What Is Perimenopause? Understanding The Transition Before Menopause

In this article: 

• Perimenopause is the natural transition before menopause, typically beginning in the 40s and lasting anywhere from 2 to 8 years.
• The stages of perimenopause are driven by changing levels of oestrogen and progesterone, which can contribute to symptoms such as hot flushes, sleep changes, mood shifts and irregular periods.
• Perimenopause and menopause are not the same thing. Perimenopause is the transition phase, while menopause is the milestone reached after 12 consecutive months without a period.
• While hormone changes drive perimenopause, factors such as sleep, stress and diet can influence the overall experience, making symptom intensity and duration different for everyone.

Perimenopause is your body’s natural transition leading up to menopause. It’s a gradual process that unfolds over several years as your hormone levels begin to change. 

Because it can look different from person to person, it can sometimes feel confusing or difficult to identify. The timing varies too. Some people notice changes earlier, while others enter perimenopause later1. 

But what exactly is it? Consider this your guide to what perimenopause actually is, the average perimenopause age, and how long it usually lasts. 

A rundown on perimenopause

Perimenopause signals the gradual wind-down of fertility as part of the body's natural ageing process2. The body enters this stage when the ovaries produce fewer follicles - the small fluid-filled sacs that contain the developing eggs needed for pregnancy. The ovaries also start producing less of certain hormones, especially oestrogen and progesterone1.

Rather than a smooth, steady decline, the early stages of perimenopause are marked by erratic fluctuations in hormone levels, followed by a progressive decline as the transition continues3 . 

These shifting hormones are behind many of the symptoms that people experience at this stage. Take hot flushes, for example. It’s one of the most commonly reported symptoms, affecting up to 80% of women4. Oestrogen helps regulate the body’s internal temperature. Disruptions to the signalling can trigger heat-loss responses at the ‘wrong’ moment5.

Hot flushes are just one of many symptoms reported during perimenopause. Research shows a range of symptoms - ranging from psychological, cognitive, sleep and metabolic changes - varying widely from person to person6. 

Can you get pregnant during perimenopause?

Yes, it’s still possible to get pregnant during perimenopause as it's a transition phase, not a complete end to fertility. Ovulation does become less frequent and harder to predict, but it doesn’t stop entirely. However, your chance of conceiving during perimenopause may be lower 7,8,9. 

When does perimenopause start?

So, at what age does perimenopause start? Typically, the perimenopause age range sits between 40 and 50. For most people, it starts in their 40s. However, others may not start until their 50s10. The timing and the experience will be different from person to person and can be influenced by things like genetics, lifestyle and their environment11. 

Can perimenopause start earlier?

While perimenopause most commonly begins in the 40s, it can start earlier for some people. Things that may influence whether perimenopause starts earlier include:

• Getting your first period young12
• Smoking13
• Lower body weight13
• Certain reproductive histories13. 

Perimenopause vs menopause: what’s the difference?

It's common to hear the two terms used interchangeably, but there are unique differences between perimenopause and menopause. Here’s a breakdown1, 7, 14: 

The simplest way to think about it is that perimenopause is the transition, while menopause is the milestone. One leads to the other, but they're not the same thing. 

How long does perimenopause last?

Perimenopause usually lasts around 4-8 years. Some people may experience a shorter 2 to 3-year transition, and others a decade or longer16. The exact length will come down to the individual.

What affects the perimenopause experience?

While perimenopause is a hormonally driven experience, how you actually feel during it can be shaped by external factors. 

• Sleep: Research suggests that poor or shorter sleep may be associated with more intense symptoms17. Disrupted sleep can also make it harder to cope with day-to-day changes17.  
• Stress: Stress doesn’t cause perimenopause, but it can influence the severity of symptoms. Several studies link higher stress to more frequent and intense symptoms18, 19, 20. 
• Diet: A higher quality diet can be associated with lower symptom intensity, while diets high in processed foods, saturated fats and sugars can be linked with more intense symptoms21. 

Supporting your wellbeing during perimenopause

Perimenopause is a natural stage of life that marks the transition toward menopause. While there are recognised stages of perimenopause, the timing and experience can vary from person to person. During this time, it's normal to experience a range of physical, emotional and menstrual changes as hormone levels fluctuate. 

Understanding what's happening in your body can help you navigate this stage with confidence. Prioritising healthy habits such as quality sleep, balanced nutrition, regular movement and stress management can support your overall wellbeing throughout the transition.

Looking to learn more? Explore the Swisse Wellness Hub for more on women's health, including articles like what's the deal with period pain and a guide to the different hormones during your menstrual cycle. 

References: 

1. Huffman, E. (2025, October 14). A season of transition: Three things you need to know about perimenopause. Harvard T.H. Chan School of Public Health. https://hsph.harvard.edu/mahalingaiah-lab/news/a-season-of-transition-three-things-you-need-to-know-about-perimenopause/
2. Torpy, J. M., Lynm, C., & Glass, R. M. (2003). Perimenopause: Beginning of menopause. JAMA, 289(7), 940. https://doi.org/10.1001/jama.289.7.940
3. Santoro, N., Roeca, C., Peters, B. A., & Neal-Perry, G. (2021). The menopause transition: Signs, symptoms, and management options. The Journal of Clinical Endocrinology & Metabolism, 106(1), 1–15. https://doi.org/10.1210/clinem/dgaa764
4. Zhang, Z., DiVittorio, J. R., Joseph, A. M., & Correa, S. M. (2021). The Effects of Estrogens on Neural Circuits That Control Temperature. Endocrinology, 162(8), bqab087. https://doi.org/10.1210/endocr/bqab087
5. Gombert-Labedens, M., Vesterdorf, K., Fuller, A., Maloney, S. K., & Baker, F. C. (2025). Effects of menopause on temperature regulation. Temperature, 12(2), 92–132. https://doi.org/10.1080/23328940.2025.2484499
6. Richardson, M. K., Coslov, N., & Woods, N. F. (2023). Seeking Health Care for Perimenopausal Symptoms: Observations from The Women Living Better Survey. Journal of Women's Health (2002), 32(4), 434–444. https://doi.org/10.1089/jwh.2022.0230
7. National Institute on Aging. (n.d.). What is menopause? U.S. Department of Health and Human Services, National Institutes of Health. https://www.nia.nih.gov/health/menopause/what-menopause
8. McKinlay, S. (1996). The normal menopause transition: an overview. Maturitas, 23(2), 137–145. https://doi.org/10.1016/0378-5122(95)00985-x
9. Bazi, T., & Zreik, T. (2006). Contraceptive Options during Perimenopause. Women's Health, 2, 899–910. https://doi.org/10.2217/17455057.2.6.899
10. Kailas, N., Sifakis, S., & Koumantakis, E. (2005). Contraception during perimenopause. The European Journal of Contraception & Reproductive Health Care, 10, 19–25. https://doi.org/10.1080/13625180400020861
11. Devalla, A. (2024). Contraception in perimenopause: a review of fecundity, fertility, and feasibility of contraceptives. International Journal of Reproduction, Contraception, Obstetrics and Gynecology. https://doi.org/10.18203/2320-1770.ijrcog20243626
12. Mishra, G., Pandeya, N., Dobson, A., et al. (2017). Early menarche, nulliparity and the risk for premature and early natural menopause. Human Reproduction (Oxford, England), 32, 679–686. https://doi.org/10.1093/humrep/dew350
13. Peycheva, D., Sullivan, A., Hardy, R., Bryson, A., Conti, G., & Ploubidis, G. (2022). Risk factors for natural menopause before the age of 45: evidence from two British population-based birth cohort studies. BMC Women's Health, 22. https://doi.org/10.1186/s12905-022-02021-4
14. World Health Organization. (2022). Menopause. https://www.who.int/news-room/fact-sheets/detail/menopause
15. Paramsothy, P., Harlow, S., Nan, B., et al. (2017). Duration of the menopausal transition is longer in women with young age at onset: the Multiethnic Study of Women's Health Across the Nation. Menopause, 24, 142–149. https://doi.org/10.1097/gme.0000000000000736
16. Santos, M., Vilerá, A., Wysocki, A., Pereira, F., Oliveira, D., & Santos, V. (2021). Sleep quality and its association with menopausal and climacteric symptoms. Revista Brasileira de Enfermagem, 74(Suppl 2), e20201150. https://doi.org/10.1590/0034-7167-2020-1150
17. Liu, X., Zhang, X., Wang, D., Zhou, J., & Li, Y. (2025). Investigation of the quality of life and influencing factors among perimenopausal women. Archives of Gynecology and Obstetrics, 312, 1253–1265. https://doi.org/10.1007/s00404-025-08116-1
18. Sood, R., Kuhle, C., Kapoor, E., Thielen, J., Frohmader, K., Mara, K., & Faubion, S. (2019). Association of mindfulness and stress with menopausal symptoms in midlife women. Climacteric, 22, 377–382. https://doi.org/10.1080/13697137.2018.1551344
19. Logan, N., Gaudreau, J., Owens, B., Oaks, B., Ward-Ritacco, C., & Sabik, N. (2025). Heightened menopausal symptoms mediate the associations between stress and depressive symptoms among midlife women. Menopause. https://doi.org/10.1097/gme.0000000000002596
20. Dourou, P., & Sousamli, A. (2025). Association between menopause and quality of life: A cross-sectional study using data from women living in Northern Greece. World Journal of Advanced Research and Reviews. https://doi.org/10.30574/wjarr.2025.25.3.0839
21. Noll, P., Campos, C., Leone, C., Zangirolami-Raimundo, J., Noll, M., Baracat, E., Júnior, J., & Sorpreso, I. (2020). Dietary intake and menopausal symptoms in postmenopausal women: a systematic review. Climacteric, 24, 128–138. https://doi.org/10.1080/13697137.2020.1828854