How Long Does Perimenopause Last?

How long perimenopause lasts varies between women. On average, it lasts 4 years,* but it can last 10 years or more for some people. Perimenopause is the time leading up to menopause and is a period of transition rather than a fixed-length event. It usually happens in your 40s, but can begin in your late 30s, and leads up to menopause, which occurs at the average age of 51 in the UK.**

Remember most of these figures are just averages, and not all of us fit into the average box – if we did, the world would be a very boring place. So, focus on you and your body, the symptoms you may be experiencing – even if you've been told you're 'too young' or that it's 'just stress' – and use them to better understand your journey. In this guide, we explore the different stages of perimenopause and how long it lasts, the potential symptoms, whether there’s anything you can do to shorten perimenopause and when you should seek support. 

The Stages of Perimenopause and How Long Each Lasts

Perimenopause has 2 main stages: early and late. These stages help to explain what is happening in your menstrual cycle. Early perimenopause usually begins in your mid-40s, but it can be earlier or later. Late perimenopause is thought to occur 1 to 3 years before menopause (when you have not had a menstrual period for at least 12 months). Let’s take a closer look at what these stages mean.    

Early perimenopause

During early perimenopause, your ovaries still release eggs, but less predictably. Your hormone levels will fluctuate and your periods may still be fairly regular, but the time between them may begin to change. 

Clinicians use a persistent difference of at least 7 days between consecutive cycle lengths as one marker of early perimenopause.* Although your periods may be regular, the time between them will shift noticeably. For example, you may be used to a 28-day cycle, but during perimenopause, the time between periods may be 21 or 35 days. You may even notice that they become lighter or heavier.

Sleep disruption, anxiety or mood changes may be more noticeable before obvious hot flushes and night sweats. It's easy to put these changes down to a demanding job or family life, especially if your periods have not changed much. Early perimenopause can last for several years, so seeking help as soon as you notice symptoms can make the menopause transition more comfortable. 

Late perimenopause

Late perimenopause is characterised by longer gaps between your periods, often 60 days or more, and ovulation becomes less frequent, although it is still possible.* The late perimenopause stage typically lasts 1 to 3 years before your final period. Hot flushes and night sweats may become more noticeable, although not everyone experiences these symptoms or an increase in their intensity or severity.

Menopause and postmenopause

Menopause is a single point in time and refers to the date of your final period. You can only confirm it looking back, once you’ve gone 12 months without a period. It marks the end of your reproductive years. Postmenopause, however, is the phase after menopause and lasts for the rest of your life. You’ll no longer have periods, but you may still experience menopause symptoms.*

These timings are averages and describe a natural menopause transition. However, factors such as hormonal contraception, hormone replacement therapy (HRT) and some operations can make bleeding patterns more difficult to interpret.

What Affects How Long Perimenopause Lasts?

Several factors influence the timing of menopause and the length of the transition. However, factors associated with earlier menopause do not necessarily mean perimenopause will be shorter for you. Unfortunately, there is no reliable way to work out when menopause will happen for you using your age, family history and symptoms. 

Factors that can influence duration

The factors that can influence the duration of menopause include:

• Age at onset. In the Study of Women’s Health Across the Nation (SWAN), the youngest women to start the menopause transition had a longer average duration (8.57 years) than women in the oldest age group (4.37 years). So, starting menopause younger doesn’t necessarily mean it’ll finish sooner.*

• Smoking. The SWAN study also found that smoking was linked to an earlier onset of menopause and a shorter duration, but it is not a desirable way to shorten your symptoms.*

• Genetics and family history. Genetics strongly influence the timing and onset of menopause. So, your mother’s or sister’s experiences may provide useful context, especially if early menopause runs in your family.

• Ethnicity. Menopause duration differs across ethnic groups. For example, the SWAN study found that African American women had a longer menopause duration than white women.*

• Body weight and health. Researchers have explored body size and health alongside menopause timing, with complex findings. The NHS lists being underweight as a cause of early menopause,** while being overweight can mean you are more likely to experience late menopause.⁺   Weight or illness can also affect periods for other reasons. There is no simple “right weight” that guarantees a shorter transition, and its length is not a measure of how well you have looked after yourself.

Medical and surgical causes

There are also some medical treatments and surgeries that can cause menopause to start abruptly rather than through a gradual perimenopause. Others can mask the symptoms, making it difficult to see the timeline. 

If you have your ovaries removed before natural menopause occurs, it causes surgical menopause. A hysterectomy that removes your womb but leaves the ovaries in place doesn’t always cause immediate menopause because they can still produce hormones. However, menopause can happen earlier. Without periods, the usual menopause timeline can be more difficult to track.*

Chemotherapy and pelvic radiotherapy can affect ovarian function. Whether the effects are temporary or permanent depends on the treatment and your circumstances.

Early menopause means menopause before 45. Premature ovarian insufficiency (POI) involves reduced ovarian function before 40 and requires assessment; ovarian activity can sometimes occur intermittently. Seek advice rather than waiting a year to see whether periods return.**

Hormonal contraception, including the pill and hormonal coil, can also mask cycle changes. They may cause your periods to stop, which can make it harder to know if you have entered menopause.

How Long Do Perimenopause Symptoms Last?

Symptom duration doesn’t always match the perimenopause timeline. Some symptoms fluctuate during perimenopause, some become more intense as you approach menopause, while others can continue for years afterwards. Having symptoms for several years does not necessarily mean you are still in perimenopause, especially if you have not had a period for at least 12 months.

Hot flushes and night sweats, known as vasomotor symptoms, have been well studied. A SWAN analysis found that the average duration of vasomotor symptoms was 7.4 years, but for African American women this increased to 10.1 years. The average time they lasted in women who had already had their final menstrual period was 4.5 years, demonstrating that menopause symptoms can continue well into postmenopause.⁺

Other common menopause symptoms include:

• Sleep disruption, including difficulty falling asleep, waking during the night or waking too early

• Mood changes, such as anxiety, irritability or low mood

• Brain fog, including difficulty concentrating or remembering words

• Joint and muscle aches and an increased risk of osteoporosis

• Vaginal and urinary symptoms, such as dryness, painful sex, needing to pee more often or recurrent urinary infections 

These symptoms are not something you simply have to “wait out”. Understanding the pattern can help you get treatment for the symptoms that bother you most at any time during perimenopause. You can find out more about perimenopause symptoms in our guide.

Signs Perimenopause is Ending

The clearest sign that perimenopause is coming to an end is your periods becoming less frequent, often with gaps of 60 days or more, and eventually stopping. In a natural transition, menopause is confirmed when you have not had a natural period, where contraception, medication or another condition does not explain the absence, for at least 12 months. 

You may also notice that some of your symptoms become less frequent or less intense, but this is not the same for everyone, and some people may continue to experience symptoms for years after menopause. 

If you have had a long gap between periods, this does not guarantee they have stopped for good. It is possible to get another period, even after a long gap, such as 8 or 10 months, which would suggest you are still in perimenopause.

Another sign that perimenopause is coming to an end is the onset of vaginal dryness or finding that it becomes more noticeable. Bone health also becomes an important topic after menopause, with 50% of women aged 80 developing osteoporosis and more than 1 in 3 women sustaining at least one osteoporosis-related fracture in their lifetime.⁺ So now may be a good time to discuss bone and heart health, including exercise, smoking, and blood pressure, with a clinician.

Do I Still Need Contraception During Perimenopause?

Yes. It is still possible to become pregnant during perimenopause. Periods may be irregular and ovulation less frequent, but that doesn’t mean ovulation has stopped. HRT itself is not a method of contraception. Pregnancy is possible until menopause is confirmed, so if you have had a period in the last 12 months, there is a chance that you could still conceive. 

The current UK guidance from the College of Sexual and Reproductive Healthcare (CoSRH)generally advises women using non-hormonal contraception to:

• Stop using it 2 years after your last natural period before the age of 50

• Stop using it 1 year after your last natural period if it occurred after the age of 50*

If you are using hormonal contraception, you should get advice before stopping because bleeding patterns may be masking your symptoms. You can usually stop taking contraception at 55, but some may need to be stopped earlier. Your clinician can discuss your options with you. 

Can You Shorten Perimenopause?

There is no proven treatment, supplement or lifestyle change that safely speeds up or stops a natural perimenopause transition. HRT can treat your symptoms, and it does not fast-forward your ovaries through the transition. You can, however, feel better during the transition. There’s no need to wait for your final period or for your symptoms to be severe enough to make everyday life unmanageable before discussing support.

Support options

Support for menopause symptoms comes in several forms, including HRT, non-hormonal treatments and lifestyle changes. You can try one or a combination of these options, but the right one depends on your preferences, medical history and even your symptoms.

HRT

HRT can relieve hot flushes and night sweats and may help associated sleep and other symptoms. You can start it during perimenopause, but the benefits and risks depend on your health, HRT and how you take it, so treatment should be personalised.

Systemic HRT replaces oestrogen. If you have a womb, you usually also need progestogen to protect its lining. Local vaginal oestrogen can help vaginal and urinary symptoms and may be used alongside systemic HRT.

Non-hormonal options

Some of the common non-hormonal treatments include:

• Menopause-specific cognitive behavioural therapy (CBT) can help with hot flushes, sleep problems and associated depressive symptoms

• Prescription non-hormonal medications may also be suitable after a clinician reviews your symptoms and medical history

Some supplements that claim to help with menopause symptoms may be useful, but there is little scientific evidence to back up their claims.

Lifestyle adjustments

Making small changes to your lifestyle can help manage your symptoms and can also be done safely alongside HRT and non-hormonal treatments. You can try:

• Prioritising a consistent sleep routine by going to bed and waking at the same time each day

• Getting regular exercise and strength training for improved wellbeing, muscle and bone health

• Reducing your alcohol or caffeine intake, which can increase the frequency and severity of symptoms like hot flushes and mood changes

• Stress management techniques, like mindfulness, meditation and yoga to help you cope with the transition and associated symptoms 

If you think you may be in perimenopause, make an appointment with a clinician rather than relying on a self-diagnosis. This can help you get the support you need at the right time.

When to See a Doctor

If your symptoms become unmanageable or affect your sleep, work or relationships, book an appointment with a doctor to find out what support and treatments are available. You can also seek advice simply to understand what has changed in your body. 

The following symptoms need prompt assessment to find out if perimenopause is the cause:

• Very heavy or prolonged bleeding

• Bleeding between periods or after sex

• Symptoms or periods stopping before the age of 40 or 45

• Any bleeding, even light episodes, that occurs after menopause 

If you get any bleeding accompanied by faintness, weakness or feeling unwell, you should get urgent medical help and call 111 for urgent advice or 999 in an emergency.

For otherwise healthy women aged 45 or over, the National Institute for Health and Care Excellence (NICE) usually recommends identifying perimenopause from symptoms and menstrual changes rather than routine hormone blood tests. Hormone levels fluctuate, so one result may not be useful.⁺

Testing may be considered at ages 40 to 45, or below 40 when premature ovarian insufficiency is suspected. Other tests may be appropriate to investigate alternative causes, but not needing a hormone test does not mean your symptoms are being dismissed.

FAQs

Can perimenopause last 10 years?

Yes. It is possible for perimenopause to last 10 years or more before your periods stop completely, and it most commonly happens during your 40s.* However, the average duration of perimenopause is 4 years.⁺

Can perimenopause last only a few months?

Yes. Perimenopause can only last for a few months, but this is less common, with perimenopause lasting, on average, for 4 years.* For some people, the decline in hormone levels happens rapidly, so it only takes a few months to a year for their periods to stop.

Does perimenopause get worse before it gets better?

Yes. It is common for perimenopause symptoms to get worse as your hormone levels fluctuate. You might find that your symptoms intensify or become more erratic or irregular before you reach menopause. 

What is the average age for perimenopause to end? 

The average age of menopause in the UK is 51, so perimenopause typically ends around that age.* However, this can vary between different ethnic groups and is only an average. Some people may reach menopause between the ages of 40 and 45, known as early menopause, or later than 51.

How long is considered too long for perimenopause?

There is no medically defined time for perimenopause to be considered too long, as its duration can vary from person to person. For some people, it can last only a few months, while for others it may last 10 years or more. If you are concerned about how long perimenopause has been happening for you, speak to a clinician about what’s happening and what could help.