Stages of Perimenopause

Very Early Perimenopause

• cycles are still regular, or you have slightly shorter luteal phases

• less progesterone

• higher, fluctuating estrogen (up to 3x higher than the menstrual years)

• the onset of low progesterone symptoms (migraines, heavy menses and more pain, sleep changes)

• this phase lasts 2-5 years

• heavier menses, increased menstrual pain, migraines, and sleep disturbance.

Early Transition

• cycle becomes more irregular by varying in length more than 7 days

• estrogen fluctuates more wildly

• sharp drops in estrogen from their high peaks can trigger hot flashes and night sweats

• this phase lasts 2-3 years

Late Transition

• This is when you have the first cycle longer than 60 days or a “missed menses”

• hot flashes and night sweats intensify as estrogen continues to fluctuate before it makes its descent to a menopausal baseline

• heavy menses are common at this stage

• breast pain should start to subside

• this phase lasts 4 years

Late Perimenopause

• The 12 months after your final menstruation

• low estrogen, low progesterone

• hot flashes may continue for 1-2 years or longer