Signs Perimenopause Is Ending

3 minute read

By: Alloy Staff|Last updated: July 1, 2024|Medically reviewed by: Sharon Malone
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As we get closer to menopause, women begin to notice changes in the symptoms they usually experience. Good news and bad news. 

Some symptoms will get better. Others will get more intense. This post will explore six signs that perimenopause is on its way out the door.

If you think you’re in menopause and are experiencing symptoms such as insomnia and hot flashes, Alloy is here to help. We provide solutions for menopausal women with hormonal treatments such as estradiol pills and estradiol vaginal cream.

 Take our assessment and discover a more personalized treatment plan

What Are the Signs Perimenopause Is Ending?

Your body might also be signaling to you that perimenopause is drawing to a close. Certain symptoms will increase in severity and frequency during the last few years of your perimenopausal cycle while others might disappear or become less intrusive.

The most common sign that perimenopause is ending, and often the most reliable, is an increased time between each period. As you near the end of perimenopause, the time between your periods should be around 60 or more days until they stop entirely.

Other common signs perimenopause is ending include the following:

  • Less frequent headaches

  • More stabilized mood

  • More hot flashes

  • Less sleep

We go into each sign in more depth below.

Less Frequent Headaches

Finally, here’s some good news. Because the wildly fluctuating hormones you’ve been experiencing in early and mid-perimenopause are starting to settle down to their new, albeit much lower levels, headaches actually start to improve. 

Women with menstrual migraines will notice that those debilitating headaches start to get fewer and farther between as the periods start to space out.  

More Stabilized Mood

The ups and downs that affect 75% of women experiencing perimenopause are likely to taper off as we begin to enter menopause. Mood fluctuations and hormonal fluctuations go hand in hand.  So it stands to reason that once you reach menopause, although your hormones will hit a new low, at least it’s a consistent low.

More Hot Flashes

Hot flash symptoms are likely to increase as you get nearer to menopause.  Although doctors don’t know the exact mechanism of what causes hot flashes, we do know that the hot flash is initiated in the brain, not as a response to your environment. 

When it’s really hot outside the temperature receptors in your skin tell your brain that it’s hot.  When you’re having a hot flash, your brain tells your body that it’s hot. The response is the same–dilation of blood vessels (flushing) coupled with sweating to cool the skin. 

We do know that estrogen, or lack thereof, is involved in temperature regulation. Lowered estrogen levels can cause this brain thermostat to malfunction.  That’s why it’s possible to have a hot flash when it’s 60 degrees in your bedroom. 

And believe it or not, the average amount of time that hot flashes last is 7 years, not 2-3 like originally thought after menopause, but for some, they can go on for as long as ten years and for about 10% of women they may last forever. 

Less Sleep

With hot flashes, night sweats, increased anxiety, and hormonal fluctuations, it is no wonder that a good night’s sleep is hard to come by. Rates of insomnia are higher for women than for men due to the unique hormonal fluctuations that start at perimenopause and continue straight through the menopausal years.

What Is Perimenopause?

Ah, the slow and steady march of time.

Simply put, perimenopause is your body’s way of letting you know that it is preparing itself for menopause. It is one of the many natural rhythms that define our lives. You can think of it as an in-between stage.

Perimenopause is a transitional window between your reproductive years and your menopausal years when ovulation (and your period) ceases.

Perimenopausal symptoms may last from a few months to several years and are categorized into two stages. During the early stage of perimenopause, you may experience changes in menstrual flow and cycle duration. The last stage of perimenopause before menopause may cause missed menstrual periods before they eventually stop altogether. At this time, estrogen levels dramatically decline over a period of six months. 

During perimenopause, your estrogen levels are not fluctuating in a regular, predictable manner like they were before. This hormonal fluctuation leads to a whole range of symptoms – from irregular periods to some of the symptoms associated with menopause, like hot flashes.

There are a number of natural, hormonal, and non-hormonal remedies for hot flashes and other symptoms of perimenopause and menopause. It can be time-consuming and confusing to sift through which remedies, supplements, and medications are best for treating your menopausal symptoms.

That’s where talking to a fully-licensed menopause-trained doctor makes all the difference.

Discover which type of treatment is right for your perimenopausal or menopausal symptoms by taking Alloy’s assessment today and work with a menopause-trained doctor.

When Perimenopause Starts

Every woman’s body operates under different hormonal, chemical, and biological pressures. Because of these variables, it’s hard to say exactly when perimenopause begins. Some women start to notice perimenopause signs as early as their 30s, while others won’t notice well into their 40s.

Certain risk behaviors, like smoking, can trigger the process earlier. Other factors, such as your family history and medical history, can affect exactly when perimenopause begins.

How Long Does Perimenopause Last?

There isn’t a set length of time perimenopause lasts, either. The average amount of time women spend in perimenopause is four years, but some women report being in perimenopause for as long as ten years. 

The drop in estrogen levels accelerates during the last couple of years of your perimenopausal cycle. Eventually, after 12 months with no period, perimenopause ends, and menopause officially begins. 

The only guarantee with perimenopause is that it will happen (and might be happening), so it's essential to be aware of the symptoms associated with it.

Symptoms of Perimenopause

Imagine your body as an intricate symphony, with hormones as the maestros conducting the show. When perimenopause enters the scene, it's like a surprise change in the composition, and the maestros are trying to adapt. 

What ensues is a series of symptoms that are as diverse and dynamic as the notes in a symphony. From hot flashes to night sweats, you’ll be heading toward new bodily experiences during the time of perimenopause.

While it might be all new at first, you’ll be relieved to know that you’re not in for surprise late perimenopause symptoms. What you experience in early perimenopause tends to be what you can expect throughout this phase of your life.

Let’s take a look at some of the most common symptoms you can expect in perimenopause. 

Irregular Periods

Some of us are very regular in our menstrual cycles, and other women naturally experience a degree of inconsistency month to month. Whatever your normal was, perimenopause will gradually change it. 

During this time, your period might take a substantial hiatus only to make a comeback. Some women are quite surprised when they get their period again after missing it for 6 months during perimenopause. It's important to note that menopause requires going 12 consecutive months without a period. 

Hot Flashes

Hot flashes, described as sudden bursts of intense heat, are one of the most recognizable symptoms of perimenopause and menopause. Despite this, some women – 1 out of 5 – never experience hot flashes.

Mood Swings

Changes in mental health are another common symptom of perimenopause — 75% of perimenopausal women report mood swings. Like other perimenopause symptoms, they’re caused by fluctuating hormone levels and may result in perimenopausal depression.

Night Sweats

Night sweats are hot flashes that happen when you are asleep. These hot flashes can pull you out of restful sleep and interfere with your sleep cycle. Many women wake up in soaked pajamas and wet sheets.


Women experiencing perimenopause also report an increase in headaches. The cause of these headaches is most often the wild fluctuations in hormonal levels. Many women report a decrease in headaches once they are through the menopausal transition and their hormones have evened out. 

Feeling Exhausted

As if the other symptoms weren’t enough, women also report feeling exhausted – mentally and physically drained. Insomnia, sleep disruption caused by fluctuating hormones, and night sweats are all to blame here.

Weight Gain 

During perimenopause, many women experience unexpected weight gain. Decreased levels of estrogen may slow metabolism, making it challenging to maintain a consistent weight. Dropping levels of estrogen also lead to more insulin resistance, an increase in visceral fat, and other metabolic changes that can lead to weight gain. The average weight gain is 1.5 lbs per year over the perimenopause transition. 

Stress and sleep disturbances during perimenopause can exacerbate weight gain, leading to poor dietary choices and decreased physical activity.

Vaginal Dryness 

Without sufficient estrogen, vaginal tissue becomes drier and less elastic. Vaginal dryness is frequently encountered throughout perimenopause, causing discomfort, decreased sensation and possible pain during physical intimacy. This is the start of the genitourinary syndrome of menopause, and can also include bladder changes and , more frequent UTIs.

Many effective treatments, including lubricants and topical estrogen therapies, can alleviate discomfort due to vaginal dryness.

How Do I Know I’m in Menopause?

Experiencing perimenopause—and figuring out exactly when it starts—can be extremely confusing as there are at least 34 symptoms of menopause that can affect each woman differently and occur on different timelines for each woman. 

However, when exactly you have reached menopause is actually very simple to discern. Once you have not had a period for 12 months, regardless of symptoms, you are considered to be in menopause. 

And menopause is forever. The average woman will spend over thirty years of her life in menopause.

Find Relief From Perimenopause and Menopause Symptoms With Alloy

We know what it’s like to go through perimenopause and menopause, and we can help. Several treatments are available to help you deal with the intrusive, bothersome, and sometimes debilitating symptoms of perimenopause and menopause. 

Alloy offers hormonal treatments, which are considered to be the most effective at managing menopause and perimenopausal symptoms. These hormonal treatments include estradiol pills, estradiol patches, estradiol sprays, estradiol gels, progesterone, low dose birth control pills and estradiol vaginal cream

We also offer low-dose paroxetine, a non-hormonal prescription therapy that can provide relief from hot flashes and night sweats. 

Not sure which solution is right for your menopause symptoms? Take our assessment today.


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“Hot Flashes: Why They Happen, Treatment, Prevention.” WebMD.

“How Do I Know I’m In Menopause?” The North American Menopause Society.'m-in-menopause-

“Insomnia.” Office on Women’s Health. November 21, 2018.

Mayo Clinic Staff. “Perimenopause - Symptoms and Causes.”  Mayo Clinic. Aug. 07, 2021.

“Perimenopause: Rocky Road to Menopause.” Harvard Women's Health Watch. April 14, 2020.,in%20sexual%20desire%20at%20midlife.

“Perimenopause: Symptoms, Treatments, Weight Gain, and More.” WebMD.

Rachel Reiff Ellis, “Why Am I So Tired? !0 Reasons Why You Are Tired All The Time.” WebMD. October 27, 2015.

“The Emotional Rollercoaster of Menopause.” WebMD.

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