- Perimenopause is the phase leading up to menopause before a woman’s final period.
- Many women do not recognize that they are in the perimenopausal stage because of subtle symptoms like mood swings.
- The duration of perimenopause varies, generally lasting from two to eight years, averaging around four years.
What is it?
Perimenopause (also called the menopause transition or menopausal transition) marks a significant phase in your life as you transition toward menopause. Often starting around 45 years, this period involves hormone fluctuations, specifically in estrogen and progesterone, as well as changes in levels of other hormones like Follicle-Stimulating Hormone (FSH), inhibin, and Anti-Müllerian Hormone (AMH). These hormones, critical for menstrual cycle regulation and fertility during your reproductive years, start to fluctuate and then decline. The period prior to this is called premenopause, when menstrual cycles are regular.
Signs & Symptoms
During the perimenopause stage, it is common for women to experience various symptoms. Often, women do not recognize they are in the perimenopausal stage because symptoms are subtle, common, and sometimes attributed to aging or other medical conditions. Symptoms may include emotional changes such as increased anxiety or mood swings, physical changes like irregular menstrual cycles, and physiological changes due to hormonal shifts. Additionally, Hispanic and Black women may experience these symptoms for a longer duration than Chinese, Japanese, and White women.
To learn more, visit the Symptoms of Menopause page.
Hormonal Changes
Your ovaries begin to produce less estrogen as perimenopause progresses, accompanied by fluctuations in FSH, inhibin, and AMH levels. In the final one to two years of this phase, the decline in estrogen becomes more rapid, often causing symptoms to intensify. Despite this, menstrual cycles continue throughout perimenopause, so pregnancy remains a possibility. For those not wishing to become pregnant, birth control should be used as appropriate until 12 consecutive months without a menstrual period, including spotting.
Women should consult healthcare professionals for an accurate diagnosis and treatment options. The duration of perimenopause can vary significantly, typically ranging from two to eight years, averaging around four years. It may last longer in women who smoke, and those who began the transition before 45 years.
Navigating perimenopause requires understanding and awareness. This stage typically begins in a woman’s mid-40s, characterized by fluctuating levels of estrogen, progesterone, FSH, inhibin, and AMH. Identifying its symptoms, which range from subtle emotional shifts to physical changes like irregular menstrual cycles, can be challenging. These symptoms often vary among different ethnic groups, adding to the complexity of recognition. As estrogen levels drop more rapidly in the later stages, symptoms may intensify, with pregnancy remaining a possibility. Understanding nuances in symptoms and length allows you to remain informed and proactive on your menopause journey.
