What is Perimenopause?

Class of Survivors member Priti Langer and friend taking a selfie at a park

Perimenopause is a transitional stage prior to menopause and is a normal part of midlife for a woman. During perimenopause, the ovaries gradually begin to make less estrogen, which can cause changes in menstrual cycles for up to 10 years before menopause. During this time, changing hormone levels may increase the risk of heart disease and stroke.

What happens to heart and brain health during perimenopause?

Levels of estrogen, which help keep blood vessels relaxed and open, start to decline markedly as menopause approaches. With less estrogen, cholesterol may begin to build up on artery walls. A buildup in vessels leading to the heart or brain can increase the risk of heart disease or stroke.

It’s important to monitor symptoms and note changes in your health, sleep, daily mood and activity levels and to discuss them with your healthcare professional.

Everyone’s risk for heart disease and stroke increases as they age, but it’s important for women to be especially aware of risk factors during perimenopause.

What are the symptoms of perimenopause?

Every woman experiences this phase differently, but some of the most common symptoms are:
  • Irregular periods
  • Hot flashes/flushes
  • Night sweats
  • Trouble sleeping
  • Headaches
  • Brain fog or trouble remembering words
  • Fatigue
  • Mood swings
  • Joint and muscle aches
  • Vaginal dryness or discomfort during sex
  • Feeling like you need to urinate more often

When does perimenopause start?

Generally, when periods get further apart, this is a sign of perimenopause. However, the start of perimenopause can vary by person. The average age for menopause is 51, but perimenopause can start up to 10 years prior. Your family may be your best answer. Ask your mom, aunts or older sisters when they stopped getting their period and about their perimenopause experience.

Why am I having perimenopausal symptoms? What is happening in my body?

During the early stages of menopause, your ovaries start to produce less estrogen. Eventually, your ovaries produce such small amounts of estrogen that they no longer release eggs. Irregular periods are often a sign of this estrogen producing slowdown and the first signs of perimenopause.

Can I still get pregnant during perimenopause?

Yes, you can still get pregnant during this time.

Última revisión: sep. 9, 2026