Periods that come early or late, hot flashes, nights when it’s hard to sleep, or mood swings you didn’t used to have. Many women begin to notice these symptoms after age 40 without realizing they may be the first signs of perimenopause.
In this article, we explain what perimenopause is, what its early symptoms are, at what age it begins, how long it lasts, and when you should see your gynecologist.
Perimenopause is the transitional stage leading up to menopause. During these years, the ovaries gradually reduce their activity, hormone levels fluctuate, and changes in menstruation and other symptoms occur. It ends after 12 consecutive months without a period, at which point menopause is confirmed.
What is perimenopause?
Perimenopause is the period during which the body prepares for the end of the reproductive stage. The ovaries do not stop functioning all at once: estrogen levels rise and fall irregularly, and progesterone levels decrease, because there are increasingly more cycles without ovulation.
These hormonal fluctuations account for most of the symptoms. That's why perimenopause can be confusing: there are months when everything seems normal and others when the changes are much more noticeable.
Stages of Perimenopause
| Stage | What's going on? | How can you tell? |
|---|---|---|
| Early perimenopause | The cycles begin to vary in length. | Periods that come a week or more earlier or later than usual. |
| Late perimenopause | The number of cycles without ovulation is increasing. | You may go two months or more without a period, and hot flashes tend to occur more frequently. |
| Menopause | Last menstrual period. | It is confirmed when a woman has gone 12 consecutive months without a period. |
| Postmenopause | The stage that follows menopause. | Hot flashes tend to subside, but other changes may occur, such as vaginal dryness. |
Perimenopause is not the same as menopause: it's the stage leading up to it, during which you still have periods, even if they're irregular. If you want to know what happens after this transition, check out our article on Symptoms and Treatment of Menopause We'll explain it to you in detail.
At what age does perimenopause begin?
Perimenopause usually begins in the mid-40s, although for some women the first changes appear in their late 30s. The average age of menopause in Spain is around 50, so the transition typically takes place during the decade leading up to that age.
The age of onset varies from woman to woman and can be influenced by genetics, smoking, or certain medical treatments. If symptoms appear before age 40, it is important to consult a doctor, as this may be a case of premature ovarian insufficiency that requires specific evaluation.
Early symptoms of perimenopause
The symptoms of perimenopause vary widely. Some women hardly notice any changes, while others experience symptoms that affect their daily lives. These are the most common ones:
Physical Symptoms
- Irregular periods, heavier or lighter than usual.
- Hot flashes and night sweats.
- Breast tenderness or pain.
- Headaches and joint pain.
- Changes in weight, especially in the abdominal area.
- Vaginal dryness and discomfort during intercourse.
Emotional and Sleep Symptoms
- Difficulty falling asleep or waking up during the night.
- Irritability and mood swings.
- Anxiety or low mood.
- Persistent fatigue.
- Difficulty concentrating or a feeling of mental fog.
- Decreased sexual desire.
The first symptom is usually a change in menstruation. The Irregular periods at age 45 They are very common, but not all menstrual changes are due to perimenopause, so it's a good idea to discuss them with your gynecologist.
Vaginal dryness can also begin at this stage and tends to worsen over the years. If this affects you, you can read our article on Vaginal Atrophy and Its Treatments.
How long does perimenopause last?
The duration of perimenopause varies greatly. On average, it lasts about four years, but it can range from a few months to eight or ten years. It ends with menopause, which occurs after 12 consecutive months without a period.
Some symptoms, such as hot flashes, may continue for a while after menopause. That's why it's a good idea not to wait until the transition is over to seek help if the symptoms are affecting your quality of life.
Can you get pregnant during perimenopause?
Yes. Although fertility declines and there are more cycles without ovulation, it is still possible to ovulate some months and become pregnant. Therefore, if you are not trying to get pregnant, it is recommended that you continue using birth control until menopause is confirmed.
Your gynecologist can advise you on which method is best for you at this stage and when you can stop using it. Some hormonal birth control methods also help regulate your periods and manage certain symptoms.
How is perimenopause diagnosed?
The diagnosis of perimenopause is primarily clinical: it is based on age, changes in menstruation, and symptoms. Hormone tests are not always conclusive, because at this stage, levels fluctuate significantly from month to month.
Even so, your gynecologist may order blood tests or other tests to rule out other causes of your symptoms, such as thyroid disorders, anemia, or uterine problems—especially if you have heavy or irregular bleeding.
Treatments for Perimenopause
Not all women need treatment. When symptoms interfere with daily life, there are various options available, which are chosen on a case-by-case basis:
- Lifestyle habits: Regular exercise, a balanced diet, adequate rest, not smoking, and limiting alcohol and caffeine can help reduce some symptoms.
- Hormone therapy: Hormone therapy for menopause can also be used during perimenopause and is very effective for hot flashes and other symptoms. Its use is evaluated on a case-by-case basis, taking into account the benefits and potential risks.
- Nonhormonal treatments: There are alternatives for women who cannot or do not want to use hormones.
- Topical treatments: moisturizers, lubricants, or vaginal treatments for dryness and intimate discomfort.
Supplements for perimenopause are very popular, but their effectiveness varies, and not all of them are suitable for every woman. It's best to consult a healthcare professional before taking them.
This stage is also a good time to focus on long-term health. The drop in estrogen accelerates bone loss, so it’s important to know how to take care of your Bone Health During Menopause.
When Should You See Your Gynecologist?
It’s a good idea to seek medical advice if your symptoms are affecting your quality of life or if you have concerns about any changes you’ve noticed. In addition, there are certain situations that should always be evaluated:
- Very heavy bleeding, with large clots or bleeding that requires changing a pad every hour.
- Periods that recur at intervals of less than three weeks.
- Bleeding between periods or after sexual intercourse.
- Any bleeding after 12 months without a period.
- Symptoms of perimenopause before age 40.
- Intense mood swings, anxiety, or persistent sadness.
Perimenopause is a natural stage of life, but you don't have to just accept it passively. A gynecological evaluation can rule out other causes, relieve symptoms, and prevent long-term health problems.
Gynecologist in Telde and Las Palmas to support you through perimenopause
At Ginelux, we support women through every stage of their lives. Our menopause unit It provides a comprehensive assessment of perimenopausal and menopausal symptoms, with a plan tailored to each woman.
If you're looking for a gynecologist in Las Palmas or Telde to evaluate your symptoms, Ginelux is located in Telde and serves women throughout Gran Canaria, including Las Palmas de Gran Canaria, Vecindario, Maspalomas, and Playa del Inglés.
Perimenopause Consultation in Gran Canaria
If you notice changes in your period, hot flashes, or other symptoms and want to know if you're going through perimenopause, you can schedule a consultation with the gynecology team at Ginelux in Telde.
Contact Ginelux →This text is intended solely for informational and educational purposes and is not a substitute for an individual medical consultation or evaluation. The symptoms, diagnosis, and treatment of perimenopause should be evaluated based on each woman’s individual circumstances. If you have any questions or experience any symptoms, consult your gynecologist.