Perimenopause usually starts in your late 30s to mid-40s and can last anywhere from a few months to several years — and there is no routine test for it. Menopause itself is defined as 12 months without a period, and the average age in the UK is 51, with 45–55 being normal. If your periods become irregular and you notice hot flushes, sleep problems, or mood changes, that pattern — not a blood test — is usually how perimenopause is diagnosed. This guide explains the timeline, the signs, and when to see a doctor. Reviewed 2026.
What perimenopause is
Perimenopause is the transition period leading up to menopause. It happens when your periods become irregular, as hormone levels begin to fall. Menopause is when your periods stop altogether — defined as not having a period for 12 months (and not using hormonal contraception).
Menopause and perimenopause can affect anyone who has periods. The transition can last for a few months or several years.
What age does perimenopause start?
Perimenopause symptoms can start in your late 30s to early 40s. Menopause itself usually happens between the ages of 45 and 55, with the average age in the UK being 51.
Important distinctions:
- Early menopause — menopause before age 45
- Premature ovarian insufficiency (POI) — menopause before age 40, affecting about 1 in 100 women; this needs specialist care
If your periods stop before 45, or you are under 40 with menopausal symptoms, see a doctor — this is not "early perimenopause," it is a different situation that needs assessment.
How long does perimenopause last?
The transition can last for a few months or several years. For many women it lasts around 4 years, but this varies widely. The length is not predictable in advance — what matters is managing symptoms and knowing when to get help.
Common symptoms
Symptoms vary a lot between people. Common ones include:
- hot flushes and night sweats
- irregular periods — heavier, lighter, or skipped
- sleep problems
- low mood, anxiety, or irritability
- memory and concentration problems ("brain fog")
- joint pain
- weight changes
- vaginal dryness
You do not need to have all of these. Even one or two, with changing periods, can be perimenopause.
Is there a test?
There is no routine test for perimenopause or menopause. A doctor usually diagnoses it based on your age and symptoms. Blood tests are not routinely needed — and hormone levels fluctuate during the transition, so a single reading can be misleading.
Red flags: when to see a doctor
- your periods stop before age 45, or you are under 40 with menopausal symptoms
- you have very heavy bleeding — soaking through pads or tampons hourly, or passing large clots
- bleeding between periods or after sex
- periods that last much longer than usual or come much more often
- symptoms are affecting your daily life — sleep, work, relationships — and self-help is not enough
These can be signs of other conditions, so they deserve a proper check — not self-diagnosis.
What helps with symptoms
Treatment depends on your symptoms and preferences. Options with evidence include:
- Hormone replacement therapy (HRT) — the most effective treatment for hot flushes and night sweats; a doctor can discuss risks and benefits for your situation
- Lifestyle changes — regular exercise, cooling layers, avoiding triggers like caffeine and alcohol, and good sleep habits
- Talking therapies — CBT can help with low mood, anxiety, and sleep problems during the transition
- Vaginal oestrogen — for vaginal dryness, available on prescription
Evidence boundary: supplements marketed for menopause symptoms have mixed evidence — some help some people, but none are proven to replace HRT or treat all symptoms. Always check with a doctor before starting anything, especially if you have health conditions or take other medicines.
What does not help
- Assuming it is "just age" — symptoms are real and treatable.
- Self-diagnosing from the internet — irregular bleeding and mood changes can have other causes.
- Unproven supplements as a substitute for care — some interact with medicines or have no evidence.
- Ignoring early menopause — before 45 needs assessment, not waiting.
Sources
- NHS — What are menopause and perimenopause?: nhs.uk/conditions/menopause-and-perimenopause/what-are-menopause-and-perimenopause (page last reviewed 19 May 2026, accessed September 2026)
- NHS — Menopause and perimenopause: nhs.uk/conditions/menopause-and-perimenopause
- NHS — Early or premature menopause: nhs.uk/conditions/early-or-premature-menopause
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