dr Louise Newson
  77. Surprising Menopause Symptoms Revisited | Dr Louise Newson
  78. Survey Shows Women’s Perceptions of Perimenopause
  79. Symptoms of Menopause
  80. The Menopause Society Statement on Misinformation Surrounding Hormone Therapy
  81. The Relation Between Perinatal Depression and Perimenopause
  82. Tips To Help Manage Menopause Symptoms
  83. Top Menopause Questions Answered: Hormones, Bones, Sex & Sleep
  84. Towards A More Accurate Global Picture of Perimenopause
  85. Videos & Podcasts: Videos – Menopause and Hormone Therapy: Current Perspectives and Controversies
  86. Videos and Podcasts: Videos – A Simple Approach To Menopause: The Menopause Quick Six (www.MQ6.ca)
  87. Webinars: Previous – IMS & ISE Symposium: What’s Hot? Options for Treatment of Hot Flushes 2025
  88. Webinars: Previous – Perimenopausal Contraception
  89. Webinars: Previous – The Burn, the Itch, the Pain, the Urge: GSM In Women
  90. Webinars: Previous – The Perimenopause Journey: An Adaptive Reproductive Phase – Webinar
  91. What Is Menopause?
  92. What Is Menopause?
  93. What Is Menopause? [+ Video]
  94. What Is the Difference Between Perimenopause, Menopause and Postmenopause?
  95. What Is the Menopause?Perimenopause
  96. When Does Perimenopause Start and How Do You Define the Beginning?
  97. Why Is Bleeding so Heavy?
  98. Why Is FSH Not Needed for Diagnosis of Menopause [Video]
  99. World Menopause Day 2024: Leaflet for Women – Menopause and Menopause Hormone Therapy
  100. PerimenopauseWorld Menopause Day 2024: Poster for Women – The 5 Ws of Menopause Hormone Therapy (MHT)

Sources

Where may I find the Sources quoted?

You may find the Sources quoted at:

Sources

  1. What Is Menopause? Perimenopause, Menopause and Postmenopause – Perimenopause? Last Updated: 13 May 2025 | Last Reviewed: 22 April 2025. Jean Hailes for Women’s Health https://www.jeanhailes.org.au/health-a-z/menopause/about-menopause Accessed: 22 July 2025
  2. Menopause: Key Facts. 16 October 2024. World Health Organization https://www.who.int/news-room/fact-sheets/detail/menopause Accessed: 22 July 2025
  3. Glossary of Terms [English]. October 2022:4. International Menopause Society https://www.imsociety.org/wp-content/uploads/2022/10/IMS-English-Factsheet-4-glossary.pdf Accessed: 22 July 2025
  4. Davis, S. R., Taylor, S., Hemachandra, C., Magraith, K., Ebeling, P. R., Jane, F., and Islam, R. M. The 2023 Practitioner’s Toolkit for Managing Menopause: Definitions. Published Online: 30 October 2023 https://www.tandfonline.com/doi/full/10.1080/13697137.2023.2258783 Accessed: 22 July 2025
  5. Perimenopause: Symptoms & Causes – Overview. 25 May 2023. Mayo Clinic https://www.mayoclinic.org/diseases-conditions/perimenopause/symptoms-causes/syc-20354666 Accessed: 22 July 2025
  6. What Is Menopause? Perimenopause, Menopause and Postmenopause – When Does Perimenopause Happen? Last Updated: 13 May 2025 | Last Reviewed: 22 April 2025. Jean Hailes for Women’s Health https://www.jeanhailes.org.au/health-a-z/menopause/about-menopause Accessed: 22 July 2025
  7. What Is Menopause? What Is Perimenopause (the Menopausal Transition)? Content Created May 2022. Australasian Menopause Society https://www.menopause.org.au/hp/information-sheets/185-what-is-menopause Accessed: 22 July 2025
  8. Perimenopause: Symptoms & Causes – Overview. 25 May 2023. Mayo Clinic https://www.mayoclinic.org/diseases-conditions/perimenopause/symptoms-causes/syc-20354666 Accessed: 22 July 2025
  9. Menopause: Symptoms – Common Symptoms of Menopause and Perimenopause: Changes To Your Periods. Page Last Reviewed: 17 May 2022. NHS https://www.nhs.uk/conditions/menopause/symptoms/ Accessed: 22 July 2025
  10. Symptoms of Menopause: Physical Symptoms of Menopause. Last Updated: 06 May 2025 | Last Reviewed: 23 April 2025. Jean Hailes for Women’s Health https://www.jeanhailes.org.au/health-a-z/menopause/menopause-symptoms#physical-and-emotional-symptoms Accessed: 22 July 2025
  11. Symptoms of Menopause: Physical Symptoms of Menopause — Mental and Emotional Symptoms. Last Updated: 06 May 2025 | Last Reviewed: 23 April 2025. Jean Hailes for Women’s Health https://www.jeanhailes.org.au/health-a-z/menopause/menopause-symptoms#physical-and-emotional-symptoms Accessed: 22 July 2025
  12. Hamoda, H., Mukherjee, A., Morris, E., Baldeweg, S. E., Jayasena, C. N., Briggs, P., Moger, S. Joint Position Statement By the British Menopause Society, Royal College of Obstetricians and Gynaecologists and Society for Endocrinology on Best Practice Recommendations for the Care of Women Experiencing the Menopause. First Published Online 10 June 2022:1 https://journals.sagepub.com/doi/full/10.1177/20533691221104879 Accessed: 22 July 2025
  13. Mayo Clinic Q and A: Perimenopause Transitions and Concerns. 20 July 2023. Mayo Clinic https://newsnetwork.mayoclinic.org/discussion/mayo-clinic-q-and-a-perimenopause-transitions-and-concerns/ Accessed: 22 July 2025
  14. What Is Menopause? When To See Your Doctor. Last Updated: 13 May 2025 | Last Reviewed: 22 April 2025. Jean Hailes https://jeanhailes.org.au/health-a-z/menopause/about-menopause/ Accessed: 22 July 2025
  15. Menopause: Diagnosis & Treatment – Treatment. 07 August 2024. Mayo Clinic https://www.mayoclinic.org/diseases-conditions/menopause/diagnosis-treatment/drc-20353401 Accessed: 22 July 2025
Topic Last Updated: 22 July 2025 – Topic Last Reviewed: 22 July 2025

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