During perimenopause, individuals experience changes in their menstrual cycle and other signs that signal a transition to menopause. The signs of perimenopause vary. Find out if you may be experiencing perimenopause symptoms and when you should consult one of NewYork-Presbyterian’s specialists.

What is Perimenopause

What is Perimenopause?

Perimenopause is the process of change leading up to a woman’s last menstrual period. This transition is a normal part of aging. For most, the average age of perimenopause is in their mid-40s, and it lasts between 4 and 10 years. But, every patient is different. Perimenopause can start at a younger or older age and last between 2 and 8 years.

Perimenopause vs. menopause

Menopause begins when an individual has not had a period—or any bleeding at all, such as spotting—for an entire year. This doesn’t happen suddenly, and the transition takes a few years for most. This transition time is called perimenopause.

During the perimenopause stage:

  • Levels of the hormones estrogen and progesterone fluctuate
  • Periods become irregular
  • It is possible to become pregnant

During menopause:

  • Estrogen and progesterone levels drop permanently
  • Periods end
  • It is not possible to become pregnant

Perimenopause Symptoms


Signs of perimenopause vary from person to person. They can be mild or more troublesome, and they can appear suddenly or develop over time. No treatment is needed unless symptoms are bothersome. Perimenopause symptoms are similar to those of menopause. They include:

  • Irregular periods or skipped periods 
  • Periods that are heavier or lighter than usual
  • Hot flashes and night sweats
  • Trouble sleeping (insomnia)
  • Mood swings, irritability
  • Vaginal dryness (causing itching or pain during sex)
  • Memory problems or trouble focusing
  • Headaches
  • Urinary incontinence or leaking

Causes of Perimenopause


Perimenopause is a natural transition that comes with aging. It is caused by changes in estrogen and progesterone, the hormones which control the build-up of the uterine lining and monthly periods. The average age for the onset of perimenopause is the mid to late 40s. Around this time, hormone levels begin to fluctuate, leading to

Risk Factors

Risk Factors

Some may experience perimenopause at an earlier age than others. This can happen for no known reason. The following risk factors also may contribute to early perimenopause:



If you have severe or bothersome perimenopause symptoms, seek a doctor’s assistance. A symptom could also be a sign of a medical issue beyond perimenopause. Here are some situations in which a doctor can help:

  • Excessive bleeding (can be caused by infection, disease, or a pregnancy problem, as well as perimenopause)
  • Urinary problems (incontinence, leaking)
  • Vaginal dryness (causing discomfort or pain during sex)
  • Perimenopause or menopause before age 40 (increases the risk of heart disease and osteoporosis)
Get Care

Get Perimenopause Relief from NewYork-Presbyterian

The experts in women’s health at NewYork-Presbyterian provide comprehensive medical care for every life stage, including perimenopause and menopause. Our goal is to partner with patients and empower them with knowledge, support, and the most effective treatment options.