When Does Perimenopause Start? A Simple Guide for Women

Your body naturally changes as you move through the different stages of life. Understanding these changes can help you navigate them with confidence and care. A transition that many women experience is perimenopause.

Perimenopause is the stage leading up to menopause and is often accompanied by shifts in your menstrual cycle, mood and overall well-being. Knowing when perimenopause typically starts and what to expect can make all the difference in how you manage this chapter.

If you need help recognizing the signs, understanding what’s happening to your body and taking the steps to support your health, here is a simple guide to help you navigate perimenopause.

What Is Perimenopause?

Many women know exactly what menopause is and how they can expect it to affect their bodies, yet not many know about perimenopause. Perimenopause is the transitional period leading up to menopause, which is when a woman has not experienced a menstrual cycle in over a year.

The most important thing to note about perimenopause is that it is not the same as menopause. The two are different processes with distinctly different effects on the body. Perimenopause can start years before a woman’s final menstrual cycle.

What Are the Signs of Perimenopause?

During perimenopause, estrogen begins declining. Estrogen is one of the reproductive hormones in women, and the decline of this hormone has varying effects on the body. Here are some signs you might be in perimenopause:

1. Disruption of the menstrual cycle: One of the first signals that your body has entered perimenopause is your menstrual cycle becoming irregular. You may notice that the time between cycles is becoming notably longer or shorter. Your flow might also become lighter or heavier, and the changes can vary monthly. Once you have experienced this symptom, you will likely begin experiencing others.
2. Increased fatigue: If you’re unexplainably tired and this is not usual for you, you might be entering perimenopause. This is often accompanied by insomnia or altered sleeping patterns.
3. Mood swings: Mood swings are a common symptom in many areas of women’s reproductive health, and perimenopause is no exception. You might notice you’re more on edge than usual or experiencing agitation at minor inconveniences.
4. Cognitive issues: Many women experience reduced cognitive functioning when they enter perimenopause. You may notice increased forgetfulness, slight issues speaking and slowed psychomotor speeds.
5. Reduced libido: Due to the hormone disruptions happening in a woman’s body during perimenopause, you may experience a reduced libido. You may experience no sexual desire, and reaching sexual arousal might become more challenging during this stage.
6. Incontinence: As women enter perimenopause and estrogen levels drop, their urethral and vaginal tissues soften as their pelvic floors relax. Due to these factors, many women experience bladder incontinence.
7. Thinning hair: Many women can expect changes to their hair when they enter perimenopause. It is common for women to experience hair and volume loss during perimenopause.
8. Night sweats: Many women incorrectly identify night sweats with menopause when it is a perimenopausal symptom. If you’re experiencing night sweats and you’re still getting a period — even if it's irregular — it’s most likely perimenopause.
9. Hot flashes: This perimenopause symptom is often mistakenly identified as menopause. Categorized by a sudden feeling of heat throughout the body, even in cool weather, a hot flash is a classic perimenopause sign.

So, when does perimenopause start? Although perimenopause can begin as early as your 30s, it typically starts later. Many women will begin experiencing perimenopausal symptoms in their mid to late 40s, many years before their last menstrual cycle. Four years is the median length for perimenopause symptoms, but they can last longer or shorter.

You’re in Perimenopause, Now What?

If you’ve identified that you might be in perimenopause based on your symptoms, you might be wondering what to do next. You can do a few things to help you feel more comfortable during this time:

1. Dress in layers: Layering is a great way to mitigate the hot flash issue. Doing this allows you to remove layers when you become hot and then add them back on when your temperature returns to normal.
2. Log your hot flashes: It might seem odd to write down whenever you have a hot flash and what preceded it, but it might help you identify the trigger of your hot flashes. Doing this will help you lessen your chances of experiencing a hot flash.
3. Get your vitamins in: Due to hormonal changes, you will be lacking in some vitamins, so eat a vitamin-rich diet or take supplements to boost your vitamin intake each day. This will help you recover from exercise faster, bring down your cholesterol levels and lower your risk of heart disease.
4. Exercise regularly: As you enter perimenopause, your body is slowly ridding itself of hormones that keep you strong and healthy, so maintaining a regular exercise routine will ensure that your muscles and bones stay healthy.
5. Consult a doctor: Although you may identify with many of these symptoms, you cannot be sure you have entered perimenopause until you consult a medical professional. If you suspect you’re in perimenopause, make an appointment to see your doctor so they can confirm it.

The Final Flash

Perimenopause is a natural part of aging, but that doesn’t mean you have to navigate it without support. Understanding when it starts and recognizing the symptoms can help you approach this phase with confidence. You can ease the transition and continue feeling your best by making thoughtful lifestyle changes. Remember, your body is shifting into a new season, and with the right care, you can thrive through it.

About the author: Beth Rush

Beth is the fitness editor at Body+Mind. She writes about how women with PCOS can hack their exercise routines to balance hormones naturally. Shecovers topics like plant-based recipes for athletes and preaching the benefits of green exercise. You can find Beth on Twitter @bodymindmag.