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Women's Health

Your Guide To Perimenopause: What To Expect & How To Feel Your Best During It

Author: Sarah Garone, NDTR

May 16, 2026

Licensed Nutritionist

By Sarah Garone, NDTR

Licensed Nutritionist

Sarah Garone, NDTR is a licensed nutritionist and freelance health and wellness writer in Mesa, AZ whose work has appeared in numerous publications.

Image by Delmaine Donson / iStock

May 16, 2026

If you're a woman of a certain age, you know it's coming eventually—you just might not know when. It could begin next month, next year, or not for another decade. We're talking about perimenopause.

Though we all know the window of menstruation doesn't last forever, there's still plenty of confusion around the time leading up to your last period.

Like, exactly how long does this stage last, and how is it different from actual menopause? We spoke to women's health experts to get the lowdown on how to get through this inevitable phase with your health (and sanity) intact.

What is perimenopause?

First things first: What is perimenopause? "Perimenopause is the five to seven years before a woman reaches her final menstrual period. She is still having periods, but she is also experiencing the symptoms of menopause, such as hot flashes/night sweats, mood changes, and weight change," explains board-certified OB-GYN Brandye Wilson-Manigat, M.D.

Got it. So what about premenopause? You may sometimes hear this term used interchangeably with perimenopause, but technically, they're not the same. "Premenopause" simply means you are in any stage before menopause, whereas "perimenopause" refers to the hormonal transition that immediately precedes menopause.

Menopause itself, on the other hand, is quite simple to pinpoint. "Menopause is the permanent cessation of menstruation, defined by when you've had your final menstrual period," Manigat says. This designation is given, she says, when you've had 12 consecutive months without any bleeding.

In this sense, you officially become menopausal on a single day (exactly 12 months after your last period). But, according to Manigat, this stage goes on for the rest of your life. "The terms menopausal and postmenopausal are frequently interchanged to describe this period of a woman's life."

What triggers perimenopause?

In chatting with friends or family members, you've probably noticed that some women hit the hormonal transition of perimenopause before others. Lauren Streicher, M.D., health medical director of community education and outreach at Midi, a virtual care clinic for perimenopause and menopause, says this mostly comes down to two factors: estrogen production and genetics.

"Perimenopause is triggered by fluctuations in ovarian estrogen production, [and] the main thing that influences when someone enters perimenopause and menopause is genetics," she says. "If your mom and older sister were still using tampons in their mid-50s, there is a good chance you will be too."

Still, she notes that ethnicity may also be a factor. At least one study1 has suggested that, compared to Caucasian-American and Japanese American women, Hispanic American and Black-American women tend to enter menopause earlier. Lifestyle and personal health history could also move the perimenopausal needle.

"Menopause tends to occur earlier in smokers and women with autoimmune diseases such as hypothyroidism, rheumatoid arthritis, and Type 1 diabetes," she says. "Women that work the night shift also tend to wind down early."

One rumor about onset that's not true: Getting your first period at a younger age means you'll hit perimenopause younger (and get over it sooner). "Contrary to popular belief, the age at which you started menstruating does not determine when you will stop—which seems kind of unfair," Streicher says.

In fact, a 2018 study2 found that women who had their first period at younger ages had longer menopausal transitions. Um, super unfair!

How long does perimenopause last?

There's good news and bad news about the potential duration of perimenopause. Research shows that perimenopause lasts four years3, on average. But in some cases, it can drag out for as long as a decade.

As for when you can expect to see the first inklings of perimenopausal changes? On average, symptoms appear in your mid-40s4, but anywhere from your late 30s to mid-50s are all fair game.

Perimenopause symptoms

Sometimes it seems like everything under the sun could be a perimenopause symptom. According to Streicher, there are over 30 physical indicators of this stage of life. Some of the most common include:

- Fatigue

- Hot flashes and night sweats

- Mood changes

- Change in menstrual cycle length (number of days from the start of one period to the start of the next period)

- Skipped or missed periods

- Heavier periods

- Brain fog

- Sleep disturbances

- Dry skin, brittle hair, and hair loss

- Body and muscle aches

- Vaginal dryness

- Increased urinary urgency and frequency

- Weight gai