Perimenopause and menopause symptoms can occur at different stages in a woman’s life. At our clinic, we’ve observed that symptoms typically manifest between the ages of 39 and 45. During this period, women may experience variations in menstrual cycles, with a difference of seven days or more between consecutive cycles. Additionally, there is a slight increase in FSH levels, while estradiol levels remain relatively stable.

Menopause symptoms commonly emerge during the perimenopause transition, occurring at a median age of 47, which is four to six years before natural menopause. Vasomotor symptoms, including hot flashes, are most likely to occur within two years after the last menstrual cycle. This menopause phase can last from one to six years after the final menses. During this time, the ovaries come close to follicular exhaustion, resulting in decreased production of estradiol and an increase in follicle-stimulating hormone (FSH) levels.

It is not uncommon for perimenopause and menopause symptoms to be mistaken for other age-related medical conditions, making the transition challenging to recognize and treat. Nearly all women with a uterus experience changes in their menstrual patterns during the perimenopause and menopause years due to hormonal fluctuations prior to ovarian follicular depletion. Furthermore, symptoms can persist long after menopause, hysterectomies, and ablations, as these procedures and the natural course of the body’s transition lead to increased FSH levels.