What age does perimenopause start?
Perimenopause usually starts in your mid-40s, though it can begin in your late 30s or not until your early 50s. It lasts about four years on average, sometimes up to eight or more, and ends at menopause: 12 months without a period. The average age of menopause is about 51. Changes before 40 should be checked by a doctor.
The usual timeline
| Stage | Typical age | What happens |
|---|---|---|
| Late reproductive years | Late 30s to early 40s | Cycles may shorten slightly; PMS may feel stronger |
| Early perimenopause | Mid-40s (can be earlier) | Cycle lengths start to vary by 7 days or more |
| Late perimenopause | Late 40s to early 50s | Gaps of 60 days or more between periods; hot flashes more common |
| Menopause | Around 51 on average | Confirmed after 12 months with no period |
| Postmenopause | After menopause | No periods; some symptoms continue for a while |
What affects when it starts
- Family history: the age your mother or sisters went through menopause is a useful clue.
- Smoking: linked with menopause one to two years earlier.
- Surgery or treatment: removal of the ovaries, some cancer treatments and some hysterectomies can bring it earlier.
- Health conditions: some autoimmune conditions are linked with earlier menopause.
Menopause before 45 is called early menopause, and before 40 premature menopause (or premature ovarian insufficiency). Both deserve a doctor's input, because low estrogen for longer affects bone and heart health.
How to know if it's starting
The first sign is usually a change in your cycle: often shorter cycles at first, then less predictable ones. Mood changes, worse PMS, poor sleep and night sweats are common early on too. See first signs of perimenopause or try the perimenopause self-check.
A few months of cycle and symptom records make it much easier to see the shift, and much easier to explain it to a doctor.
Mood in perimenopause
Estrogen swings unpredictably in perimenopause, and for many people mood is affected before periods change much: irritability, anxiety, low mood or rage that feels new. It's common, it's real, and it's treatable. Read perimenopause mood swings and the full perimenopause guide.
See a doctor if you have perimenopause symptoms before 45 (especially before 40), if periods become very heavy or come less than 21 days apart, if you bleed after sex or between periods, or if symptoms affect your daily life. If low mood brings thoughts of self-harm, call your local emergency number, or in the US call or text 988.
Frequently asked questions
Can perimenopause start at 38?
Yes, for some people it starts in the late 30s. It's worth checking with a doctor to rule out other causes.
How long does perimenopause last?
About four years on average, but it can be a few months or eight years or more. See how long does perimenopause last.
What age do periods stop?
Usually between 45 and 55, around 51 on average. See what age do periods stop.
Can a blood test tell me if I'm in perimenopause?
Over 45, doctors usually diagnose by symptoms, because hormone levels swing too much for one test to be reliable.
Sources
- Cleveland Clinic: Perimenopause
- NHS: Menopause and perimenopause
- NHS: Early or premature menopause
- National Institute on Aging: What is menopause?
This page is for information only and isn鈥檛 medical advice. If something worries you, please talk to a doctor.
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