What Is Perimenopause?

Many South African women have never heard of, or know very little about perimenopause.

Perimenopause is the time or phase before menopause.

It is a time of change, as your body shifts or moves from your reproductive years – having a menstrual period and being able to become pregnant – towards the permanent end of having menstrual periods and no longer being able to become pregnant.

Timing of perimenopause

Perimenopause typically happens 4 to 8 years before your last or final menstrual period (menopause).

Most women begin perimenopause in their mid-40s. However, perimenopause can begin for some women in their mid-30s.

Perimenopause is a time of unpredictable and often significant hormonal swings or fluctuations – sometimes surging too high or dropping too low (click here for more on the hormonal changes that happen during perimenopause).

Key signs and symptoms of perimenopause

During perimenopause you will experience changes to your menstrual cycle.

Perimenopause is also a time when conceiving a child or becoming pregnant become more difficult for many women

This of course does not mean that women cannot become pregnant during perimenopause.

Do not forget that while women experience changes to their periods because of hormonal changes – and as perimenopause progresses women will have more and more menstrual cycles where they do not produce an egg – some women are still able to become pregnant during perimenopause.

So, contraception and measures to avoid becoming pregnant (if that is what you want) remain important.

There are in fact an increasing number of South African women who fall pregnant in their 40s, and their perimenopause does affect their postpartum experiences.

Many symptoms appear during perimenopause. These include sleep changes and disturbances, vasomotor symptoms (including night sweats and hot flushes) and mental health symptoms (brain fog, depression, anxiety).

The changes to your body are also different over time.

So, a distinction is made between an early versus late perimenopause phase.

My Menopause SA

Evidence-based menopause information for South African women.

Page last reviewed: 1 March 2026
Next review due: 1 March 2027

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All Understanding Perimenopause & Menopause

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