When Does Perimenopause Start and End?

From My Weekly Newsletter

Many women ask me when perimenopause really begins and when it ends, and whether they will ever feel 'normal' again. Let’s break it down.

Hi there,

This is Vered, your Health Coach.

Welcome to my weekly newsletter '3 Tips, 2 Ideas, 1 love', where we focus on building habits that work, so you stay steady through perimenopause.

No quick fixes. Real strategies that fit your life.

This Week's Topic: When Does Perimenopause Begins & Ends

Perimenopause doesn’t always begin with missed periods.

The first hormone to decline is progesterone, and that change can bring symptoms before your cycle looks different.

Progesterone normally has a calming effect on the brain and nervous system.

When levels drop, you may notice trouble sleeping, mood swings, anxiety, or even new fears, like feeling uneasy about driving or heights.

Bloating, fluid retention, or headaches can also appear at this stage.

These changes can start as early as your mid-30s, although most women notice them in their early 40s.

Genetics, lifestyle, and overall health all influence when and how strongly you feel the shifts.

This is why some women say they feel “off” years before their period becomes irregular. Perimenopause can last 4-10 years.

So when does perimenopause end?

It ends at menopause, which is really just a single point in time. It's the day you have gone twelve months without a period.

The average age for menopause is 49-53 years old.

After that, you are in postmenopause, and that stage lasts for the rest of your life.

For many women, symptoms improve or even disappear with time. Which is why some women think 'it's over' once they feel better.

But the focus now shifts. You still need to think about bone, brain and heart health, because those changes have no signs.

And will you ever feel “normal” again?

The answer is yes, but it may not be the same normal you remember from your 20s or 30s.

Most women find a new steady point where symptoms ease, energy returns, and life feels balanced again.

The path there looks different for everyone, but reaching it is possible.

3 Tips for Women 40+

1. Track your symptoms.

Download my Printable List of 150+ Perimenopause Symptoms

Review it every three months and notice what is changing.

2. Use a period app.

Apps like Clue or Flo make it easier to follow cycle patterns and record symptoms.

Your cycle won't start changing drastically.

It's the small changes that turn out to be early clues that things are shifting. This data helps you and your doctor.

3. Protect your sleep.

Some sleep changes show up in the week before your period.

The rest of the month you can feel fine. Watch for this pattern.

If that happens, avoid alcohol in the evenings and caffeine after midday.

Take magnesium glycinate especially on the days leading up to your cycle.

If it gets really bad, ask your doctor about progesterone in that last week.

2 Ideas for Women 40+ (suggestions)

1. Think of perimenopause as training for the future.

The habits you build now, such as strength training, eating more protein, and improving sleep, prepare your body for postmenopause.

2. Get a midlife health check.

Even if you feel well, testing gives you a baseline.

Focus on optimal numbers, not just what's 'within range'.

• ApoB (cholesterol particles): under 40 to 60 mg/dL (ApoB gives a clearer picture of heart risk than a standard lipids profile)

• Fasting glucose: under 90 mg/dL

• HbA1c: under 5.4%

• Fasting insulin: 5-7 μIU/mL

• Uric Acid: under 5 mg/dL (lower levels may be protective against developing heart disease and high blood pressure)

• Blood pressure: 120/80 mmHg

• Vitamin D: 40-60 ng/mL

• B12: 400-600 pg/mL

• 
  

These numbers protect your heart, bones, and brain. And they also start shifting in perimenopause.

(Within range means your result falls inside the lab’s normal limits, which are set to catch disease. Optimal means your result is in the range linked to the best long-term health. For example, a fasting glucose of 99 mg/dL is considered normal, but numbers under 90 mg/dL are linked to better prevention of diabetes.)

1 Love

A resource I highly recommend for all women ages 40+ is Dr. Lisa Mosconi’s book The Menopause Brain.

Dr. Lisa Mosconi is a neuroscientist and brain health researcher who focuses on women.

She explains how hormones affect memory, mood, and cognition, and how to support your brain through perimenopause and beyond.

The book also gives you science-based tools, from nutrition to exercise to daily habits, that support long-term brain health.

Most importantly, it reframes menopause as a transition, not an ending, and gives you the confidence to approach it with knowledge and practical strategies.

You can find it on Amazon (here is the link)

If you’re going to read one book about menopause, let it be The Menopause Brain by Lisa Mosconi.

Every week in ‘3 Tips, 2 Ideas, 1 Love,’ you’ll find practical strategies to help you manage perimenopause with confidence. From the latest health research to simple habits, seasonal recipes, and tools I trust, my goal is to give you information you can use right away.

Small steps can lead to big changes.

With gratitude and health,

Vered

P.S. Would You Like More Help?

Here’s how I can help you:

• Change your habits that make eating, exercise, sleep and stress management easier

• Support you in building practical routines that stick and fit your lifestyle

• Clearly explain what to do in perimenopause to reduce symptoms and feel better

I’m offering a free 20-minute consultation to help you start feeling better and more in control. You can book this call here.

For more information about my services, visit my website www.veredwestell.com