How Long Does Perimenopause Last?

Understanding the stages and What to Expect

Perimenopause is a stage many women don’t expect—and one that often raises more questions than answers. While most people are familiar with the term "menopause," it's often perimenopause that brings the first noticeable changes. So, how long does perimenopause last? And what should you expect while going through it?

As specialists working closely with women across Surrey, we’ve helped many navigate this transitional time with clarity and confidence. We’ll explain the typical duration of perimenopause, what symptoms to expect, and how to manage them effectively.

What Is Perimenopause?

Perimenopause refers to the time leading up to menopause, when the ovaries begin to produce less oestrogen and progesterone. This stage is marked by hormonal fluctuations that can cause a range of symptoms. It officially ends when you’ve gone 12 months without a menstrual period—this point is defined as menopause.

Many women begin perimenopause in their early-to-mid 40s, though it can begin earlier for some. Others may not notice any symptoms until their late 40s. It’s important to note that perimenopause is a process, not a single event. And like menopause itself, it varies from woman to woman.

So, How Long Does Perimenopause Last?

The length of perimenopause varies widely, but on average, it lasts between four to eight years. Some women experience symptoms for only a year or two, while others may feel the effects for up to a decade.

Several factors can influence how long perimenopause lasts:

• Genetics: The age your mother or older sisters reached menopause can provide some insight into your own timeline.

• Health Conditions: Autoimmune conditions or chronic health issues can affect hormone function.

• Smoking: Smokers may enter menopause earlier and have a shorter perimenopausal period.

• Medical Interventions: Treatments like chemotherapy, pelvic surgery, or hysterectomy can impact hormone production and influence timing.

Perimenopause tends to follow a general pattern, though it doesn’t follow a strict schedule. We often remind women that it’s not about hitting a certain age—it’s about the changes happening in your body.

Early Perimenopause

In the early stages of perimenopause, menstrual cycles might still be regular, but other subtle changes may begin:

• Mild mood swings

• Increased sensitivity to stress

• Breast tenderness

• Occasional night sweats or hot flushes

• Slight changes in period length or flow

These symptoms can come and go unpredictably, which often makes it difficult to realise that perimenopause has begun.

Late Perimenopause

As the ovaries continue to slow down hormone production, cycles often become more erratic. This stage tends to bring more pronounced symptoms, such as:

• Irregular or missed periods

• Heavier or lighter bleeding than usual

• Hot flushes and night sweats occurring more frequently

• Disturbed sleep and fatigue

• Anxiety, brain fog, or low mood

• Vaginal dryness or discomfort during sex

• Weight gain, especially around the abdomen

During this phase, oestrogen levels drop more sharply. Many women describe feeling “not quite themselves,” which can understandably cause worry. The key here is recognising that these changes are part of a natural, albeit challenging, process—and they can be managed with the right support.

When Perimenopause Becomes Menopause

Once a full 12 months have passed since your last period, you’re considered to be in menopause. The average age for menopause in the UK is 51, though some experience it earlier or later. After this point, you enter postmenopause, where hormone levels stabilise at a lower level.

It’s worth noting that while some symptoms ease after menopause, others—like vaginal dryness or joint stiffness—can persist or even develop later.

The NHS guide to menopause stages has more detail on this transition.

How Can You Manage Perimenopause Symptoms?

Every woman’s experience of symptoms with perimenopause is different, so there’s no one-size-fits-all solution. That said, the right combination of medical support, lifestyle adjustments, and emotional care can make this transition far more manageable.

1. Medical Support

Many women benefit from Hormone Replacement Therapy (HRT) during perimenopause. HRT replaces the oestrogen your body is no longer producing at consistent levels and can ease hot flushes, mood swings, and sleep disturbances.

We often explore HRT options with women experiencing multiple symptoms. There are also non-hormonal alternatives for those who prefer or need a different route.

If you're curious about treatment, the NHS menopause treatment page is a useful starting point.

2. Lifestyle Adjustments

Simple daily changes can go a long way toward easing symptoms:

• Exercise regularly, especially strength training and walking, to protect bone health and regulate mood

• Eat a nutrient-rich diet, focusing on calcium, magnesium, healthy fats, and protein

• Cut back on caffeine and alcohol, which can intensify flushes and worsen sleep

• Establish a wind-down routine before bed to improve sleep quality

• Practice mindfulness, breathing exercises, or journalling to manage stress

When working with clients at our menopause clinic in Kingston, we always build a plan that works around each woman’s life, rather than expecting her to overhaul everything overnight.

When to Seek Specialist Help

We encourage women to speak to a menopause specialist if:

• Symptoms are affecting your daily quality of life

• You're not sure if you're perimenopausal and want a clearer understanding

• Your periods have become erratic or heavy

• You're experiencing low mood, anxiety, or memory issues

• You want to explore HRT or other treatments

• You’re simply looking for reassurance and direction

If you’re based in Guildford or elsewhere in Surrey, we’re here to support you at Surrey Menopause Clinic. While we’re based in Kingston, we regularly work with women from across the region who want evidence-based, personalised care that focuses on both symptom relief and long-term health. You can contact us here if you’d like to arrange a consultation. You can also book an appointment using our online tool here.

How Long Is Too Long?

It’s a common question, if perimenopause can last up to ten years, how do I know if what I’m experiencing is normal?

We always say—if something doesn’t feel right, don’t wait it out. There’s no need to “push through” years of discomfort. You deserve to feel good, supported, and well-informed during this time.

With specific support, symptoms can often be brought under control within months, not years. And even if you're at the very beginning of perimenopause, getting ahead of the process can make a real difference later on.