How Can You Tell If You're Going Through Perimenopause?

Perimenopause, which literally means “around menopause,” is a word used to describe the symptoms and time period leading up to menopause. Menopause is defined as not having had your period or menstrual cycle for one full year. Many women are perimenopausal but don’t know that this is what they are experiencing. Read on to learn more about the defining factors and symptoms of this phase of life.

Calendar, phone, and tampons.

Is perimenopause a medical condition?

Perimenopause may sound like a condition or disease, but the term actually describes a certain time period in a woman's life. This makes it a bit more difficult to pinpoint what it means, because each woman's experience can be different.

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When does perimenopause happen?

Menopause typically happens around the age of 51. Based on that, you can enter perimenopause anywhere from your late 30s to late 40s. Sometimes you may have a strange menstrual period and think that you have entered perimenopause, only to get back on track in subsequent months. Usually, it takes several irregular cycles and being over age 40 before your doctor will say that you are perimenopausal, although there isn’t a specific blood test to verify this.

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What are the symptoms of perimenopause?

During this time, the levels of the hormones progesterone and estrogen in your body start to fluctuate. This means that your period may become irregular, coming more frequently or less frequently. The flow may be lighter or heavier as well. You may also experience vaginal dryness due to decreased estrogen, which can cause painful sex. There are treatments for this, both hormonal and non-hormonal. Night sweats and hot flashes may also occur.

Woman at doctors office getting results of tests.

How is perimenopause diagnosed?

Interestingly enough, "diagnosing" perimenopause is mostly about your age and the symptoms you’re dealing with. There is not a specific test to diagnose perimenopause that would be useful. Your doctor or midwife will take a look at your medical history and the symptoms you are having (both those related to your menstrual cycle and other potential symptoms, like night sweats or hot flashes), and make the diagnosis based on that criteria.

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Will I need to use birth control if I'm perimenopausal?

You should continue to use birth control during this time. Many women are confused by the erratic nature of their cycles during perimenopause. The absence of regular periods may lull you into thinking you can’t get pregnant, but this isn’t true. While your fertility is diminishing with age, pregnancy can and does still occur in perimenopausal women. You and your doctor can discuss birth control options that can prevent pregnancy and help with symptoms of perimenopause at the same time.

Woman talking with doctor about treatment options.

Should I seek help for perimenopausal symptoms?

If you experience bleeding after sex, that lasts much longer than usual, or occurs more frequently than every three weeks, or if you soak more than a pad or tampon per hour, it’s time to seek treatment. If other symptoms are disrupting your life — for example, vaginal dryness or sleep problems — they can be treated too. Your doctor can help you find the best treatment for you. Depending on your diagnosis, options may include medications, procedures such as an endometrial ablation, or hysterectomy.

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Are there health risks associated with perimenopause?

The biggest risk during perimenopause is that you will be less physically active, thus increasing your risk of chronic conditions like heart disease or diabetes due to weight gain, high blood pressure, and other lifestyle-related illnesses. There’s also the risk of unplanned pregnancy, as mentioned before. Make sure to watch for bleeding patterns that may be a sign that something is wrong. Seeing your practitioner regularly can help you manage issues that arise.

Older woman reviewing medical file with her doctor.

How long does perimenopause last?

Technically, perimenopause can last for up to 10 years. Some women find that they ease into this phase and don’t really notice until just before the end. Other women find that they are very cognizant of even the smaller changes in their bodies. Symptom management can be the difference between being miserable and surviving and thriving.

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How will I know I'm done with perimenopause?

There is an end in sight! Once you have not had a period for one year, you are said to have entered menopause. This means that any vaginal bleeding you may have after this time would need to be reported to your health care provider as dysfunctional uterine bleeding. It may be a symptom of something else, including various female cancers, so get it checked by your doctor right away.

Happy woman smiling.

The bottom line on perimenopause

Perimenopause is something that may or may not present with symptoms. If you do have symptoms, they can range from mildly annoying to life-disrupting. The good news is that there are many treatments available to help you if the symptoms interfere with your life and overall health. Everyone experiences this time of life slightly differently, and your doctor or other practitioner can help you navigate the symptoms and choices before menopause and beyond. Don't hesitate to reach out to them.

Robin Elise Weiss, Ph.D.
Meet Our Writer
Robin Elise Weiss, Ph.D.

Robin Elise Weiss, Ph.D., LCCE, CLC, AdvCD(DONA) is a childbirth educator, doula, founder of, and the award-winning pregnancy and parenting author of “The Complete Illustrated Guide to Pregnancy” and more than 10 other books. Between her nine children, teaching childbirth classes, and attending births for more than two decades, she has built up an impressive and practical knowledge base. You can follow Robin on Twitter @RobinPregnancy, Instagram @Robineliseweiss, and Facebook @childbirthtrainings.