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Perimenopause: what it is and what to expect

Key points

  • Perimenopause is the time before menopause, when your hormone levels change.
  • The Office on Women's Health (US) says it usually begins in your mid- to late 40s.
  • The same source says it lasts about four years on average, and up to 10 years for some women.
  • Periods may change, and the Office on Women's Health (US) says you can still become pregnant.
  • Sleep and mood can change too. The Office on Women's Health (US) advises telling your health care provider which symptoms bother you most.

What perimenopause is

Menopause is the point when your periods have stopped for 12 months in a row. The Office on Women's Health (US) says perimenopause is the time before that point, when your hormone levels are changing. MedlinePlus (US) uses two names for it: the menopausal transition, or perimenopause. [1] [3]

The Office on Women's Health (US) says perimenopause usually starts in your mid- to late 40s. It says the time spent in this stage is about four years on average. For some women it can stretch to as long as 10 years before menopause arrives. [1]

Changes you may notice

The Office on Women's Health (US) says symptoms can start during perimenopause. One change is in your periods. They may come shorter or longer than before, and they may be lighter or heavier. Some months a period may be skipped altogether. [1] [2]

A hot flash is a sudden feeling of heat. It often comes with flushing, when the skin turns red, and with sweating. The Office on Women's Health (US) explains that night sweats are hot flashes that happen while you sleep. MedlinePlus (US) describes a hot flash as a sudden warm feeling in the face, neck, and chest. [2] [3]

Sleep and mood can change as well. The Office on Women's Health (US) says night sweats, bladder symptoms, and mood changes can all get in the way of sleep. It also says you may feel more irritable or anxious, or notice signs of depression. Vaginal dryness is another symptom it lists. [2]

Pregnancy during this time

Irregular periods do not mean pregnancy is no longer possible. The Office on Women's Health (US) says that during perimenopause your periods may be irregular, yet you can still become pregnant. [1]

When to see a doctor

The Office on Women's Health (US) advises telling your health care provider which symptoms bother you most. It also advises telling your provider about trouble sleeping, and about new or worsening pain. [2]

The Office on Women's Health (US) says bleeding from the vagina after 12 months with no period is not normal. It says to see your health care provider right away if this happens. [2]

MedlinePlus (US) says that if lifestyle changes do not ease your symptoms enough, you may want to contact your health care provider. [3]

Sources

  1. Office on Women's Health (US): Menopause basics (opens in a new tab). Last updated October 19, 2026.
  2. Office on Women's Health (US): Menopause symptoms and relief (opens in a new tab). Last updated October 19, 2026.
  3. MedlinePlus (US): Menopause (opens in a new tab). Last updated August 3, 2026.

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