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When does perimenopause start?

Written by:, PhD, Founder and Inventor of the Proov test — the first and only FDA-cleared test to confirm successful ovulation at home.

Updated on 10/4/22

While you may be familiar with menopause, perimenopause maybe be a little more of a mystery to you. In fact, these two terms can get a little confusing and many people use them interchangeably when they refer to two different periods of your life. 

Menopause marks the moment of transition after a woman hasn’t had a period for 12 months. Perimenopause on the other hand, refers to the transition period leading up to the moment of menopause, when you may begin experiencing those oh-so-common (and not always fun) symptoms, like hot flashes, night sweats, and more. 

But when exactly does perimenopause start? While the exact answer is a little different for every woman, we can learn more about when perimenopause typically starts. Let’s dive in!

when does perimenopause start?

Perimenopause refers to the transition period leading up to the moment of menopause.

When does perimenopause start?

Our bodies are governed by hormones, and starting from puberty when we start menstruating and ovulating, reproductive hormones play a very important role in our lives.

Our fertile years cover a span of over 3 decades, then our ovarian reserve — the amount of eggs remaining in our ovaries — starts to diminish and our hormones start shifting as we approach menopause.

Perimenopause is the period of time in the life of a woman that covers the years prior to the onset of menopause. Depending on each individual, perimenopause might last anywhere between 2 to 10 years, and may start as early as their late 30s and as late as their mid 40s.

It is important to keep in mind that even though it can be a time of change, there is nothing scary about perimenopause — every woman will experience it! It is a completely natural transition, and while it does mark the end of your reproductive years, it can also be seen as a new beginning. 

Well, how do I know if perimenopause is starting?

At Proov, we believe knowledge is essential. Understanding your body can help you detect and recognize perimenopause symptoms so you can tackle those symptoms and improve your quality of life. 

It’s important to note that even though not every woman will experience perimenopause symptoms, those who do experience symptoms tend to ask for the help of a healthcare professional in an overwhelming proportion: 90%.

The first visible “sign” of perimenopause is usually your period. Period changes are the first red flag that your hormones are no longer where you’d want them to be and are typically much more obvious for women who have been very regular.

As you get older, and your ovarian reserve decreases, the chances of ovulating every month also decrease. Lack of ovulation inevitably leads to changes in hormone levels (mainly low progesterone) and therefore changes in your overall cycle length, which will then become shorter.

What about the infamous hot flashes? Well, follicle stimulating hormone (FSH) is to blame.

When our ovarian reserve is optimal, the ovary recruits one follicle each month and prepares it for ovulation with the help of FSH. When there are plenty of follicles to choose from, the ovary will only need a tiny bit of FSH to get the dominant follicle to grow.

As eggs become scarce and hormones are out of whack, the ovary will struggle to prepare an egg for ovulation every month, so it will send a signal to the brain asking for help. The help comes under the form of a longer and stronger FSH surge that is the culprit of many unpleasant symptoms that mimic menopause, including hot flashes, problems falling and staying asleep, and difficulty getting pregnant.

If you are experiencing any of the symptoms above, you might want to see where your hormones stand. Proov can help!

Proov Reserve consists of urinary FSH tests, also called “menopause tests” that you can take at the beginning of the cycle, on cycle days 5, 7 and 9. Our free Proov Insight app will help you read the tests and will offer you quantitative results, as well as an Ovarian Reserve score at the end of the testing period.


You can bring this information to your doctor to discuss more in depth testing if needed (especially if you are still trying to conceive) or simply elaborate an action plan to stay ahead of the game and tackle the perimenopause symptoms.

However, if you want a more thorough assessment, we offer Proov Complete, the first at home test to measure all 4 main cycle hormones. The Complete kit consists of FSH tests and the multihormone test that can measure luteinizing hormone (LH), E1G (the urine metabolite of estrogen), and PdG (the urine metabolite of progesterone) on the same strip.

Readable only with the help of the Proov Insight app, Complete covers your entire cycle and provides an in-depth look at all your hormone levels and patterns.

when does perimenopause start?

What can I do about my perimenopause symptoms?

The transition to menopause may impact you both physically and mentally. Imbalanced hormones are no joke and the sooner you identify the issue, the better you will be able to get in control of the situation.

Although most doctors will tell you hormonal replacement therapy is your best bet (and that may very well be the best option for you!), know there are other natural ways to get relief. 

Maintain a healthy weight: We know it’s easier said than done, but weight has an impact on your hormonal balance and also increases your risk of developing diabetes and heart disease.

Exercise: Helpful not just for maintaining a healthy body weight but it could also help you with mobility, which tends to diminish as your estrogen levels are decreasing. 

Avoid certain foods: Spicy foods may make you hot and can trigger hot flashes. Adjacently, caffeine and alcohol may impact sleep quality, especially when you have them in the evening.

But add other foods in: Eat more foods that contain phytoestrogens might help you feel better, because they mimic the effects of estrogen. These foods are soy, tofu, beans, flax seeds and sesame seeds.

Supplements: Try herbal supplements that promote your body’s natural hormone production.

Stay hydrated: This is a great tip, because on one hand it helps with dryness associated with low estrogen, but also helps decrease bloating — yet another annoying and very common perimenopause symptom.

Is there any way to delay perimenopause?

Medicine has made tremendous progress in the last few years. Ten years ago, the idea of ovarian rejuvenation didn’t even exist.

Today we have new techniques emerging, like ovarian PRP (platelet rich plasma) or adult stem cell therapy. Both are experimental, costly, and are mostly used to treat premature ovarian failure in young women who get confronted with perimenopause and menopause at very early ages, in their 20s and early 30s.

Apart from these situations, we can technically say that perimenopause can’t be delayed and is a normal phase in the life of any woman.

What you can do though, is make sure you know your body, your cycle, and your hormones, so that you can spot the first symptoms of perimenopause and act accordingly to improve your quality of life during this transitory period.

Have questions? Email us!