Perimenopause can be a confusing and confounding time for any woman trying to figure out what's going on and (Oh god, WHY!!?!!), and where she is in the grand scheme of peri-things. 

Well, we're here to put that to bed for you.  Read on and get a handle on where you could be in the perimenopause journey.  Believe us, it really helps getting the info.

Okay, so first thing's first: there are four stages to perimenopause. 

On average, perimenopause lasts around 7 years but can last anywhere from 2 - 12 years. 

Have a squizz at this diagram to see the different stages and what might be happening:


The Four Stages of Perimenopause

  1. Very Early Perimenopause
  2. Early Menopause Transition
  3. Late Menopause Transition
  4. Late Perimenopause.

This diagram shows the absolute hormonal rollercoaster we're on (that we did NOT ask to get aboard!) *note estradiol is a type of oestrogen:

In the diagram above it shows you what oestrogen and progesterone are up to, below is a list of symptoms they cause.

Symptoms of high and fluctuating Oestrogen

Symptoms of Low Progesterone

  • Mood changes - less able to cope with stress, increased risk of depression, anxiety and memory loss
  • Sleep disturbances (if you need better sleep, we can help)
  • Hot flashes and night sweats 
  • Heart palpitations
  • Migraines
  • Heavy periods
  • Painful periods.

Note that some of the symptoms are the same for low progesterone and fluctuating and high oestrogen as they are caused by the combination of the low progesterone and high and fluctuating oestrogen.

STAGE 1: Very Early Perimenopause (lasts 2 - 5 years on average)

  • Cycles are still regular but could be shorter in length, maybe between 21-26 days. 
  • Likely to have less progesterone and more oestrogen.
  • Symptoms might be heavier periods, increased period pain, migraines, sleep disturbances.

STAGE 2: Early Menopause Transition (2 - 3 years on average)

  • Cycles are starting to be irregular and vary in length up to seven days
  • Likely to have less progesterone and more oestrogen. Oestrogen is starting to fluctuate and when it drops it goes lower than you are used to.
  • Symptoms might be more hot flashes and night sweats.

Need help with these symptoms? Go here.

STAGE 3: Late Menopause Transition (you might be 4 years away from menopause)

  • You start to miss cycles or have your first cycle that is longer than 60 days.
  • Symptoms could increase: hot flashes/night sweats and heavier periods. Breast pain should ease if you have any.

STAGE 4: Late Perimenopause (the twelve months from your final period)

This is the start of your body getting used to low oestrogen and you should start to feel less of the symptoms associated with the wild fluctuating oestrogen levels like migraines and mood symptoms. 

While you are transitioning from late menopause transition to late perimenopause you will float between the two stages until you don’t have a period for 12 months (at that point you have reached Menopause).

For example you might not have a period for 8 months and feel less of the wild fluctuating oestrogen symptoms. Then you might get another period and experience symptoms and then the countdown starts again until you reach 12 months with no period.  Drives you nuts!


After that wild ride, and you hit 12 months and no period, that's when you reach Menopause: no more wild fluctuating oestrogen symptoms! Hooray!

It’s important to remember the healthier you are going through perimenopause the less health issues you will take into the menopause years.



Hormone Repair Manual, Lara Briden ND

February 03, 2022 — Angela Greely

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