When does perimenopause start?

Perimenopause is the stage of life when a woman’s hormonal changes begin as the body moves towards the menopause milestone. These changes can start earlier than many women expect.

Understanding when perimenopause typically begins can help women recognise symptoms sooner and seek appropriate advice and care.

What is perimenopause?

Perimenopause is the transitional phase leading up to the menopause milestone. During this time the ovaries gradually produce less oestrogen and progesterone. Hormone levels may fluctuate from time to time, which can lead to a range of physical and emotional symptoms.

Perimenopause ends when menopause occurs. Menopause is defined as the point when a woman has gone 12 consecutive months without a menstrual period.

What age does perimenopause start?

Most women begin perimenopause in their 40s.

For many women the first signs are subtle. Changes may include slightly irregular periods, changes in sleep, mood changes or new symptoms such as hot flushes.

Because hormone levels fluctuate during this stage, symptoms may come and go and may vary from month to month.

Can perimenopause start early?

Yes. Some women begin experiencing perimenopause symptoms in their late 30s. This is called early perimenopause. While it is less common, it is a recognised pattern.

Women may notice symptoms such as:

changes in menstrual cycle timing
night waking
anxiety or mood changes
brain fog
reduced energy

These symptoms can occur even when periods are still regular.

Why perimenopause age varies

The age at which perimenopause begins can differ between women. Several factors may influence timing, including genetics, smoking, certain medical treatments such as chemotherapy or surgery involving the ovaries.

For most women however, perimenopause simply begins naturally as the ovaries gradually change their hormone production.

How long does perimenopause last?

How long perimenopause lasts typically varies between individuals before menopause occurs.

For many women the transition lasts around 4 to 8 years, although this can vary.

Some women experience relatively mild symptoms, while others may experience symptoms that affect daily life, sleep or work.

When to see a doctor

For those noticing changes or symptoms in their late 30s or 40s, a perimenopause consultation can be a useful step in gaining clarity and managing hormonal transitions.

Medical advice may be particularly helpful if you experience:

troublesome sleep problems
significant mood changes or anxiety
heavy or very irregular periods
symptoms that affect daily life

A doctor can assess symptoms, rule out other possible causes and discuss perimenopause treatment options if needed.

Key points

Perimenopause is the transition leading up to menopause.
Most women begin perimenopause in their 40s.
Some women begin experiencing symptoms in their late 30s.
Hormone levels fluctuate during this time which can cause a range of symptoms.
Medical advice can help if symptoms become bothersome or unclear.

Medically reviewed by Dr Susana Rodriguez, menopause clinician at ClaraSana Women’s Health, Perth.

Our content is based on up-to-date Australian guidelines & may differ from information on other sites.

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