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Your symptoms are real-get menopause care

If you’re in the thick of perimenopause right now, you probably know that sometimes it can be a real drag. Between hot flashes, mood swings, and insomnia, this transitional phase is a rollercoaster of changes.
Naturally, you may be wondering, “How do I know when perimenopause is ending?”
While there’s no way to know for certain when perimenopause will end for each individual woman, there are some signs that can signal that the end of perimenopause is near.
Below, learn more about 10 signs that perimenopause is ending.
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Perimenopause, also called the menopause transition, is the timeframe leading up to your final menstrual period. You typically start perimenopause between the ages of 45 and 55, and it can last several years.
During perimenopause, the levels of estrogen and progesterone made by your ovaries start to drop sharply. These hormonal fluctuations are what cause many of the symptoms that come to mind when we think of menopause.
There are several perimenopausal stages to be aware of. They are:
Late reproductive years
Early perimenopause
Late perimenopause
Early postmenopause
The stages of perimenopause are generally defined by the regularity of your period and levels of follicle-stimulating hormone (FSH). As you move through these stages, menstruation becomes sparser and FSH levels get higher.
Here, we’re focusing on the late perimenopause stage, the time shortly before your last period.
Below are some late perimenopause symptoms to be aware of. While they won’t predict exactly when perimenopause ends for you, they can be signs that its end is nigh.
Changes in your menstrual cycle, such as irregular periods, are one of the most common signs of perimenopause. If you’ve started to notice that your periods are farther apart, you may be nearing the end of perimenopause.
During the early stage of perimenopause, the time between your periods can vary by up to seven days. However, as you enter the late stage of perimenopause, 60 or more days may pass between your periods.
Vasomotor symptoms, which include hot flashes and night sweats, are some of the most common symptoms of perimenopause. Research estimates that up to 75% of women experience vasomotor symptoms during this time.
Vasomotor symptoms like hot flashes peak in late perimenopause and early postmenopause. For example, one 2025 study found that, among moderate-to-severe symptoms, hot flashes showed the greatest change in prevalence from the late reproductive years to late perimenopause.
Vasomotor symptoms can continue even after you’ve reached menopause. Some research suggests that they can last a median of 4.5 years after your final menstrual period.
Vaginal dryness is another symptom that you may notice during perimenopause. This can make sex uncomfortable and sometimes downright painful.
The not-so-great news is that you may notice an increase in vaginal dryness as you approach your last period. Indeed, some research has found that later stages of menopause are more closely linked with vaginal dryness.
If you’re feeling less and less in the mood lately, it may be a sign that you’re approaching the end of perimenopause. A noticeable drop in sex drive is a potential sign you’ve reached late perimenopause.
A drop in sexual desire happens during late perimenopause and early postmenopause. Factors that may influence this include estrogen levels, the severity of other perimenopausal symptoms, and stress.
You may notice you need to pee more as menopause nears. Increased urinary frequency or urinary incontinence are just a couple of aspects of genitourinary syndrome of menopause (GSM).
GSM may affect more than 50% of women during perimenopause. It also leads to symptoms previously discussed, such as vaginal dryness and loss of libido.
When it comes to urinary incontinence in particular, some research has found that women in late perimenopause are more likely to develop it compared to premenopausal and early perimenopausal women.
Quality sleep during perimenopause can be hard to come by. This can be due to a variety of factors.
For example, hot flashes and night sweats may wake you up at night. Stress or mood changes like depression and anxiety can also mess with your sleep.
As you reach the end of perimenopause, sleep disturbances will likely persist or may get worse. Compared to women in early perimenopause, women in late perimenopause are 1.3 times more likely to experience insomnia, per one 2017 study.
Hormonal fluctuations earlier in perimenopause are associated with rapid changes in mood, called mood swings. As hormone levels continue to decrease closer to menopause, you may notice that you have fewer mood swings.
However, you may also notice that mental health changes continue during late perimenopause. For example, researchers have found that perimenopausal and early postmenopausal women are two to four times more likely to have depressive symptoms than before the menopausal transition.
Other research has suggested that women with low levels of anxiety prior to perimenopause were more likely to report higher levels of anxiety in the perimenopausal and postmenopausal period compared to women who had higher anxiety to begin with.
Shifting hormone levels are one of the potential triggers for migraine. If you’ve ever noticed that your migraines are more common around your period, you’re acutely aware of this.
As hormonal fluctuations occur earlier in perimenopause, you may find that you’re having more frequent migraines. Other factors like poor sleep, stress, and anxiety or depression during this timeframe certainly don’t help.
However, as hormone levels stabilize in late menopause, you may notice you have fewer migraines.
Drops in estrogen levels that happen during perimenopause can lead to changes in body composition and metabolism. This often leads to weight gain.
Women gain roughly one pound per year during perimenopause. As menopause approaches, body composition changes: Fat mass, particularly belly fat, increases, while lean mass decreases.
In addition to weight gain, there’s also an increase in other cardiovascular disease risk factors as you move through perimenopause, although you may not notice them without testing from a healthcare provider. For example, cholesterol levels and plaque buildup in the blood vessels can also increase.
This sign of late perimenopause is a silent, but important, one. Bone loss, which is linked to declining estrogen levels, can accelerate during late perimenopause.
Loss of bone density increases the risk for osteoporosis, a condition that affects 1 in 5 women over age 50 and increases the risk of potentially serious fractures.
Because bone density loss isn’t typically a symptom you’d notice, screening for osteoporosis is recommended for all women 65 and older. If you’re younger and have risk factors for osteoporosis, you may start screening earlier.
Still have questions about the end of perimenopause? Here are answers to some frequently asked questions.
The length of perimenopause can vary widely. The median duration of perimenopause is four years.
There’s no standard length of time that late perimenopause lasts. Research suggests that once you’ve entered late perimenopause, it can be one to three years until your final period.
You’re considered to be in menopause when it’s been at least 12 consecutive months since your last period. The average age of menopause in the United States is 52.
As you can imagine, the symptoms of menopause can really put a damper on your daily activities and quality of life. That’s why addressing them is so important.
Fortunately, there are a variety of treatment options available. For example, using menopausal hormone therapy can help with many menopause symptoms, improving women’s health and well-being.
There are several treatments that can help you manage perimenopause symptoms. One part of your treatment plan may be hormone replacement therapy (HRT).
HRT uses synthetic versions of hormones, such as estradiol and progestin, to supplement missing estrogen and progesterone. This helps alleviate many symptoms of menopause that are associated with hormonal changes. Local formulations of HRT can also be used to improve vaginal lubrication.
In addition to HRT, a healthcare professional can also recommend a variety of non-hormonal treatments and lifestyle changes that can help reduce your symptoms.
Ultimately, there’s no sure way to tell when perimenopause will end. However, there are some signs and symptoms that perimenopause may be wrapping up.
For example, you’ll start to notice longer stretches between your periods. Some symptoms, such as hot flashes, vaginal dryness, and sleep problems, may intensify, while others, such as mood swings and migraine, start to improve.
Regardless of what stage of perimenopause you’re in, talk to a healthcare provider about any bothersome symptoms. There are a variety of effective treatments for perimenopause symptoms.
Whether you’re frequently woken up by night sweats, struggling with weight gain, or dealing with depression, a healthcare provider can help develop a treatment plan tailored to you. They may also be able to recommend other ways to support your health and wellness during this transition, as well.
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This article is for informational purposes only and does not constitute medical advice. The information contained herein is not a substitute for and should never be relied upon for professional medical advice. Always talk to your doctor about the risks and benefits of any treatment. Learn more about our editorial standards here.
Full Name: Julia Switzer, MD, FACOG
Professional Title(s): Board Certified Obstetrician Gynecologist
Current Role at Hims & Hers: Medical Advisor
Education:
Bachelor of Arts - Bryn Mawr College, 2003
Doctor of Medicine - Sidney Kimmel Medical College, 2009
Training:
Residency in Obstetrics and Gynecology - Thomas Jefferson University Hospital, 2009–2013
Medical Licenses:
Pennsylvania
Board Certifications:
Other Certificates & Certifications
Certified Menopause Provider
Affiliations & Memberships:
Fellow of the American College of Obstetrics and Gynecology
Member of The Menopause Society
Member of The Obstetrical Society of Philadelphia
Specialties & Areas of Focus:
Women’s Health
Menopause
Years of Experience: 16
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