# What is perimenopause?

> The transition nobody explained properly

Category: Perimenopause · 4 min read · Written by the Splash team · Sources checked October 2026
URL: https://splash.care/learn/perimenopause/what-is-it

## Quick answer

Perimenopause is the transition before menopause, when the ovaries gradually produce less oestrogen and periods become irregular. It usually starts in your mid-40s and can last several years. Menopause itself is one year after your last period; the average age in the UK is 51. You can still get pregnant during perimenopause.

- Perimenopause is the hormone transition before your periods stop.
- Menopause = 12 months without a period; usually 45 to 55, average about 51.
- You still need contraception during perimenopause, and HRT is not contraception.
- Symptoms before 45 deserve medical support.

Perimenopause is the run-up to menopause. Your ovaries gradually make less of their [hormones](https://splash.care/learn/cycle-basics/hormones-explained), and levels can swing up and down. You still have periods, but they and your body may start doing new things. It affects anyone who has periods, including trans men and non-binary people.

- [Perimenopause](https://splash.care/learn/glossary/perimenopause): hormone changes and symptoms, while you still have periods.
- [Menopause](https://splash.care/learn/glossary/menopause): when you have not had a period for 12 months.
- [Postmenopause](https://splash.care/learn/glossary#postmenopause): everything after that.

**45 to 55** The age menopause usually happens, says the NHS. The average age is around 51.

Perimenopause often starts in your 40s. It ends when you reach menopause, and the NHS says symptoms usually last 7 to 9 years, sometimes longer. Everyone is different: some people barely notice it, while others have symptoms that affect work, relationships and [sleep](https://splash.care/learn/movement-sleep/sleep-cycle).

If menopause happens before 45 it is called early menopause, and before 40 it is called premature ovarian insufficiency ([Premature ovarian insufficiency](https://splash.care/learn/glossary/poi)). Menopause can also happen earlier after surgery to remove the ovaries, or after some cancer treatments. All of these deserve medical support.

**Myth:** You cannot get pregnant in perimenopause.

**Fact:** You can. The NHS says you still need contraception for 2 years after your last period if you are 40 to 49, and for 1 year if you are 50 or over. HRT is not contraception.

**Myth:** Perimenopause only happens at 50.

**Fact:** Perimenopause often starts years before your last period. Symptoms can begin while your periods are still regular, sometimes in your early to mid 40s.

**Quick quiz:** When is someone said to have reached menopause?

1. When hot flushes start
2. After 12 months with no period
3. At age 50

Answer: After 12 months with no period. Menopause is when you have not had a period for 12 months (if you are not using hormonal contraception that affects periods). Age 50 is just an average.

> **Splash says:** switch the app to perimenopause mode to track symptoms alongside your changing cycles. Great evidence to take to a doctor.

### When to see a doctor

See a GP if perimenopause symptoms affect your life, or if you have symptoms or stopped periods before 45. Help is available, and you do not have to “just put up with it”. Early advice can reduce the effect on your health, relationships and work.

## Questions people ask

### How long does perimenopause last?

It varies, but it often lasts several years. It ends at menopause, defined as 12 months without a period.

### Can I get pregnant in perimenopause?

Yes. You still ovulate some of the time, so the NHS advises using contraception until two years after your last period if you are under 50, or one year if you are over 50.

## Sources

1. [NHS: Menopause and perimenopause](https://www.nhs.uk/conditions/menopause-and-perimenopause/)
2. [NHS: Symptoms of menopause and perimenopause](https://www.nhs.uk/conditions/menopause-and-perimenopause/symptoms/)
3. [NHS: Early or premature menopause](https://www.nhs.uk/conditions/early-or-premature-menopause/)
4. [NICE NG23: Menopause: identification and management](https://www.nice.org.uk/guidance/ng23)
5. [ACOG: The Menopause Years](https://www.acog.org/womens-health/faqs/the-menopause-years)

This is general information, not medical advice. Splash can’t diagnose. If you’re worried, talk to a GP, pharmacist or sexual health clinic. In an emergency call 999 (UK) or 911 (US).