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Perimenopause, or menopause transition, begins several years before menopause. It's the time when the ovaries gradually begin to make less estrogen. It usually starts in a woman's 40s, but can start in her 30s or even earlier.

Perimenopause lasts up until menopause, the point when the ovaries stop releasing eggs. In the last 1 to 2 years of perimenopause, this drop in estrogen speeds up. At this stage, many women have menopause symptoms.

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How Long Does Perimenopause Last?

The average length of perimenopause is 4 years, but for some women this stage may last only a few months or continue for 10 years. Perimenopause ends when a woman has gone 12 months without having her period.

What Are the Signs of Perimenopause?

Women in perimenopause have at least some these symptoms:

Are My Perimenopausal Symptoms Normal or Something to Be Concerned About?

Irregular periods are common and normal during perimenopause. But other conditions can cause changes in menstrual bleeding. If any of the following situations apply to you, see a doctor to rule out other causes:

  • Your periods are very heavy, or they have blood clots.
  • Your periods last several days longer than usual.
  • You spot between periods.
  • You have spotting after sex.
  • Your periods happen closer together.

Causes of abnormal bleeding include hormone problems, birth control pills, pregnancy, fibroids, blood clotting problems or, rarely, cancer.

How Is Perimenopause Diagnosed?

Often your doctor can make the diagnosis of perimenopause based on your symptoms. A blood test to check hormone levels may also help, but your hormone levels are changing during perimenopause. It may be more helpful to have several blood tests done at different times for comparison.

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