Pinpointing the Signs of Perimenopause

Some call it a transition. To others, it’s a stage. But no matter what view you take, perimenopause is the period in a woman’s reproductive life that begins some years — anywhere from 2 to 10 — before menopause. Diana E. Hoppe, MD, a gynecologist at Scripps Memorial Hospital Encinitas in southern California, says, “For most women, perimenopausal symptoms show up in their 40s, although for some, the signs may start as early as their 30s.” The average length of perimenopause is four years, and it ends when you’re officially in menopause, meaning that you have gone without a period for 12 consecutive months.

As a woman nears the end of perimenopause — generally in the last year or two — she may begin to have menopausal symptoms, such as experiencing consecutive months during which she doesn’t have a menstrual period. Many of the symptoms of perimenopause are like those of premenstrual syndrome (PMS). “The difference is that PMS is usually predictable and is based on your menstrual cycle,” Dr. Hoppe says. “Perimenopausal symptoms are based on hormones that aren’t necessarily still following a typical 28-day cycle.” Additionally, while many perimenopausal symptoms, including hot flashes and night sweats, are similar to those experienced in menopause, Hoppe says you can tell the difference because you’ll still have a period during perimenopause.

Signs of Perimenopause

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