Perimenopause Symptoms: A Complete Guide for Women 40+

Perimenopause begins on average at age 45 and can last 4-10 years. Here's what symptoms to expect, when to consider HRT, and which providers can help.

1 min readReviewed May 2026

By Sarah Editor, MA Journalism, Certified Menopause Coach · Medically reviewed by Jane Smith, MD, MD, NAMS-certified · menopause nams

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Last medically reviewed: 5/14/2026 · Next review due: May 2027

Disclosure: Jane Smith, MD declares no financial relationship with the telehealth providers featured in this content.

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Perimenopause is the transition phase before menopause when hormone levels begin to fluctuate. Most women experience some symptoms — common ones include hot flashes, night sweats, sleep disturbances, mood changes, brain fog, and irregular periods.