Perimenopause
Key facts
- Perimenopause is the stage of life leading up to your last period (menopause).
- During perimenopause, your periods may be irregular and you may have other symptoms, such as hot flushes and vaginal dryness.
- Tests usually aren't needed to check if you are in perimenopause.
- Keeping a healthy lifestyle and a healthy weight can help relieve your symptoms.
- Treatments are available to help you manage your perimenopause symptoms.
What is perimenopause?
Perimenopause is the stage of life leading up to your last menstrual period. During this stage you may have some of the symptoms of menopause.
Perimenopause ends one year after your last period — this is known as menopause. The next life stage is known as post-menopause.
Perimenopause usually starts in your 40s. On average, perimenopause lasts 4 to 6 years. However, it can last from 1 to 10 years.
What are the symptoms of perimenopause?
A common symptom of perimenopause is irregular periods.
Your periods may:
- come more or less often
- be longer or shorter than usual
- be lighter or heavier than usual
Some months you might not get a period. It can change from month to month.
What other perimenopause symptoms may I get?
Most females will have some physical or emotional symptoms of menopause.
About:
- 3 in 5 females will have mild to moderate symptoms
- 1 in 5 females will have symptoms severe enough to affect their daily activities
- 1 in 5 females won't have any symptoms at all
Physical symptoms of perimenopause may include:
- hot flushes and night sweats
- disturbed sleep and tiredness
- headaches
- sore muscles and joints
- vaginal dryness
- sore breasts
Emotional and mental symptoms of perimenopause may include:
- mood swings
- brain fog
- anxiety or depression
You may also have weight gain despite not changing your diet or exercise.
CHECK YOUR SYMPTOMS — Use the Symptom Checker and find out if you need to seek medical help.
What causes perimenopause?
Perimenopause takes place as your ovaries start to run out of eggs.
The levels of hormones in your body, such as oestrogen, change during this time. Changes in your hormone levels can cause perimenopausal symptoms like hot flushes.
Some people experience sudden menopause because of surgery or cancer treatment.
When should I see my doctor?
You should speak with your doctor if you are having trouble with perimenopausal symptoms.
Even though changes in your periods are normal in perimenopause, you should see your doctor if:
- your bleeding is very heavy or continues for a long time
- you have bleeding after not having your period for a year
- bleeding happens after you've had sex
- you have polycystic ovarian syndrome (PCOS)
- you are obese
Your doctor may refer you to a:
- gynaecologist (specialist in female health)
- psychologist
- endocrinologist (hormone doctor)
- dietitian
FIND A HEALTH SERVICE — The Service Finder can help you find doctors, pharmacies, hospitals and other health services.
How is perimenopause diagnosed?
Your doctor will talk to you about your symptoms.
If you're under 45 years, your doctor may arrange a blood test to check your level of follicle stimulating hormone (FSH). This test can help to rule out other causes for your symptoms.
Your doctor will talk about treatment options with you.
They may also discuss:
Your doctor will also talk to you about contraception.
How is perimenopause treated?
Your treatment will depend on the symptoms that are bothering you.
There are 3 treatment categories:
Currently, no, complementary medicines, such as supplements and herbs, have enough evidence to prove that they stop menopausal symptoms.
If you suffer from vaginal dryness, you can use lubricants to feel more comfortable.
Can perimenopause be prevented?
Perimenopause is the life-stage before menopause and cannot be prevented.
Complications of perimenopause
Females with a history of major depressive disorder and hormone-related mood conditions are at risk of depression.
Pregnancy
You can still become pregnant before you reach menopause.
A missing period may mean you are pregnant. It's important to take a pregnancy test if you miss a period.
You should use contraception during perimenopause if you don't want to be pregnant.
Resources and support
NSW Health has a list of perimenopause symptoms to help you have conversations with your doctor. The list is available in English and other languages. There is also a checklist for Aboriginal women and an easy-read checklist.
Partners and families of people experiencing perimenopause can learn more at:
- Jean Hailes — information for partners
- NSW Health — understanding menopause for partners and families
You can also call the healthdirect helpline on 1800 022 222 (known as NURSE-ON-CALL in Victoria). A registered nurse is available to speak with 24 hours a day, 7 days a week.
Learn more here about the development and quality assurance of healthdirect content.
Last reviewed: November 2023
