What is perimenopause?

Perimenopause, also called the menopause transition, begins before periods stop completely. Ovulation and hormone levels can become less predictable, so cycles may be closer together, farther apart, heavier, lighter or occasionally missed. Symptoms can include [Hot Flushes](/symptoms/hot-flushes/), [Night Sweats](/symptoms/night-sweats/), sleep disruption, vaginal dryness, lower sexual desire and mood changes.

The experience differs from person to person and symptoms may not appear in a fixed order. Similar changes can result from pregnancy, thyroid conditions, medicines or other health problems, so a clinician may consider the whole picture rather than one symptom.

Track bleeding, temperature symptoms, sleep, mood, pain and medicines for several weeks. Use breathable layers, keep the bedroom cool, maintain regular movement and choose routines that protect sleep. If symptoms interfere with work, relationships or daily life, arrange a review to discuss options suited to your medical history and preferences.

Contraception may still be needed while periods occur because ovulation can happen unpredictably. Ask a clinician about pregnancy planning, contraception and treatments rather than assuming a missed period confirms menopause.

Arrange an appointment for bleeding between periods, bleeding after sex, very heavy bleeding, persistent pelvic pain, or symptoms that are difficult to manage. Seek urgent care for fainting, severe pain, chest pain or severe breathlessness. New severe low mood or thoughts of self-harm need immediate support.

Ask whether your symptoms fit perimenopause, what other causes should be checked, and which treatments or lifestyle changes may help. You can discuss [Irregular Periods](/symptoms/irregular-periods/), [Missed Period](/symptoms/missed-period/) or [Low Sex Drive](/symptoms/low-sex-drive/) as part of the same review.