7 Signs Perimenopause is Finally Ending

The moods. The drama. The body changes. The acne! Who knew you could have acne and wrinkles…ON wrinkles? And unlike when you were a teenager and your parents said mortifying things like “oh dear, she’s becoming a woman,”  no one gives you a pass during the “midlife puberty” that is perimenopause. 

The saving grace? This phase, too, does end. If you’re screaming EXACTLY WHEN?!?, we can give you a few clues: If you’ve noticed that the frequent headaches and spontaneous crying sessions you’ve basically accepted as your new normal have seemed to settle down lately, these could be signs perimenopause is ending. Symptoms associated with hormonal fluctuations, like dramatic mood swings and menstrual migraines (normal during perimenopause, according to the American College of Obstetrics and Gynecology) will taper off as hormones level out and you begin to enter menopause. 

But—and don’t throw plates at us—the fun isn’t quite over yet. While some symptoms end, others get more intense as you approach menopause. Your internal thermostat, for example, will now malfunction more often, ushering in hot flashes and sleepless nights on the regular, says Jerilynn Prior, M.D., a professor of endocrinology at the University of British Columbia in Vancouver, Canada. Yes, the good times just keep on coming!

About the Experts

Nathan Goodyear, M.D., is medical director of Brio-Medical, a holistic, integrative healing center in Scottsdale, AZ. In addition to being board-certified in obstetrics and gynecology, Dr. Goodyear is a Fellow in Functional and Regenerative Medicine.

Jerilynn Prior, M.D., is a professor of endocrinology at the University of British Columbia, in Vancouver, Canada who focuses on, among other things, the menstrual cycle and the study and treatment of vasomotor symptoms.

What Is Perimenopause?

This is the transitional time leading up to menopause, which is when you go an entire year without having a period. Perimenopause may last up to a decade. If you’re in your 40s, waking up in a sweat at 3 a.m. every night and your periods are unpredictable and heavy, chances are you’re in it. 

“Perimenopause translates to around and surrounding the cessation of a woman’s monthly menses cycle,” says integrative physician Nathan Goodyear, M.D. It’s the natural process of your ovaries slowly shuttering their ovulation operations and your periods ending, as your body leaves your reproductive years in the rear view.

When does perimenopause start?

For many women, perimenopause starts in their 40s, but some start to experience symptoms in their mid to late 30s. “Early perimenopause is associated with minimal cycle dysfunction and minimal symptoms,” says Goodyear. So, you may be well into perimenopause before you realize what’s happening. 

By the time you’ve officially arrived in perimenopause territory, you’ll likely have noticed a few changes to your body and your cycle.

The symptoms of perimenopause, which will ramp up as you move through it, include hot flashes, mood changes, brain fog, breast soreness, and thinning hair (just to name a few). Which you experience, and to what degree, varies from person to person. Some have very few if any noticeable symptoms, while others are blessed with a handful or more.

Stages of Perimenopause

While perimenopause can feel like getting run over by a metaphorical truck, it doesn’t hit you all at once. Instead, the transition into menopause can be separated into four phases:

• Late reproductive stage: Your period becomes unpredictable. It might show up a few days early or late, even if you’ve had a regular cycle your entire life. You may also start to notice hot flashes, sleep disturbances, and sore breasts.
• Early perimenopause: Your period varies by more than a week and other symptoms may pick up. So, planning a beach vacation around your cycle gets more and more annoying.
• Late perimenopause: Some months, your period won’t show up altogether. (Only to appear at the most inconvenient moment possible. Because, of course it did, right?)
• Menopause: If you haven’t had a period in over a year, you’re officially in menopause. Welcome!

What Are the Signs Perimenopause is Ending?

Below are the biggest symptoms of late perimenopause:

1. More time between periods

This is the most common sign that you’re nearing the final stages of perimenopause, says Goodyear. In late perimenopause, the time between periods will stretch to 60 days or more, until they stop completely.

2. Less painful boobs, lighter flow and you’re on a more even keel

“Breast tenderness gets better, heavy flow gets better, already the mood symptoms are getting better,” says Prior.

3. More hot flashes

Unfortunately, “The hot flashes tend to get worse at this stage,” says Prior. That’s because estrogen levels are bottoming out during late perimenopause. This can confuse your body’s thermostat causing the brain to send signals to blood vessels to flush, resulting in redness, sweating, and that feeling that you’re burning up.

4. Your skin feels like a sauna in the night

You’re likely to experience more night sweats (which are really just hot flashes while you sleep).

5. Vaginal issues

Sorry to say, you may start to notice some vaginal dryness and tightness during sex, according to the North American Menopause Society. Plummeting estrogen levels result in less cervical mucus and vaginal lubrication and a less stretchable vagina.

6. More headaches

You may have noticed an uptick in migraines or tension headaches during the early stages of perimenopause. These temple tantrums may pick up as you transition into menopause, according to the Mayo Clinic.

7. You have trouble sleeping

While insomnia risk goes up in all stages of perimenopause, a 2018 study found that sleeplessness worsens in the later stages of perimenopause (1).

Of course, the definitive signal that perimenopause has ended is that you’ve gone 12 consecutive months with no period. After a full year of being period-free, you are officially in menopause, also referred to as being postmenopausal, since menopause is technically a milestone you hit, not a phase. In the U.S., the average age for the final period is 52, according to the U.S. Department of Health and Human Services, but it can happen sooner or later.

More Menopause

8 Signs You Might Need Menopause Hormone Therapy

Perimenopause Decoded: Common Signs and Smart Solutions

How Long Does Perimenopause Last?

Perimenopause can last from two to 10 years. Once you have the first anniversary of your last period and transition into menopause, you’ll likely experience menopause symptoms for around four years. 

What signals the end of menopause? That depends on how you look at it. Technically, once you hit menopause, you’re in it for life, but the annoying symptoms will eventually fade over time as your body adjusts to its new normal. 

And, if you’re lucky, you may experience one consequence of late perimenopause cited by many women as the pot of gold at the end of this pain-in-the-butt transition: so-called menopausal zest. “It’s the feeling of knowing who you are, what you have been able to deal with and that you’re standing on your own two feet,” says Prior. “It’s a kind of self-actualizing experience.”