What Is Perimenopause?

By BSc (embryologist), BSc, MSc (embryologist) and BA, MA (fertility counselor).
Last Update: 03/18/2015

Perimenopause, also called premenopause, is the natural transition period to menopause. It is the stage of a woman's life when her ovarian reserve starts diminishing and her menstrual cycle becomes irregular. Perimenopause usually happens in women with between the ages of 40 and 48.

Perimenopause usually lasts for 4 years. However, some women may experience it for only a few months or up to 10 years. It ends one year after menopause, which is when a woman hasn't had her period for more than 12 months.

Changes in the organism

When menopause is close, a series of changes take place in the body, such as:

  • Ovaries release eggs with less regularity.
  • Ovaries secret fewer regulatory hormones.
  • Fertility diminishes.
  • Menstrual cycles become shorter.
  • Testosterone diminishes.


Estrogen and progesterone are two regulatory hormones that control the female cycle and are produced by the ovaries. As menopause approaches, the quantity of secreted hormones diminishes, which causes menstrual fluctuations.

A reduction in estradiol levels is the main cause of perimenopause.


You will be perimenopausal when you experience some of the following symptoms. The intensity of these symptoms will not be the same for every woman.

  • Irregular menstruation: cycles may be shorter or longer and bleeding may be more or less abundant. There are different types of perimenopause: premature, when menstruation begins at least 7 days either before or after it was supposed to; and late, which occurs when a woman doesn't menstruate for at least two months and there's an interval of a minimum of 60 days between menstruations.
  • Hot flashes and sleep problems: about 65% or 75% of women have hot flashes. These are more intense in cases of late perimenopause. Sleep problems may be caused by hot flashes or by hormonal changes.
  • Mood changes.
  • Loss of sexual desire.
  • Headaches.
  • Diminished vaginal lubrification.
  • Leakage of urine when coughing or sneezing.
  • Constant need to urinate.
  • Breast pain.

Hot flashes

Perimenopause and pregnancy

Menopause is only confirmed after 12 months without menstruation, so the possibility of a pregnancy cannot be discarded. Perimenopause is indicative of a low ovarian reserve but, until the start of menopause, ovulation cannot be completely ruled out.

Ovulations, and consequently, menstruations can be occasionally and randomly produced. For this reason, although unusual, chances for pregnancy do exist.

Treatment and symptom relief

In most cases, simple life changes are enough: a healthy diet rich in fibber, low grease and antioxidant food, soya, exercise, herbal infusions, vitamin E, relaxing exercises, and rest.

Before consuming any supplement, vitamin or herbal infusions, a doctor should be consulted. If the doctor believes it is necessary, a hormone replacement therapy or HRT will be administered. This is used in order to suppress the hormonal deficit and to relief symptoms associated with this period of a woman's life.

According to several studies, hormone replacement therapy is a very effective treatment, eliminating hot flashes and psychological alterations.

FAQs from users

Can you get pregnant with donor eggs after menopause?

By Rebeca Reus BSc, MSc (embryologist).

Yes, it is possible to have a baby after menopause, a phenomenon known as postmenopausal pregnancy. Menopause is defined as the cessation of menstruation, which means the loss of ovarian activity. However, this does not affect the uterus, which is still functional, and able to carry a pregnancy. This is perfectly possible with either donor eggs from a young girl, the woman's own previously frozen eggs, or the couple's frozen embryos, if any.

Our editors have made great efforts to create this content for you. By sharing this post, you are helping us to keep ourselves motivated to work even harder.


Authors and contributors

 Laura Rollán Guilén
Laura Rollán Guilén
Bachelor's Degree in Biology from the University of Valencia (UV). Specialist in Human Assisted Reproduction. Writer of scientific contents. More information about Laura Rollán Guilén
 Rebeca Reus
Rebeca Reus
BSc, MSc
Degree in Human Biology (Biochemistry) from the Pompeu Fabra University (UPF). Official Master's Degree in Clinical Analysis Laboratory from the UPF and Master’s Degree about the Theoretical Basis and Laboratory Procedures in Assisted Reproduction from the University of Valencia (UV). More information about Rebeca Reus
Adapted into english by:
 Sandra Fernández
Sandra Fernández
Fertility Counselor
Bachelor of Arts in Translation and Interpreting (English, Spanish, Catalan, German) from the University of Valencia (UV) and Heriot-Watt University, Riccarton Campus (Edinburgh, UK). Postgraduate Course in Legal Translation from the University of Valencia. Specialist in Medical Translation, with several years of experience in the field of Assisted Reproduction. More information about Sandra Fernández

Find the latest news on assisted reproduction in our channels.