9 Signs Perimenopause Is Ending (Because Yes, It Really Will End)

Beth Ann Mayer
·9-min read

A person doesn't just jump from reproductive years to menopause. There's an in-between phase known as perimenopause that can last about a decade.

"The term perimenopause translates to around menopause," explains Dr. Pelin Batur, MD, FACP, MSCP, an OB/GYN and menopause specialist at Cleveland Clinic. "Menopause occurs when you have gone one year without any menstrual bleeding in the absence of a medication or medical condition that may stop periods."

Wondering, "How do I know perimenopause is ending?" It's a common question, but Dr. Batur says it can be challenging to provide a hard-and-fast answer as to when you'll know the end of perimenopause is near.

"You only know that you're in menopause when you look back and realize it's been a year without bleeding," Dr. Batur says. "Otherwise, how you’re bleeding and how your symptoms feel don’t always correlate. This is why it's important to take things one day at a time because no one will be able to predict when you will go into menopause."

Still, experts and research indicate that there are some typical signs perimenopause is ending, and understanding them can help you tune into your body and prepare for the next chapter.

"Being prepared and knowledgeable about the details of these hormonal transitions will empower and comfort you along this chaotic journey," says Dr. Sherry Ross, MD, a board-certified OB/GYN and women’s health expert at Providence Saint John’s Health Center. "Knowing there are helpful treatment options will reduce anxiety and help ease you into menopause."

Doctors shared common clues that you're at the end of perimenopause, stages of menopause and when a specific sign means you should call your doctor.

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9 Signs Perimenopause Is Ending

1. Irregular periods

The telltale sign you're toward the end of perimenopause: Irregular menstrual cycles become even less regular. Research from 2016 also reports that the end of the reproductive years for a person with a uterus begins with the first onset of period irregularity.

"Irregular periods are synonymous with perimenopause," Dr. Ross says. "As you get closer to menopause, the periods will continue to be erratic. Once you stop having a period for one year, you are officially in menopause."

2. Hot flashes and night sweats

Researchers and medical professionals define hot flashes as "heat, sweating, flushing, anxiety, and chills lasting for one to five minutes." This uncomfortable symptom is commonly associated with something a person experiences "during menopause," with some research reporting that more than 8 in 10 people report having them. More specifically, hot flashes are something a person can experience during perimenopause, especially toward the end.

"Hot flashes and night sweats, also known as vasomotor symptoms, occur due in part to low estrogen effects on the thermoregulatory center of the brain, narrowing the window of comfortable temperature," says Dr. Alyssa Dweck, MS, MD, FACOG, the chief medical officer of Bonafide Health.

A small 2023-published study of 31 perimenopausal women ages 41 to 55 listed hot flashes as a common symptom. 

3. Heart palpitations

Hot flashes are also a vasomotor symptom, and Dr. Ross says they become more prominent toward the end of perimenopause as estrogen levels plummet.

Research suggests that up to 42% of perimenopausal people experience heart palpitations (and that number jumps to 54% postmenopause).

4. Disrupted sleep

Some of the signs listed above can trigger this one: Problems sleeping.

"Disrupted sleep occurs for multiple reasons; one major reason is night sweats, which cause multiple nighttime awakenings due to sweating and discomfort," Dr. Dweck says.

Research from 2019 suggests nighttime wakings are the most common sleep-related complaint during the transition to menopause, and they can negatively affect a person's quality of life and productivity at work.

The National Institute of Aging notes that ways to improve sleep during perimenopause include exercising regularly (not close to bedtime), keeping a regular sleep schedule and avoiding naps in the late afternoon and early evening.

5. Weight gain

Exercising, eating well and still gaining weight? It may be a sign you're close to the end of perimenopause.

"Aside from aging and genetics being a reason for weight gain, menopause and the loss of estrogen contribute to your favorite jeans not fitting as comfortably," Dr. Ross says.

Research published in 2019 also linked lower estrogen with weight gain during this transition period.

6. Mood changes

Perimenopause isn't just a time of physical shifts.

"Mood changes may become more dramatic and frequent during the end of perimenopause and the beginning of menopause," Dr. Ross says. "The complete loss of estrogen during the menopause transition intensifies depression, anxiety and mood swings."

Mood swings during perimenopause are unsurprising when you consider that research shows that estrogen receptors are found in areas of the brain tasked with mood regulation.

7. Low sex drive

Busy trying to avoid getting busy? You're not alone. "Low libido or sex drive begins in perimenopause and gets worse during menopause," Dr. Ross says. "The decline in estrogen and testosterone contributes to a loss of interest in any sexual activity."

Older research from 2010 also points to data showing that hormonal changes can lead to decreased libido.

8. Vaginal dryness

Dr. Ross says that vaginal dryness can become more noticeable as perimenopause nears its end, citing a common culprit. "Estrogen is a great hydrating and moisturizing hormone," Dr. Ross says. "Loss of estrogen makes the skin all over the body and vagina dry and irritated. The tissue of the vagina becomes thin, pale, dry, and less lubricated, resulting in pain with sexual activity."

This dryness can also contribute to declining sexual desire.

9. Hair loss

If the shower drain is more clogged with hair than usual, it could be a sign perimenopause is ending.

"Hair loss occurs during the dramatic hormonal changes of menopause, including estrogen and androgens," Dr. Ross says. "Hair thinning appears as hair follicles become more fragile during menopause."

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Stages of Menopause

Curious about what the stages of menopause actually are? Here's what to know.

Reproductive stage (stages -5, -4, -3b and -3a)

In 2011, scientists developed the STRAW + 10 staging system during a Stages of Reproductive Aging Workshop (STRAW). They helped define the stages of menopause.

"The reproductive phase typically is about five years prior to menopause," Dr. Batur says, later adding that sometimes it can start earlier. "During this time, the ovaries are still producing eggs, so the possibility of pregnancy exists." The reproductive stage will vary by person, but typically it starts in the late 30s or early 40s

Dr. Batur says that symptoms can be more unpredictable during this time, with a person feeling great some months and worse others. Bleeding starts to become more erratic.

Menopausal transition stage (Stages -2 and -1)

This transition period includes early and late perimenopause, explains Dr. Mary Farhi, MD, MPH, an obstetrician and gynecologist at Rush University System for Health and an associate professor at Rush Medical College. Dr. Farhi says the length of early perimenopause varies by person, but it will typically start in one's early to mid 40s.

Postmenopause stage (stages +1a, +1b, +1c, and stage +2)

After the menopausal transition, a person enters postmenopause.

"Once you go into menopause—so, 12 months without a period—you remain the rest of your life in the postmenopausal stage," Dr. Batur says. "There are many women that bleed regularly with minimal symptoms until their final menstrual period, so these phases aren't necessarily symptomatic or obvious for everyone."

How To Know When You've Reached Menopause

Dr. Batur says a person can feel confident that they have gone into menopause if they are:

  • Near the average age of menopause (52)

  • Have gone 12 months without a period

  • Are not on any medications or medical treatments that may impact the periods (such as chemotherapy or cancer radiation treatment)

When To Call a Doctor

Perimenopause and menopause are natural, and signs like hot flashes are typical. However, there are some instances where it's best to call a doctor.

"If you are in your 20s, 30s or early 40s and are getting cycle irregularities, you should discuss this with your clinician," Dr. Batur says. "It is important to identify early or premature menopause and rule out other conditions that may mimic menopause in younger age groups."

Also, just because the uncomfortable signs perimenopause is ending (or that you are officially postmenopausal) are "common" doesn't mean you have to white-knuckle through them.

"Women should see their provider if the symptoms they are experiencing are impacting their quality of life," Dr. Farhi says. "There are many options to help manage symptoms, and there is no need for a woman to suffer during this transition or in menopause."

Remember: "Just like we begin to have bodily changes with menarche—breast buds, mood changes, vaginal secretions and discharge—we also begin to have changes with the perimenopausal transition," Dr. Farhi says. "Just as menarche is not a disease, neither is perimenopause! It is a natural transition through our reproductive years until we reach the end of our reproductive years, called menopause."

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