Perimenopause can be a confusing time, especially when your period, sleep, mood, and body all seem to be changing all at once. You might be wondering:
Perimenopause is the transition phase before menopause, when your hormones start to fluctuate and your menstrual cycle becomes less predictable. It’s the time in which a woman’s body prepares to stop having periods.1
The phases of menopause (perimenopause, menopause, and postmenopause) often get lumped together as being “menopause,” but they are distinct.2
Perimenopause usually starts several years before menopause, as your ovaries gradually produce less estrogen and ovulation becomes less predictable. This transition often begins 8-10 years before menopause.
If you’re wondering, “What age does perimenopause start?” there is a typical range, but the exact age is individual, influenced by genetics, health history, and lifestyle.
For most women, perimenopause typically starts in their 40s. However, symptoms can begin anytime from your late 30s to your early 50s.
Yes, perimenopause can start in your 30s, although it’s less common. Unfortunately, because it is less common, symptoms of perimenopause may be blamed on other causes, such as stress, poor nutrition, or depression.3
Some factors are linked to earlier perimenopause and menopause:4
Perimenopause is a completely natural process that occurs as you age and your body shifts from regular ovulation and menstrual cycles toward menopause. It’s the beginning of the end of your potential reproductive years.
During perimenopause, your ovaries produce less estrogen and progesterone, which can cause symptoms such as hot flashes, brain fog, and mood swings. Additionally, ovulation becomes more irregular. You may ovulate some months but not every cycle, and your menstrual cycle might lengthen from 28 days to 35 days. Flow can also be erratic, with periods being early, late, heavy, light, or skipped entirely.
Symptoms of perimenopause are caused by changing hormone levels in the body. For example, low estrogen levels may cause night sweats or hot flashes. Your exact symptoms will depend on your hormone levels.6
The most common symptoms of perimenopause are also usually the first signs of it. These include changes in your period, hot flashes, night sweats and sleep disturbances, mood changes, brain fog, and weight gain. These symptoms are sometimes called the “34 symptoms of perimenopause” in popular media. Not everyone will experience all symptoms, but having multiple signs often suggests perimenopause.
1. Irregular periods
2. Hot flashes
3. Night sweats
4. Sleep disturbances
5. Fatigue
6. Mood swings/mood changes
7. Irritability
8. Depression or anxiety
9. Migraines or headaches
10. Dizziness or light-headedness
11. Brain fog/difficulty concentrating
12. Memory lapses
13. Panic disorder
14. Weight gain or changes in body composition
15. Hair thinning or changes in hair texture
16. Skin changes (dryness, loss of elasticity)
17. Joint pain or stiffness
18. Decreased bone density
19. Increased risk of cardiovascular disease
20. Breast tenderness, soreness, or changes
21. Palpitations or irregular heartbeat
22. Digestive issues (bloating, indigestion, constipation)
23. Tingling hands, feet, arms, and legs
24. Burning mouth
25. Changes in sense of taste
26. Muscle aches and tension
27. Sensations resembling electric shock
28. Itchiness
29. Brittle nails
30. Allergies
31. Vaginal dryness
32. Reduced libido
33. Urinary frequency or increased risk for a urinary tract infection
34. Urinary incontinence
Perimenopause doesn’t have a fixed length, so the answer to “how long does perimenopause last” will vary from woman to woman. Most experts state that perimenopause typically lasts anywhere from 2-8 years. At least one study, published in JAMA Internal Medicine, suggested that health-care professionals “counsel women to expect that frequent VMS (vasomotor symptoms, such as hot flashes and night sweats) could last more than seven years, and they may last longer for Black women.”7
Your own timeline depends on factors such as genetics, health, and how your ovaries gradually slow down hormone production.
Perimenopause can be broken into two phases:
While irregular periods, hot flashes, and mood changes are common in perimenopause, there are important red flags to watch for. If these arise, it may be time to contact a healthcare professional, such as a gynecologist.
For example:
If you experience sudden or severe depression8 or anxiety, chest pain, heart palpitations, fainting episodes, repeated bleeding after intercourse, bleeding after menopause (after you’ve gone 12 months without a period), or sudden and unusual pelvic pain, contact a medical professional.
Yes, you can get pregnant during perimenopause. Your body is still ovulating during this time, even if it is less consistent. Until you’ve gone a full 12 months without a period, you are still ovulating, and pregnancy is possible.
Perimenopause is a clinical diagnosis.9 This means it’s based on your symptoms, health history, and age as opposed to lab results. While there isn’t a single definitive test to show you’re experiencing perimenopause, a health-care professional may order blood tests to check your hormone levels. They may also request ultrasounds or biopsies to rule out other causes of your symptoms.
While there’s no way to stop perimenopause itself, there are ways to manage the symptoms so you feel like yourself and protect your long-term health. If you’re also wondering how to lose weight during perimenopause, the same foundations that ease symptoms often help with weight and energy.
Start first with some lifestyle foundations, such as regular movement (especially a mix of walking and cardio plus strength training). This can help with mood, sleep, hot flashes, and long-term health. Eat mostly whole foods and cut back on ultra-processed foods, added sugars, and alcohol, which can affect your sleep.
Use a consistent sleep schedule, a cool, dark bedroom, and a calming sleep routine to help combat sleep symptoms. Finally, consider stress-management tools such as walks, mindfulness, and therapy to help with mood and anxiety.
Hormone shifts, age-related muscle loss, interrupted sleep, and stress all make it harder to regulate your weight, especially around the abdomen. A higher waist circumference is a risk factor for cardiovascular and metabolic diseases in menopausal women.10 Additionally, the decreased circulation of estrogen throughout the body can cause issues with osteoporosis that manifests as low bone density and a higher risk of fractures.
Some of the risk factors can be managed by drinking more water, and incorporating foods rich in calcium, iron, and vitamin D.
Nutritional supplement support for perimenopausal women
Nutrients can help support you as you address some of the symptoms of perimenopause.11
In addition to individual nutrients, Thorne offers a botanical formula – Perimenopause Complete – to address the most common and some of the less common symptoms of perimenopause.* If low libido is an issue, we have you covered there too. Women’s Libido Boost pairs well with Perimenopause Complete to support libido and improve vaginal dryness.*
A quality multi-vitamin/mineral formula, such as Women’s Multi 50+ by Thorne, will address nutrient gaps and enhance bone support and cardiovascular support.*
What is perimenopause?
Perimenopause is the transition period before menopause when your hormone levels start to fluctuate, and your menstrual cycle becomes less predictable. Ovulation becomes more erratic, periods often change in timing or flow, and symptoms such as hot flashes, sleep problems, and mood shifts may appear. It ends once you reach menopause – the point as which is has been 12 months since you had a period.
When does perimenopause start?
Perimenopause generally starts 8-10 years before menopause, most often in your 40s. However, it can begin earlier or later. Some people notice changes in their late 30s, while others don’t enter perimenopause until their early 50s. The exact timing varies based on genetics, health, and lifestyle.
How long does perimenopause last?
Perimenopause can last anywhere from a few months to several years. Most medical sources estimate a typical duration of 2-8 years, depending on the individual. You’re considered to have reached menopause once you’ve gone 12 consecutive months without a period.
What are the first signs of perimenopause?
The first signs of perimenopause are often changes in your period, such as cycles becoming longer or shorter, heavier or lighter, or occasionally skipped. Early symptoms can also include worsening PMS, new sleep problems, hot flashes or night sweats, mood swings, and vaginal dryness, even while you’re still having frequent periods.
What are the symptoms of perimenopause?
Perimenopause symptoms vary but commonly include irregular periods, hot flashes, night sweats, sleep disturbances, and mood changes such as irritability, anxiety, or low mood. Many people also notice brain fog, vaginal dryness, changes in sex drive, weight gain or body-shape changes, and new or worsening migraines or joint aches.
What are the “34 symptoms of perimenopause”?
The “34 symptoms of perimenopause” is a popular list that groups many possible changes. The list usually includes hot flashes, night sweats, irregular periods, mood changes, anxiety, brain fog, sleep problems, vaginal dryness, low libido, weight gain, and other symptoms. Not everyone experiences all 34 symptoms. Your symptom mix will be individual.
Can you get pregnant during perimenopause?
Yes, you can still get pregnant during perimenopause. Although ovulation becomes less predictable, it doesn’t stop entirely right away. As long as you’re still having periods – even irregularly – there’s a chance of releasing an egg. If you don’t want to become pregnant, you still need reliable contraception until you’ve gone 12 months without a period.
Are there tips on how to lose weight during perimenopause?
To lose weight during perimenopause, focus on realistic, sustainable habits. Prioritize strength training to maintain muscle and metabolism, build meals around protein, fiber, and healthy fats, and reduce sugary drinks, ultra-processed foods, and excess alcohol. Improving sleep and stress management also helps to regulate appetite and energy, making weight loss easier to achieve.
Perimenopause is a natural transition, but that doesn’t mean you have to “just live with it.” Understanding what’s happening with your hormones, cycles, and symptoms is the first step toward getting real support. If you found this helpful, explore our related articles on menopause, mindset, brain fog, and symptom relief strategies.
Source: Thorne Take 5 Daily
