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Before discussing everything about perimenopause, it would be important to clarify what is menopause. Menopause is a naturally occurring stage in women life which means the cessation of menstrual periods – it is a time of the end of women’s reproductive function and reproductive years. Medically menopause is defined as the absence of menstrual periods for 12 consecutive months. Usually menopause happens between the ages of 45 and 55. During menopause, a women’s reproductive system changes, resulting in a discontinuation of estrogen production, the menstrual cycle, and egg maturation.

Definition and causes

Perimenopause is a naturally occurring transition period of women life which is happening before menopause – it is the time when your body begins its transition into menopause. It is the stage of women’s reproductive life that begins several years before menopause, when the ovaries gradually begin to produce less estrogens. It usually starts in women’s 40s, but can start in women’s 30s.

Woman in perimenopause

Sometimes perimenopause called “premenopause” – it is a transitional stage of 2-11 years before complete cessation of the menstrual period – it develops when women’s reproductive system begins slowing down, resulting in decreased production of hormones (mainly estrogens and progesterone). Perimenopause is the interval in which women’s body makes a natural shift from regular menstrual cycles and regular monthly ovulations to irregular menstrual cycles, anovulation and natural permanent infertility.

Women start perimenopause at different ages but in most cases it is happening at 40s. The average duration of perimenopause is 5-6 years and it can appear in women from 35 to 50 years of age. First signals of perimenopause are irregular periods (missed periods, long periods, short menstrual cycles, and unusual light periods). In early perimenopause women could also experience menopause-like symptoms, such as hot flashes, sleep problems and vaginal dryness.

The average length of perimenopause is 4-5 years but for some women this stage may last only a few months or continue for 10-15 years. Women can notice some changes in their body for about 10 to 15 years before actually going through menopause. Once you’ve gone through 12 consecutive months without a menstrual period, you’ve officially reached menopause.

Menopause TESTS


Not all women experience perimenopause symptoms before entering into the menopause. There are many women who don’t experience any perimenopause symptoms. In general premenopause and menopause affect each woman differently – nothing works exact the same way in every woman. Each woman has different hormonal status, different lifestyle, different eating habits and different physical activities and spends most of time in different professional environments. Women body is influenced by many factors and by everything they do. That’s why it is completely normal when some women don’t experience perimenopause symptoms and gradually move into menopause stage without hassle. This is because they simply go through the stage where they stop menstruating before they realize that they have reached menopause.

The intensity, duration and frequency of perimenopause symptoms also can be different. Some women experienced very light and short perimenopausal symptoms and some experienced severe long unpleasant symptoms during perimenopause.

The symptoms of peri-menopause are different for every woman. Perimenopause symptoms can occur frequently or only occasionally. The symptoms may range in intensity from mild to severe. Perimenopause symptoms could be different and women could have some or many perimenopause symptoms at the same time. These are the most common symptoms of perimenopause:

  • Hot flashes and night sweats
  • Breast tenderness
  • Worsening of premenstrual syndrome
  • Decreased libido (sex drive)
  • Fatigue (often several days before menstruation)
  • Irregular periods (short or longer or strange and unpredictable)
  • Menstrual periods becomes heavier or lighter
  • Weight gain
  • Vaginal dryness; discomfort during sex
  • Urine leakage when coughing or sneezing
  • Urinary urgency (a pressing need to urinate more frequently)
  • Mood swings (anger, anxiety, depression, irritability, etc.)
  • Headaches (from mild to migraines with aura and visual distortions)
  • Water Retention – Bloating
  • Sleep disorders.


Despite a decline in fertility during the perimenopause stage, women can still become pregnant and regular modern contraception would be strongly recommended. If you do not want to become pregnant, you should continue to use some form of birth control until you reach menopause. You can stop contraception only if you already have gone 12 months without having your period.

For some women, getting pregnant can be difficult once they are in their late 30s to early 40s due to a decline in fertility. But, if becoming pregnant is the goal, there are fertility-enhancing treatments and techniques that can help you get pregnant – see all details in “Assisted Reproduction”.

Treatment – make it easy

Irregular periods are common and normal during perimenopause. But, other conditions can cause abnormalities in menstrual bleeding. What to expect if you have the following:

  • Your periods are very heavy, or accompanied by blood clots – see all possible causes for uterine bleeding.
  • Your periods last several days longer than usual – see all possible causes for abnormal periods.
  • You have brown discharge and/or spotting between periods – see all possible causes for brown discharge
  • You experience spotting after sex – see all possible causes for bleeding after sex
  • Your have very short menstrual cycle – see all possibilities in section about periods
  • In all above mentioned cases better to visit your doctor for professional advice.

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