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Perimenopause

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

Clara Siegmund
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.

Modified On:
October 6, 2025
Published:
Aug 16, 2024
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Published:
Oct 7, 2025
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Each perimenopause journey is different, but certain common signs and symptoms may indicate that perimenopause is ending. Here’s what to look out for.

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

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:

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:

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
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

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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.
https://www.oova.life/blog/10-dpo
Can stress affect 10 DPO symptoms?
Yes, stress can worsen or mimic 10 DPO symptoms. Stress increases cortisol, which can cause cramping, fatigue, and mood changes similar to both PMS and early pregnancy. During the two-week wait, try stress-reduction techniques like gentle exercise, meditation, or spending time with loved ones.
https://www.oova.life/blog/10-dpo
Is it better to test at 10 DPO or wait?
It's better to wait until 12–14 DPO for more accurate results. Testing at 10 DPO often leads to false negatives because hCG levels may still be too low. If you absolutely can't wait, use a sensitive early detection test with first morning urine, and be prepared to retest in 2–3 days if negative.
https://www.oova.life/blog/10-dpo
What does implantation bleeding look like at 10 DPO?
Implantation bleeding at 10 DPO is typically light pink or brown, much lighter than a period, and lasts 1–2 days. It's often just spotting when you wipe or a few drops on a panty liner. However, only 15–20% of pregnant women experience implantation bleeding—most don't have any bleeding at all.
https://www.oova.life/blog/10-dpo
Why am I cramping at 10 DPO?
Cramping at 10 DPO can be caused by elevated progesterone (whether you're pregnant or not), implantation (if you're pregnant), or premenstrual cramping. Unfortunately, cramping alone can't tell you if you're pregnant since progesterone causes similar symptoms in both scenarios.
https://www.oova.life/blog/10-dpo
What are the chances of a BFP at 10 DPO?
If you're pregnant, you have about a 50–60% chance of getting a positive test at 10 DPO. This means there's a 40–50% chance of a false negative even if you conceived. Chances improve significantly by 12–14 DPO.
https://www.oova.life/blog/10-dpo
What DPO is most accurate for pregnancy testing?
14 DPO (the day of your missed period) is the most accurate time to test, with 99% accuracy. 12 DPO offers 80–90% accuracy. 10 DPO has only 50–60% accuracy. For best results, wait as long as you can—ideally until 12–14 DPO.
https://www.oova.life/blog/10-dpo
Is 10 DPO too early to test?
10 DPO is considered early for pregnancy testing. While some women get positives at 10 DPO, accuracy is only 50–60% if you're pregnant. For best results, wait until 12 DPO (80–90% accuracy) or 14 DPO/missed period (99% accuracy).
https://www.oova.life/blog/10-dpo
Can you have implantation at 10 DPO?
Yes, implantation can still occur at 10 DPO, though 84% of women have already implanted by this point. Late implantation at 10–12 DPO is normal. If implantation happens at 10 DPO, you won't get a positive pregnancy test for another 2–3 days.
https://www.oova.life/blog/10-dpo
What does a negative test at 10 DPO mean?
A negative test at 10 DPO does not mean you're not pregnant. It's very common to get negatives at 10 DPO even if you conceived. Your hCG levels may still be too low, or implantation may have occurred later. Wait until 12–14 DPO to retest for more accurate results.
https://www.oova.life/blog/10-dpo
Can you get a positive pregnancy test at 10 DPO?
Yes, but only about 50–60% of pregnant women will get a positive at 10 DPO. The other 40–50% have hCG levels that are still too low to detect. If you test negative at 10 DPO, wait 2–3 days and test again.
https://www.oova.life/blog/high-progesterone-symptoms
Can high progesterone cause weight gain?
Yes, elevated progesterone can cause temporary weight gain through water retention and bloating. This is a normal part of the luteal phase and early pregnancy.
https://www.oova.life/blog/how-to-increase-estrogen
Does stress affect estrogen levels?
Yes, chronic stress elevates cortisol, which can suppress estrogen production and disrupt hormonal balance. Stress reduction through meditation, yoga, adequate sleep, and self-care practices helps maintain optimal estrogen levels.
https://www.oova.life/blog/how-to-increase-estrogen
When should I consider medical treatment for low estrogen?
Consider medical intervention if natural methods don't improve symptoms after 3 months, if symptoms severely impact quality of life, if you're experiencing early menopause (before 40), or if you have fertility concerns. Hormone replacement therapy may be appropriate in these cases.
https://www.oova.life/blog/how-to-increase-estrogen
What are the signs that my estrogen is increasing?
Signs of rising estrogen include more regular menstrual cycles, reduced hot flashes, improved vaginal lubrication, better mood stability, increased energy, and improved skin elasticity. You may also notice reduced symptoms that originally indicated low estrogen.
https://www.oova.life/blog/how-to-increase-estrogen
Can exercise increase estrogen levels?
Yes, moderate exercise stimulates estrogen release and helps maintain hormonal balance. Aim for 150 minutes of moderate cardio weekly plus strength training twice per week. However, excessive exercise can actually lower estrogen, so balance is key.
https://www.oova.life/blog/how-to-increase-estrogen
How long does it take to increase estrogen naturally?
With consistent dietary and lifestyle changes, you may notice improvements in symptoms within 4-8 weeks. However, significant hormonal changes typically take 2-3 months. Tracking your cycle and symptoms can help you monitor progress.
https://www.oova.life/blog/how-to-increase-estrogen
What foods increase estrogen levels naturally?
Foods high in phytoestrogens can help increase estrogen naturally. The best options include flax seeds (high in lignans), soy products (tofu, tempeh, edamame), lentils, chickpeas, whole grains (oats, quinoa, brown rice), and garlic. These plant compounds mimic estrogen's effects in the body.
https://www.oova.life/blog/perimenopause
What helps relieve hot flashes quickly?
Cool environments, layered clothing, herbal teas, and medical treatments like gabapentin or HRT may help—depending on severity. Lifestyle changes like reducing caffeine and alcohol can also provide relief.
https://www.oova.life/blog/perimenopause
Are there tests to confirm perimenopause?
Yes. Tests measuring estradiol, LH, and FSH levels can indicate hormonal shifts—but diagnosis is often symptom-based since hormone levels fluctuate widely during perimenopause.
https://www.oova.life/blog/perimenopause
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. Diagnosis is often based on symptoms combined with age and menstrual pattern changes.
https://www.oova.life/blog/perimenopause
What's the earliest age perimenopause can start?
Some women begin experiencing symptoms as early as their mid-30s, though perimenopause typically starts between ages 38-45.
https://www.oova.life/blog/perimenopause
Does perimenopause affect mental clarity?
Yes. Brain fog and difficulty concentrating are common during hormone fluctuations in perimenopause.
https://www.oova.life/blog/TBD-10-symptoms-and-how-to-get-relief
What happens after the last sign of perimenopause?
After your final period, you enter postmenopause. You'll need 12 consecutive months without a period to confirm menopause. Many symptoms gradually improve, though some like vaginal dryness may persist without treatment.
https://www.oova.life/blog/TBD-10-symptoms-and-how-to-get-relief
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.
https://www.oova.life/blog/high-progesterone-symptoms
Is high progesterone a sign of pregnancy?
Yes, high progesterone is one of the earliest indicators of pregnancy. Progesterone levels rise significantly after conception to support the developing embryo and reach their peak during the third trimester.
https://www.oova.life/blog/TBD-10-symptoms-and-how-to-get-relief
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.
https://www.oova.life/blog/TBD-10-symptoms-and-how-to-get-relief
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.
https://www.oova.life/blog/TBD-10-symptoms-and-how-to-get-relief
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.
https://www.oova.life/blog/high-progesterone-symptoms
What are the symptoms of high progesterone?
High progesterone symptoms include fatigue, bloating, breast tenderness, weight gain, anxiety, depression, headaches, and food cravings. During pregnancy, you may also experience increased nipple sensitivity and muscle aches.
https://www.oova.life/blog/TBD-10-symptoms-and-how-to-get-relief
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.
https://www.oova.life/blog/high-progesterone-symptoms
When should I be concerned about high progesterone?
Consult a healthcare provider if you experience high progesterone symptoms outside your luteal phase when not pregnant, or if symptoms include severe pelvic pain, abnormal vaginal bleeding, or rapid weight gain while on hormone therapy.
https://www.oova.life/blog/high-progesterone-symptoms
How do you test progesterone levels?
Progesterone can be measured through blood tests at your doctor's office or at-home urine tests that measure PdG (a progesterone metabolite). Testing is typically done during the luteal phase, about 7 days after ovulation.

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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