Perimenopause

Signs Perimenopause is Ending: 10 Symptoms and How to Get Relief

Clara Siegmund

Each perimenopause journey is different, but certain common signs and symptoms may indicate that perimenopause is ending. Here’s what to look out for.

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Modified On:

October 6, 2025

Published:

Aug 16, 2024

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Signs that perimenopause is ending include periods becoming increasingly infrequent (60+ days apart), intensifying hot flashes, worsening vaginal symptoms, and increased depressive symptoms. Brain fog typically starts to lift in late perimenopause. You've officially reached menopause after 12 consecutive months without a period.

Going through perimenopause isn’t an exact science. The transition to menopause looks and feels differently for each person. From symptoms and severity to total length, no two perimenopause experiences are exactly the same.

Still, certain perimenopause commonalities can give you a sense of where you are in your perimenopause journey. And if you’re wondering how to tell if perimenopause is ending, a few of those common signs can clue you in.

Here are ten signs that perimenopause is ending, plus how to get relief from perimenopause symptoms.

1. Periods are few and far between

One of the most telltale signs that perimenopause may be ending is your period—or rather, lack thereof.

Irregular periods are a common sign of perimenopause. As you get closer to menopause, your cycle becomes more and more irregular and your period comes more and more infrequently. In fact, you may even go 60 days or more between periods by late perimenopause!

‍>>MORE: Everything You Need to Know About Perimenopause Periods

Keep in mind, however, that as long as you get periods, you haven’t reached the end of perimenopause. Menopause officially starts only after you’ve gone 12 consecutive months without a period. If your period comes, even if it’s been months since the last one, the clock starts over.

2. Hot flashes intensify

Hot flashes and night sweats, also called vasomotor symptoms (VMS), may get worse as you near menopause.

Hot flashes generally start around two years before your final period and peak in intensity 12 months after the final period. So, if your hot flashes suddenly happen more frequently and feel more unbearable, it could be one of the signs that perimenopause is ending.

In general, hot flashes gradually resolve after official menopause, but may last another ten years. Talk to your doctor about treatment options if hot flashes are interfering with your comfort and well-being.

3. Vaginal symptoms worsen

Perimenopause may be ending soon if your vaginal symptoms worsen.

Estrogen is crucial to vaginal health. As this hormone approaches its lowest point during late perimenopause and menopause, it’s increasingly unable to properly regulate vaginal health. This can lead to an increase in symptoms related to vaginal atrophy and genitourinary syndrome of menopause (GSM).

Symptoms include:

Vaginal dryness, irritation, burning, and itching
Vaginal, pelvic, or abdominal pain
Decreased lubrication
Pain or discomfort during sex
Pain or discomfort while peeing
Overactive bladder
Recurrent urinary tract infections (UTIs)

According to estimates, 33% of people in late perimenopause may experience increased vaginal dryness and more pain during sex. After official menopause, 40% to 57% of people may have vaginal symptoms. Numbers may well be higher, though, as these symptoms often go unreported.

Vaginal symptoms can be distressing, but you don’t have to suffer in silence. Talk to your doctor about symptoms so you can develop a treatment plan and get relief.

4. Depressive symptoms increase

If symptoms of perimenopause depression start to worsen, it could mean that perimenopause is ending.

Research shows that symptoms of depression and anxiety increase significantly in late perimenopause, particularly as more time passes between periods.

Perimenopause depression symptoms include:

Feeling sad and tearful a majority of the time
Feeling worthless and hopeless
Avoiding contact with friends and loved ones
Loss of interest or pleasure in activities you used to enjoy
Sleeping too much or too little

Like so many other perimenopause symptoms, depression and mood symptoms are related to fluctuations in hormones, particularly estrogen and progesterone. Depressive symptoms can also stem from factors like hot flashes, sleep disturbances, stressful life changes, and other distressing perimenopause symptoms.

If you’re experiencing symptoms of depression at any point during perimenopause, reach out to a doctor or therapist to establish a care plan.

5. Brain fog starts to lift

Perimenopause brain fog can make it hard to think. These cognitive symptoms include:

Feeling forgetful
Difficulty concentrating
Feeling mentally cloudy and sluggish
Difficulty with word recall
Difficulty with written or verbal comprehension
Difficulty with task completion

Perimenopause brain fog can be confusing, disorienting, and concerning, but the good news is, it’s not permanent.

In fact, long-term studies have shown that brain fog improves in late perimenopause. After official menopause, you’ll likely be back at your normal, pre-menopause cognitive levels.

In other words, if you feel like your brain fog is finally starting to lift, it may be a sign that perimenopause is ending.

6. Sex drive changes

Changes in your sex drive may also signal that perimenopause is ending.

Perimenopause symptoms tend to ramp up the closer you get to menopause. This can create a symptom cocktail that changes the way you think and feel about sex—and very understandably so.

For some people, sex drive may decrease. Reasons include more severe:

Vaginal symptoms
Mood swings
Stress and anxiety
Sleep disturbances

Sex drive can also increase, though this is somewhat rarer. For some, the lower likelihood of pregnancy may make you feel more confident and drive libido.

Whatever your sex drive, remember that you can get pregnant during perimenopause. To avoid pregnancy, be sure to practice safe sex until you’ve officially reached menopause. Or, if you’re trying to get pregnant, consider tracking your hormones with an at-home fertility kit to find your fertile window and optimize your chances of conceiving.

Other signs that perimenopause is ending

Other signs that perimenopause may end soon include:

Skin changes: Skin may become drier, thinner, and less elastic.‍
Hair changes: You may experience hair loss or hair thinning on your head.‍
Headaches and migraine: Headaches and migraine may increase in frequency and intensity. After menopause, you may experience relief.‍
Bone loss: Bone loss can speed up, increasing your risk of fractures and osteoporosis.

How to treat late perimenopause symptoms

If your late perimenopause symptoms are making your day-to-day life uncomfortable, talk to your doctor about how to find relief.

Lifestyle strategies, medical interventions, natural remedies, and more may help smooth your perimenopause experience, including:

Regular exercise
Diet changes
Over-the-counter and prescription medications
Hormone replacement therapies (HRT), like bioidentical HRT and estrogen HRT
Certain natural remedies, like herbal supplements
Certain vitamins

Signs perimenopause is ending: the takeaway

Many perimenopause symptoms tend to worsen the closer you get to menopause.

Signs like longer stretches between periods, increased hot flashes, and more severe vaginal symptoms can all clue you in that perimenopause may be ending.

However, perimenopause is a waiting game. It’s impossible to say how much longer, exactly, perimenopause will last after you begin to notice these signs.

In the meantime, you and your doctor can make a perimenopause treatment plan so you can feel your best as you transition into the next phase of your life.

Frequently Asked Questions About Perimenopause Ending

What are the first signs that perimenopause is ending?

The earliest signs include longer gaps between periods (60+ days), intensifying hot flashes that peak around your final period, and worsening vaginal dryness. These symptoms typically increase in late perimenopause before you reach official menopause.

How long does late perimenopause last?

Late perimenopause typically lasts 1-3 years before your final period. However, the exact duration varies significantly from person to person. You've reached menopause after 12 consecutive months without a period.

Do symptoms get worse before perimenopause ends?

Yes, most perimenopause symptoms intensify in the final 1-2 years before menopause. Hot flashes peak around your final period, vaginal symptoms worsen, and mood changes increase. However, brain fog typically improves in late perimenopause.

When do perimenopause symptoms finally stop?

Some symptoms like brain fog improve after menopause, while others like hot flashes may continue for up to 10 years post-menopause. Vaginal symptoms often persist or worsen without treatment. Each person's timeline is different.

Can you still get pregnant in late perimenopause?

Yes, you can still get pregnant during perimenopause as long as you're having periods, even if they're infrequent. Continue using birth control until you've gone 12 consecutive months without a period and have officially reached menopause.

What happens after the last sign of perimenopause?

After your final period, you enter postmenopause. You'll need 12 consecutive months

About the author

Clara Siegmund is a writer, editor, and translator (French to English) from Brooklyn, New York. She has a BA in English and French Studies from Wesleyan University and an MA in Translation from the Sorbonne. She is passionate about literature, reproductive justice, and using language to make information accessible.‍

Sources

Bleibel B & Nguyen H. (2023). Vaginal Atrophy.
Endocrine Society. (2022). Menopause and Bone Loss.
Gava G, et al. (2019). Cognition, Mood and Sleep in Menopausal Transition: The Role of Menopause Hormone Therapy.
Grant M D, et al. (2015). Menopausal Symptoms: Comparative Effectiveness of Therapies.
Joffe H, et al. (2020). Impact of Estradiol Variability and Progesterone on Mood in Perimenopausal Women With Depressive Symptoms.
Peacock K, et al. (2023). Menopause.
Santoro N. (2016). Perimenopause: From Research to Practice.
UpToDate, Bachmann G, et al. (2024). Patient Education: Vaginal Dryness (Beyond the Basics).

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https://www.oova.life/blog/fertility-vitamins

How long does it take for fertility vitamins to work?

Because egg development takes about 90 days, you may see benefits after 3 months of consistent supplementation. However, some benefits (like improved energy from iron) may appear sooner.

https://www.oova.life/blog/fertility-vitamins

Are prenatal vitamins the same as fertility vitamins?

They're similar but not identical. Prenatal vitamins are designed for pregnancy needs, while fertility vitamins may contain different ratios or additional nutrients like CoQ10 or inositol specifically for supporting conception.

https://www.oova.life/blog/fertility-vitamins

Do men need fertility vitamins too?

Absolutely. Male fertility accounts for about 40-50% of infertility cases. Men benefit from vitamins C and E, zinc, selenium, folate, and CoQ10 to improve sperm quality, count, and motility.

https://www.oova.life/blog/fertility-vitamins

Yes, excessive amounts of certain vitamins and minerals can be harmful. Fat-soluble vitamins (A, D, E, K) and minerals like iron can accumulate to toxic levels. Always follow recommended dosages and consult your healthcare provider.

Can I take too many fertility vitamins?

https://www.oova.life/blog/fertility-vitamins

When should I start taking fertility vitamins?

Begin taking fertility vitamins at least 3 months before trying to conceive, ideally 6-12 months. This gives your body time to build adequate nutrient stores for conception and early pregnancy.

https://www.oova.life/blog/fertility-vitamins

Which vitamin is most important for fertility?

Folate (folic acid) is considered most critical because it prevents neural tube defects and supports healthy egg development. However, fertility depends on multiple nutrients working together, so a comprehensive approach is best.

https://www.oova.life/blog/signs-of-ovulation-while-breastfeeding

Should I take a pregnancy test if I think I'm ovulating while breastfeeding?

If you've had unprotected intercourse and notice signs of ovulation, taking a pregnancy test is reasonable, especially if your period doesn't arrive when expected. Home pregnancy tests are accurate from the first day of a missed period.

https://www.oova.life/blog/signs-of-ovulation-while-breastfeeding

Will ovulation affect my milk supply?

Some women notice temporary milk supply dips around ovulation or during their period due to hormonal fluctuations. This is usually brief and doesn't require weaning. Continued nursing typically restores supply.

https://www.oova.life/blog/signs-of-ovulation-while-breastfeeding

Does pumping breast milk suppress ovulation like nursing does?

Pumping is less effective at suppressing ovulation than direct breastfeeding. The physical stimulation of nursing more effectively triggers prolactin release. If you're pumping exclusively or frequently, ovulation may return sooner.

https://www.oova.life/blog/signs-of-ovulation-while-breastfeeding

How effective is breastfeeding as birth control?

When all LAM criteria are met (exclusive breastfeeding, no period, less than 6 months postpartum), it's about 98% effective comparable to hormonal birth control. However, effectiveness drops significantly when any criterion is not met.

https://www.oova.life/blog/signs-of-ovulation-while-breastfeeding

Can you get pregnant while breastfeeding before your first period?

Yes, you can ovulate and therefore get pregnant before your first postpartum period returns. Ovulation occurs before menstruation in the cycle sequence, so your first fertile window happens before you realize your period is coming back.

https://www.oova.life/blog/signs-ovulation-is-over

Do you always have symptoms when ovulation ends?

Not everyone experiences noticeable symptoms. Some people have very subtle signs while others have pronounced changes. This is why hormone tracking provides more objective confirmation than symptoms alone.

https://www.oova.life/blog/signs-ovulation-is-over

What's the difference between ovulation and the fertile window?

Ovulation is the specific moment when the egg is released and lasts 12-48 hours. The fertile window is approximately 6 days, the 5 days before ovulation plus ovulation day, because sperm can survive several days while waiting for the egg.

https://www.oova.life/blog/signs-ovulation-is-over

How accurate is basal body temperature for confirming ovulation?

BBT is fairly reliable when tracked consistently, but it confirms ovulation retrospectively (1-2 days after it occurs) rather than predicting it. It's most useful when combined with other tracking methods.

https://www.oova.life/blog/signs-ovulation-is-over

Can you ovulate twice in one cycle?

While rare, it's possible to release two eggs during one ovulation event (within 24 hours), which can result in fraternal twins. However, you don't ovulate twice at different times in a single cycle.

https://www.oova.life/blog/signs-ovulation-is-over

How many days after ovulation can you get pregnant?

The egg is only viable for 12-24 hours after ovulation. However, since sperm can survive up to 5 days, your fertile window includes the 5 days before ovulation and the day of ovulation itself.

https://www.oova.life/blog/why-is-my-period-late-but-my-pregnancy-test-is-negative

Can stress really delay your period?

Absolutely. Stress affects the hypothalamus, which regulates hormones controlling your menstrual cycle. Significant stress can delay ovulation and therefore your period.

https://www.oova.life/blog/why-is-my-period-late-but-my-pregnancy-test-is-negative

What should I do if my period is 2 weeks late but the test is negative?

Take another test. If it's still negative and your period doesn't arrive, schedule an appointment with your healthcare provider to investigate potential causes.

https://www.oova.life/blog/why-is-my-period-late-but-my-pregnancy-test-is-negative

Can you be pregnant with a negative test?

Yes, especially if you test too early. Wait until at least a few days after your missed period and retest. HCG levels need time to rise to detectable levels.

https://www.oova.life/blog/why-is-my-period-late-but-my-pregnancy-test-is-negative

How long can your period be late without being pregnant?

Periods can be late for various reasons unrelated to pregnancy. If you're not pregnant, a period can be delayed by several days to weeks due to stress, illness, or hormonal changes. However, if your period is more than a week late and tests remain negative, consult your doctor.

https://www.oova.life/blog/hormonal-imbalance-symptoms

Will hormonal imbalance symptoms go away on their own?

Some temporary imbalances resolve naturally, especially those related to life transitions, but persistent symptoms typically require intervention to improve.

https://www.oova.life/blog/hormonal-imbalance-symptoms

Are hormonal imbalances more common in women?

While women experience certain hormonal imbalances more frequently (like PCOS and thyroid disorders), men also experience hormonal issues, particularly with testosterone and thyroid hormones.

https://www.oova.life/blog/hormonal-imbalance-symptoms

Can stress alone cause hormonal imbalances?

Yes, chronic stress significantly impacts cortisol, which can then disrupt other hormones including thyroid hormones and sex hormones.

https://www.oova.life/blog/hormonal-imbalance-symptoms

How quickly can hormonal imbalance symptoms appear?

Some symptoms develop gradually over months, while others can appear within weeks depending on the hormone affected and severity of the imbalance.

perimenopause-periods

Should I still see my gynecologist if my periods are just "weird" but not painful?

Yes. Annual visits remain important during perimenopause. Your provider can help determine if your "weird" periods are typical perimenopause changes or something requiring attention. They can also discuss management options to improve your quality of life.

perimenopause-periods

How long do irregular periods last before menopause?

Irregular perimenopause periods typically last 4 to 8 years before your final period, though this varies greatly. Some women experience irregularity for just a few months, while others have irregular periods for over a decade before reaching menopause.

perimenopause-periods

Is it normal to have two periods in one month during perimenopause?

Yes, this can happen, especially in early perimenopause when cycles shorten. You might have a 21 day cycle, meaning you could have a period at the beginning and end of the same calendar month. Track these patterns to distinguish between short cycles and abnormal bleeding.

perimenopause-periods

Why are my periods suddenly so heavy in my 40s?

Heavy perimenopause periods often result from estrogen dominance. When progesterone drops but estrogen remains high, your uterine lining builds up more than usual, causing heavier bleeding when it sheds. This is common in perimenopause but should be evaluated if it affects your daily life.

perimenopause-periods

Can I still get pregnant if my periods are irregular during perimenopause?

Yes. As long as you're having periods, even irregular ones, you may still be ovulating. Pregnancy is possible until you've gone 12 full months without any period. If you don't want to become pregnant, continue using contraception throughout perimenopause.

perimenopause-and-weight-gain

Can you prevent perimenopause weight gain completely?

While you may not prevent all weight changes during perimenopause, you can minimize gain through proactive strategies. Starting strength training before perimenopause, maintaining consistent sleep habits, and managing stress can help your body adapt to hormonal changes more smoothly. Remember, some body changes during this transition are normal and healthy.

perimenopause-and-weight-gain

At what age does perimenopause weight gain typically start?

Perimenopause weight gain can begin in your late 30s or early 40s, often coinciding with the first hormonal changes. Many women notice gradual changes starting 5 to 10 years before their final period. The timing varies greatly based on genetics, lifestyle, and overall health.

perimenopause-and-weight-gain

Does everyone gain the same amount during perimenopause?

No. Perimenopause weight gain varies significantly. Some women gain 5 pounds, others 20 or more, and some maintain their weight. Factors include genetics, starting weight, activity level, stress, sleep quality, and how dramatically hormones fluctuate. Your experience is unique to your body.

Is perimenopause weight gain different from regular aging weight gain?

Yes. While metabolism naturally slows with age, perimenopause weight gain has distinct characteristics. The hormonal shifts cause fat redistribution to the midsection, even if overall weight doesn't change dramatically. This abdominal weight gain pattern is specifically linked to declining estrogen and progesterone, not just aging.

perimenopause-and-weight-gain

Will the weight come off after menopause?

Perimenopause weight gain often stabilizes after menopause when hormones level out, but the weight doesn't automatically disappear. The metabolic and body composition changes that occur during perimenopause tend to persist. However, with consistent healthy habits, weight management becomes more predictable post menopause than during the fluctuating perimenopause years.

https://www.oova.life/blog/progesterone-supplementation-guide

Can I take progesterone if I'm breastfeeding?

Yes, progesterone is generally safe while breastfeeding and doesn't significantly affect milk supply. However, always discuss with your healthcare provider before starting any hormone supplementation while nursing.

https://www.oova.life/blog/progesterone-supplementation-guide

Is it safe to take progesterone throughout pregnancy?

Yes, when prescribed by your healthcare provider. Progesterone supplementation in early pregnancy is safe and can reduce miscarriage risk in women with low progesterone or a history of pregnancy loss. Most providers continue supplementation through the first trimester (weeks 10-12) when the placenta takes over.

https://www.oova.life/blog/progesterone-supplementation-guide

Can progesterone supplementation cause weight gain?

Progesterone can cause temporary water retention and bloating, which may show up as a few pounds on the scale, but it doesn't cause true fat weight gain. Most women don't experience significant weight changes from progesterone supplementation.

https://www.oova.life/blog/progesterone-supplementation-guide

Can I switch from pills to suppositories or vice versa?

Yes, but only under your doctor's guidance. The dosing and timing may need adjustment when switching between forms since they're absorbed differently. Never switch on your own, especially if you're pregnant or undergoing fertility treatment.

https://www.oova.life/blog/progesterone-supplementation-guide

Will progesterone supplementation delay my period?

Yes, progesterone keeps the uterine lining intact, so if you're not pregnant and continue taking progesterone, your period will be delayed. Once you stop taking it, your period should start within 2-10 days. If you are pregnant, progesterone helps maintain the pregnancy and you won't get a period.

https://www.oova.life/blog/progesterone-supplementation-guide

Should I take progesterone pills orally or vaginally?

For fertility and pregnancy support, vaginal progesterone is usually preferred because it delivers higher concentrations directly to the uterus. For perimenopause or general hormone balance, oral progesterone often works well and is more convenient. Your doctor will recommend the best route based on your specific needs.

https://www.oova.life/blog/progesterone-supplementation-guide

When should I start taking progesterone after ovulation?

Typically, progesterone supplementation for luteal phase support starts 2-3 days after ovulation (confirmed by LH surge or temperature rise). Your doctor will give you specific timing based on your protocol. Some women start immediately after a positive ovulation test.

https://www.oova.life/blog/progesterone-supplementation-guide

What's better: progesterone cream or pills?

Pills (oral micronized progesterone) are generally more effective and reliable than creams because absorption from creams is inconsistent. For medical conditions like fertility issues, low progesterone, or HRT, prescription pills or suppositories are strongly recommended over over-the-counter creams.

https://www.oova.life/blog/low-vs-high-progesterone-symptoms

How can I tell if I have low or high progesterone?

The only definitive way to know is through hormone testing via blood tests or at-home urine tests that measure progesterone metabolites. However, symptom patterns can provide clues: anxiety and irregular periods suggest low progesterone, while bloating and extreme fatigue suggest high progesterone.

https://www.oova.life/blog/low-vs-high-progesterone-symptoms

When during my cycle should I test progesterone levels?

Test progesterone levels during the luteal phase, typically 7 days after ovulation or around day 21 of a 28-day cycle. This is when progesterone should be at its peak, making it easier to identify if levels are too low or too high.

https://www.oova.life/blog/low-vs-high-progesterone-symptoms

What are the main differences between low and high progesterone symptoms?

Low progesterone typically causes irregular or heavy periods, anxiety, hot flashes, and sleep issues. High progesterone causes bloating, fatigue, intense breast tenderness, and depression-like mood changes. Low progesterone symptoms persist throughout your cycle, while high progesterone symptoms are most intense during the luteal phase.

https://www.oova.life/blog/low-vs-high-progesterone-symptoms

Can you have symptoms of both low and high progesterone?

Some symptoms like breast tenderness and mood changes can occur with both low and high progesterone, making it confusing. However, the timing, intensity, and accompanying symptoms differ. Hormone testing is the best way to determine which imbalance you're experiencing.