Perimenopause

What Is Perimenopause? Age, Symptoms, and Treatment

Zoe Kaplan

Perimenopause, often referred to as the “menopausal transition,” is a natural biological process that happens before menopause. Here's what to look out for and how to handle any symptoms that flare up.

Published:

Feb 1, 2025

Est. Read Time:

Hot flashes, mood swings, and irregular periods are hallmark signs of perimenopause—the transitional phase before menopause. Often called the "menopausal transition," perimenopause can feel confusing and overwhelming due to fluctuating hormones. But it’s a completely natural stage in every woman’s reproductive journey.

In this guide, we’ll explore:

What perimenopause is
When perimenopause typically starts
What symptoms you may experience
Whether pregnancy is still possible
How to manage perimenopause naturally and medically

What Is Perimenopause?

Perimenopause is the time leading up to menopause, marked by declining estrogen and progesterone levels. These hormonal shifts can cause a wide range of emotional and physical symptoms.

Key Differences:

Menopause: Defined as 12 consecutive months without a period
Perimenopause: Can begin years earlier, often in your late 30s or early 40s

Learn more: What Are the Stages of Perimenopause?

When Does Perimenopause Start?

Perimenopause usually begins between ages 38–45 but varies greatly. Some experience changes earlier, while others notice symptoms much later. This phase can last anywhere from 2 to 10 years, gradually leading to menopause.

Common Signs and Symptoms of Perimenopause

Perimenopause doesn’t feel the same for everyone—but here are the most common symptoms:

Physical Symptoms

Hot flashes & night sweats
Irregular menstrual cycles
Vaginal dryness or discomfort
Weight gain & bloating
Breast tenderness
Joint and muscle pain

Emotional & Cognitive Changes

Mood swings or irritability
Fatigue & low energy
Trouble concentrating ("brain fog")
Sleep disturbances
Decreased libido

Skin, Hair, and Bone Health

Thinning hair or dry skin
Changes in bone density
Acne or itchiness

PMS vs. Perimenopause Symptoms

It’s easy to confuse PMS with perimenopause. The key difference? Timing.

PMS symptoms occur predictably before your period.
Perimenopause symptoms can appear anytime in your cycle and persist or fluctuate unpredictably.

Can You Get Pregnant During Perimenopause?

Yes, pregnancy is still possible during perimenopause—even if it's less likely.

Why?

Ovulation becomes irregular, but not absent
Egg quality declines with age
Fertility drops to about 5% per cycle after age 40

More on this topic: Symptoms of Ovulation During Perimenopause

How Long Does Perimenopause Last?

The duration varies, but perimenopause typically lasts between 4 and 10 years. For some, it’s short-lived; for others, symptoms can linger well into their 50s.

Managing Perimenopause Symptoms

While there’s no “cure” for perimenopause, many treatments—natural and medical—can help ease symptoms.

Lifestyle Modifications

Nutrition: Eat foods rich in calcium, magnesium, vitamin D & phytoestrogens
Exercise: Include strength training and cardio to maintain bone and heart health (Learn what workouts are best for each part of your cycle)

Stress Relief: Try yoga, meditation, or breathwork
Sleep Hygiene: Keep a consistent routine and reduce screen time before bed

Natural Remedies

Herbal Supplements: Black cohosh, evening primrose oil (with medical guidance)
Acupuncture: May reduce hot flashes and anxiety
Vaginal Estrogen: Creams or rings for dryness and pain during intercourse

Medical Treatments

Hormone Replacement Therapy (HRT)

Alleviates severe hot flashes, mood swings, and vaginal discomfort
Comes with risks—consult a physician before starting

Non-Hormonal Medications

SSRIs/SNRIs: May help with mood and hot flashes
Gabapentin: Sometimes used to relieve hot flashes or sleep issues

Emotional Health & Support

Mental wellness matters. Join perimenopause support groups or talk to a licensed therapist. Emotional symptoms are valid—and manageable.

Tip: Use hormone-tracking tools like the Oova Kit to monitor patterns and guide conversations with your doctor.

FAQs About Perimenopause

What’s the earliest age perimenopause can start?

Some women begin experiencing symptoms as early as their mid-30s.

Does perimenopause affect mental clarity?

Yes. Brain fog and difficulty concentrating are common during hormone fluctuations.

How do I know it’s perimenopause and not something else?

A doctor may recommend hormone testing (like LH, E3G, and PdG) and track symptom timing.

Are there tests to confirm perimenopause?

Yes. Tests measuring estradiol, LH, and FSH levels can indicate hormonal shifts—but diagnosis is often symptom-based.

What helps relieve hot flashes quickly?

Cool environments, layered clothing, herbal teas, and gabapentin or HRT may help—depending on severity.

Final Thoughts

Perimenopause is a unique phase that affects every woman differently. The more you know, the more empowered you'll feel to manage the changes.

Start tracking your hormones today with the Oova Kit—backed by science, built for your body.

About the author

Zoe Kaplan is a writer and content strategist passionate about creating content that helps people navigate the world a little more easily. Zoe has worked across verticals, from women's career development to reproductive health. You can check out more of her work at zoeakaplan.com.

Sources

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About the Oova Blog:
‍Our content is developed with a commitment to high editorial standards and reliability. We prioritize referencing reputable sources and sharing where our insights come from. The Oova Blog is intended for informational purposes only and is never a substitute for professional medical advice. Always consult a healthcare provider before making any health decisions.

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