What is Perimenopause and When Does It Actually Start?

As you approach your 40'syour body begins preparing for one of life's significant transitions- menopause. However, before you reach that milestone, you may start to experience symptoms. This is perimenopause- the transition to the big M. Learn more about it and how long you can expect it to last. 

What is Perimenopause and When Does It Actually Start?

Perimenopause is a natural, yet often misunderstood, phase in a woman’s life. It marks the transitional time leading up to menopause — the point when the ovaries stop releasing eggs and menstruation ends. But unlike menopause, which is defined by a single milestone (12 months without a period), perimenopause is a gradual process that can last several years, bringing with it a range of hormonal fluctuations and symptoms.

What is Perimenopause?

The word perimenopause literally means “around menopause.” It’s the time when the body begins its shift from regular reproductive cycles to the end of fertility. During this phase, the ovaries slowly begin to produce less estrogen, one of the body’s key reproductive hormones. This decrease in estrogen doesn’t happen overnight — it fluctuates over time, which is why symptoms can be inconsistent and sometimes confusing.

Common symptoms of perimenopause include:

• Irregular periods

• Hot flashes and night sweats

• Mood swings or increased anxiety

• Sleep disturbances

• Vaginal dryness

• Brain fog or trouble concentrating

• Decreased libido

• Weight changes or bloating

Not every woman will experience all these symptoms, and the severity varies greatly. Some may breeze through perimenopause with only mild changes, while others may find the transition quite disruptive.

When Does Perimenopause Start?

Here’s where it gets tricky — perimenopause can start earlier than most people think. While the average age for menopause in the United States is around 51, perimenopause often begins in a woman's 40s — sometimes even as early as the mid-30s.

On average, perimenopause lasts 4 to 7 years, but for some, it can extend over a decade. The first sign is typically a change in menstrual patterns — shorter or longer cycles, missed periods, or heavier/lighter bleeding. Because many of these symptoms overlap with everyday stress, thyroid issues, or lifestyle changes, perimenopause is frequently overlooked or misdiagnosed.

How Do You Know You’re in Perimenopause?

There isn’t one single test to confirm perimenopause. Diagnosis usually involves:

• A review of your menstrual history

• A discussion of symptoms

• Hormone level testing (though fluctuating hormones can make results inconsistent)

• Ruling out other potential causes like thyroid disease

If you're noticing changes in your cycle or experiencing symptoms like fatigue, sleep issues, or mood shifts — and you're in your 30s or 40s — it’s worth having a conversation with your healthcare provider. Early awareness allows you to make informed choices about your health, including hormone therapy, lifestyle adjustments, and targeted wellness plans.

Embracing the Transition

Perimenopause is not a disease — it's a phase of life. Still, its impact on day-to-day well-being is real. With the right support, education, and resources, women can move through perimenopause with empowerment rather than frustration.

Whether you’re just starting to notice changes or you’re in the thick of symptoms, know this: you’re not alone, and help is available. Understanding perimenopause is the first step toward taking control of your hormonal health and finding a path that works best for you! 

Need support navigating perimenopause? At NDA Medical Spa and EquiLux, Unlock Your Biology  we offer personalized consultations and hormone testing to help you understand your body and find solutions that align with your goals.

 Reach out today to start your journey with clarity and confidence.