Perimenopause is the natural transition leading up to menopause, when hormone levels fluctuate and decline. Your body is getting ready to stop having periods. Like puberty, it’s both a biological and identity shift that can stir complex feelings about aging, fertility, and self.

People often use “Menopause” for the entire transition, but technically it’s not the same. Perimenopause is the transition phase before menopause. Menopause is when you have gone 12 months without a period. Thereafter, you’re considered postmenopausal.

This is what makes perimenopause confusing—it’s hard to predict and it is different for everyone. In the U.S., the average age of menopause is 51, and perimenopause usually begins several years earlier. Most women notice changes in their 40s, though symptoms can start as early as the 30s or as late as the early 50s.

On average, perimenopause lasts 4–10 years, though it can be shorter or longer for some women. Timing and duration can also vary by race and ethnicity—for example, Black and Hispanic women often experience an earlier onset and sometimes longer or more intense symptoms compared with White or Asian women.

No. Perimenopause is the natural transition leading up to menopause, while early menopause means your final period occurs before age 45. Learn more about other ways to enter menopause here. More on what to know.

During perimenopause, hormone levels begin to shift. Estrogen starts to decline but also rises and falls unpredictably, and it’s these fluctuations that trigger many of the symptoms women experience. At the same time, progesterone levels gradually decline, which can also contribute to changes in menstrual cycles, mood, and sleep.

Everyone’s experience is different, but changes in your period—longer, shorter, heavier, or lighter—along with hot flashes, sleep changes, mood shifts, and vaginal or urinary changes can all be early signs of perimenopause.

There’s no single test for perimenopause. Diagnosis is usually based on your age, menstrual cycle changes, and symptoms. Blood hormone tests aren’t always reliable because levels fluctuate daily.

Yes. Ovulation can still occur, even with irregular cycles. If pregnancy is not desired, contraception is recommended until menopause is confirmed.

Look for doctors or clinicians who understand menopause—gynecologists, menopause specialists, or informed primary care providers. The Menopause Society offers additional training and certification.  Find a certified provider here. Because menopause is a transition that unfolds over many years, it should be discussed at multiple visits. Since it also affects overall health, longevity, and quality of life, getting the right care is essential.

Nearly 80% of women experience perimenopause symptoms, but many don’t connect them to hormonal changes right away. Awareness helps women seek support, explore treatment options, and improve your quality of life during this stage.