Pinkishe Foundation
25/10/2026
Medically reviewed by
Dr. Shehla Jamal
Perimenopause is the time of change leading up to menopause. It usually starts in your 40s, though it can begin earlier. Your ovaries slowly make less oestrogen, and your hormone levels rise and fall unevenly. This stage can last from a few months to several years. It ends at menopause, which is confirmed once you have gone 12 months without a period.
One of the first changes most women notice is in their periods. Knowing what to expect makes this time less worrying. Here are the common changes, the other symptoms, what helps, and how to tell what is normal from what needs a doctor.
Your cycle may become shorter or longer than usual. It can also vary a lot from one month to the next.
You may miss a month or two, and then your period comes back. This makes it hard to know when to expect it, so keep a pad in your bag. If you miss a period and there is any chance you are pregnant, take a pregnancy test.
Some women have heavier periods. Others have lighter or patchy bleeding. Small clots can also become more common.
Light spotting between periods can happen because of changing hormones. But spotting can also have other causes, so do not ignore it. See the next section.
Periods may last longer than before. What was once a five-day period might stretch to six or seven days. This can change from cycle to cycle.
See a doctor if you bleed between periods or after sex, your period lasts more than seven days, you soak a pad every hour or two, or you pass clots larger than a coin. These are common in perimenopause, but they need to be checked.
Heavy bleeding month after month can also lead to anaemia, which leaves you tired, dizzy or breathless. Anaemia is treatable, so mention these feelings to your doctor.
It helps to note the dates and flow of each period, in a diary or with our period and ovulation calculator. Your doctor can then see the pattern.
Yes. Even with irregular periods, you can still release an egg in some months. No day of your cycle is fully safe. If you do not want to become pregnant, use contraception until a doctor says you can stop, and talk to your doctor about which method suits you now.
Many women have hot flashes and night sweats in perimenopause. These sudden waves of heat can be uncomfortable and can disturb your day and your sleep.
Changing hormones can affect your mood. You may feel irritable, anxious or low. This is real, and you do not have to manage it alone. Talk to someone you trust, and see a doctor if low mood or anxiety lasts more than two weeks.
If you ever feel hopeless or have thoughts of harming yourself, please talk to someone today. Call Tele-MANAS, the government's free mental health helpline, on 14416 or 1-800-891-4416, at any hour. In an emergency, call 112.
Night sweats and hormone changes can make it hard to fall asleep or stay asleep.
Lower oestrogen can make the vagina drier. This can cause discomfort in daily life and during sex. Water-based lubricants and vaginal moisturisers can help. If it does not get better, see your doctor.
Simple home food helps: dal, sabzi, whole grains, fruit, and protein such as paneer, eggs, chana or rajma. Get calcium from food first, such as dahi, milk, paneer, ragi, til and green leafy vegetables. Ask your doctor to test your vitamin D level before you take any supplement. Drink water steadily through the day.
Yoga, meditation and slow breathing can help with mood swings and stress.
Regular movement, such as brisk walking, yoga or strength training, can improve mood and sleep.
See your doctor regularly in these years, and talk about any big change in your periods or how you feel. Ask which checks you need, such as blood pressure, blood sugar, thyroid and haemoglobin.
If symptoms are hard to live with, hormone therapy (HRT) can help. It is safe and effective for many women, but it is not right for everyone. Non-hormonal medicines are another option. Discuss the benefits and risks with a gynaecologist to decide what is right for you.
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Have a question about perimenopause? Call our menstrual helpline on 85888 70999. It answers at any hour.
A simple printable sheet that marks your period days, your fertile window and your ovulation day. We will email it to you now.
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Prefer to work out your dates now? Open the free ovulation calculatorIt usually starts in your 40s, but it can start earlier or later. The timing is different for every woman. If you have signs of menopause before 45, see a doctor.
It can last from a few months to several years. It ends at menopause, once you have gone 12 months without a period.
Yes, they are common. Your cycle may get shorter or longer, you may skip periods, and the flow may change. But bleeding between periods or after sex, periods longer than 7 days, or very heavy bleeding need a doctor's check.
There is no single blood test that confirms it. A doctor usually goes by your age, your symptoms and your periods, and may test to rule out other causes such as thyroid problems or anaemia.
Many women manage with good food, regular movement, stress care and steady sleep. If symptoms are severe, talk to a gynaecologist about hormone therapy or non-hormonal medicines.
Yes. You can still get pregnant in perimenopause, even with irregular periods. Use contraception until a doctor says you can stop.
Perimenopause is the time of change before menopause, and irregular periods are a normal part of it. Some bleeding, such as very heavy periods or bleeding between periods or after sex, still needs a doctor. Good food, movement, stress care and, for some women, hormone therapy can make this time easier.
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