Perimenopause: definition and meaning
Perimenopause is the transition leading up to menopause, when the ovaries gradually make less and more erratic estrogen and progesterone. It usually begins in the mid 40s, sometimes earlier, and lasts about 4 to 8 years. Periods become irregular, and symptoms like hot flashes, poor sleep and mood changes are common. It ends 12 months after the last period.
Common signs
- Changing cycles: shorter at first, then skipped or longer gaps
- Heavier or lighter periods than usual
- Hot flashes and night sweats
- Sleep problems, even without night sweats
- Mood changes, anxiety, irritability and brain fog
- Worsening PMS or new PMDD-like symptoms
Why mood can be harder
In perimenopause estrogen doesn't just fall: it swings, sometimes higher than before, then crashes. Brains that are sensitive to hormone changes feel these swings. Anxiety and low mood become more common, especially in people with a history of PMS or postnatal depression. See perimenopause mood swings.
Getting support
Diagnosis is usually based on age and symptoms, not a blood test. Treatments include hormone therapy, non-hormonal medicines for hot flashes and mood, CBT, and lifestyle changes. You can still get pregnant until periods have stopped for 12 months. Read the full guide to perimenopause or try our perimenopause self-check.
See a doctor for very heavy bleeding, bleeding between periods or after sex, periods closer than 21 days apart, or low mood that doesn't lift.
Frequently asked questions
What is the first sign of perimenopause?
For many it's a change in cycle length, often shorter cycles, along with new sleep problems or mood changes. See first signs of perimenopause.
Can perimenopause start in your 30s?
It can start in the late 30s for some people, though the mid 40s is more typical.
Sources
This page is for information only and isn鈥檛 medical advice. If something worries you, please talk to a doctor.
Keep reading
Perimenopause: what it is, when it starts and how it feelsPerimenopause explained kindly: what's happening to your hormones, when it usually starts, how long it lasts, how it can feel, and what really helps.
Perimenopause symptoms: the full list, and what helps each onePerimenopause symptoms explained: cycle changes, hot flushes, sleep, mood, brain fog and body changes, with what helps each one and when to see a doctor.
Menopause: definition and meaningMenopause is the point 12 months after your last period, usually around age 51. What it means, how it differs from perimenopause, and common symptoms.
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