Perimenopause

Perimenopause is the bridge between your reproductive years and menopause — a transition that unfolds gradually over months or years, not all at once. During this time, your ovaries begin producing less estrogen and progesterone, and the hormonal fluctuations that result can affect everything from your menstrual cycle to your sleep, mood, and energy levels.

The most noticeable sign of perimenopause for many women is a change in their periods: they may become irregular in timing, shorter or longer, lighter or heavier, or more unpredictable overall. Hot flashes, night sweats, difficulty sleeping, vaginal dryness, and shifts in mood or concentration are also common. These experiences vary enormously from woman to woman — some sail through with minimal disruption, while others find the transition significantly affects their daily life.

Perimenopause typically begins in the mid-to-late 40s, though it can start as early as the late 30s for some women. It ends when you've gone 12 consecutive months without a menstrual period — at that point, you've reached menopause. Until then, you can still become pregnant, so contraception is still relevant if that's a consideration. Understanding that these changes are a normal biological process — not a malfunction — can make navigating them feel a little less unsettling.

Perimenopause is a significant health transition, and recognizing it for what it is matters. Many women experience symptoms for years without knowing they're in perimenopause, chalking up disrupted sleep, mood changes, or irregular periods to stress or other causes. Knowing what's happening hormonally can bring clarity — and opens the door to real conversations about symptom management.

There are many options for managing perimenopausal symptoms, from lifestyle adjustments to hormone therapy to non-hormonal medications, depending on your health history and preferences. Perimenopause is also the time when bone density begins to decline more quickly and cardiovascular risk starts to shift — making it a meaningful moment to take stock of your overall health with your care team.