• Menopause

When Does Perimenopause Start and How Long Does it Last?

Medically reviewed and edited by Lauren Cramer, PA- C

Published: August 14, 2025
Updated: November 18, 2025
2 mins

Perimenopause is the natural transitional phase that occurs before menopause, marking the time when a woman’s body begins to shift from regular reproductive cycles toward the end of fertility. During this period, hormonal changes – particularly fluctuations in estrogen and progesterone – can lead to a variety of physical and emotional symptoms. 

Understanding perimenopause and knowing when perimenopause starts is important because it helps women anticipate these changes, make informed health decisions, and address symptoms early. Awareness of timing and duration can also guide lifestyle adjustments, medical consultations, and overall reproductive health planning.

What is Perimenopause?

Perimenopause is the stage in a woman’s life leading up to menopause, during which the ovaries gradually produce less estrogen and progesterone. This phase marks the body’s natural transition from regular menstrual cycles to the end of fertility and is an essential part of reproductive aging. These hormonal shifts during perimenopause can bring noticeable changes – such as irregular periods, hot flashes, and mood fluctuations. While this is a normal physiologic process, it can be the start of unseen changes in bone, cardiovascular and cognitive function.

When Does Perimenopause Start?

Many women begin to notice signs of perimenopause in their early 40s, though it can start as early as the late 30s or as late as the early 50s. The average age of perimenopause tends to fall around 45, but this can vary widely from woman to woman. 

Several factors play a role in determining when perimenopause begins for an individual: genetics and family history, lifestyle habits such as smoking, diet, and stress, and medical history including surgeries, chemotherapy, or hormonal conditions.

Starting perimenopause earlier or later than the average is usually not cause for alarm. Women who enter this phase in their late 30s or mid 40s may simply reflect normal biological variability. However, if perimenopause begins unusually early or late, it can sometimes signal underlying health issues, making a consultation with a healthcare provider helpful for peace of mind and proper guidance.

How Long Does Perimenopause Last?

Perimenopause usually lasts between seven to 10 years though this can also vary significantly from woman to woman. Some may experience a shorter transition of just a few years, while others may notice symptoms stretching to over a decade. 

The length of perimenopause can be influenced by several factors, including genetics, overall health, and lifestyle choices. Women with certain medical conditions or a history of surgical interventions affecting the ovaries may experience a shorter or longer perimenopause. While variations in duration are often normal, extremely short or unusually prolonged transitions can sometimes warrant a discussion with a healthcare provider to rule out underlying issues.

Signs Perimenopause is Ending

As perimenopause winds down, cycles usually become infrequent and eventually cease; menopause is confirmed after 12 months without a period. Vasomotor symptoms often stabilize or gradually ease. These changes reflect declining ovarian function – lower, less variable estradiol and progesterone with a compensatory rise in FSH – signaling the transition into menopause.

Where Can I Learn More About Managing Perimenopause?

If you suspect you’re approaching perimenopause or are experiencing symptoms associated with hormonal imbalance, you don’t have to tough it out alone. With personalized hormone therapy, expert guidance, and support that fits your life, getting back to balance is more accessible than ever – thanks to the LifeMD Women’s Health Program.

Visit our site to learn more about how to take the first step toward feeling like you again.

Lauren Cramer, PA- C

Lauren is a passionate and dedicated board-certified physician assistant. She received her Bachelor’s degree in Kinesiology and Exercise Science from SUNY Cortland — graduating magna cum laude while competing as a three-sport collegiate athlete in indoor and outdoor track and cross country. She went on to complete her Master’s degree in Biological Sciences and earn her Physician Assistant degree from Daemen College in Buffalo, New York. Lauren has years of focused experience in perimenopause, menopause, and postmenopause care, specializing in hormone replacement therapy (HRT), bone health optimization, and a functional medicine approach to women’s wellness. She integrates evidence-based hormone therapy with lifestyle, nutrition, and metabolic strategies to support long-term vitality, cognitive health, and bone density. In addition to her women’s health expertise, Lauren has a well-rounded background in allergy, asthma, otology, laryngology, and rhinology. Functional medicine has always been a passion of hers, and she continues to pursue advanced certification to deepen her ability to deliver personalized, root-cause care to her patients.

Talk To A Doctor

How does LifeMD work?