Medically reviewed by Catherine Hansen, MD, OBGYN & Menopause specialist

Noticing changes and wondering if perimenopause is winding down? Key signs indicate the finale of this transitional phase is in sight. This concise guide will help you identify those signs perimenopause is ending, as your body prepares for the next stage of its hormonal journey. Without diving into medical jargon or overwhelming detail, we’ll outline the physical and emotional markers to watch for and offer a sneak peek at effective strategies for the late perimenopause period, ensuring you’re well-supported as you approach menopause.

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Understanding Perimenopause

Perimenopause is like the prelude to a significant life change, signaling that menopause, including early menopause, is on the horizon. This natural transition can be a bumpy ride, starting as early as the mid-30s and lasting right up until menopause itself, which is marked by 12 consecutive months without a menstrual period. During this time, many of us experience a cocktail of symptoms, from mood swings to decreased fertility, and even changes in sexual function, which can be as diverse as our individual stories.

Moreover, factors such as family history, lifestyle choices like smoking, or previous cancer treatments can bring about an earlier onset of perimenopause, further illustrating the uniqueness of each person’s experience.

Hormonal Fluctuations

The ebb and flow of our monthly cycles during perimenopause are at the mercy of wildly fluctuating hormones, particularly estrogen and progesterone. As these hormones dance to an erratic rhythm, they impact ovulation and menstruation, leading to a symphony of symptoms that can range from hot flashes to night sweats, and even menstrual migraines.

The decline in estrogen levels is like a conductor losing grip over the orchestra, leading to hormonal imbalance and a whole range of menopausal symptoms that play out in your body. This imbalance in hormone levels can cause discomfort and affect overall well-being.

Stages of Perimenopause

Perimenopause is not a single note; it’s a composition with distinct early and late stages. In the early stage, also known as early perimenopause, you might notice your once regular menstrual cycle becoming as unpredictable as spring weather, with changes in flow and frequency that signal the beginning of this transitional window.

As you travel through the menopausal transition to the late stage, you might find the crescendo of symptoms like hot flashes, a clear indicator that your body is nearing the menopause transition.

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Top Signs Perimenopause Is Ending

As perimenopause draws to a close, there are telltale signs that the menopause journey is nearing its next chapter. It’s like sensing the calm after a storm, where certain symptoms become less frequent, while others intensify before they subside. The finale of perimenopause is confirmed when you’ve reached an entire year without a menstrual period, including any light spotting.

But before you reach that milestone, your body queues up a series of changes that signal you’re on the final stretch.

Lengthening Time Between Periods

One of the most significant signs that perimenopause is ending is the lengthening of time between periods. It’s as if the waves of your menstrual cycle are reaching further shores, with gaps of 60 days or more becoming the new norm. This increased span between periods can vary from woman to woman and is related to the cessation of ovarian function that results in less and less ovulation over time.

Decreasing Headache Frequency

As you sail towards the end of perimenopause, the once frequent and debilitating headaches, particularly menstrual migraines, begin to subside. It’s like the clouds parting to reveal clearer skies, with headache frequency decreasing, a welcome respite for many.

The irregular ovulation patterns during late perimenopause contribute to irregular periods, offering a potential break from the menstrual cramping that may have been a regular part of life for years.

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Intensifying Hot Flashes

While some symptoms wane, others, like hot flashes, may crescendo in intensity. It’s a paradox of the perimenopause finale—just as you’re nearing the finish line, these bursts of intense heat can become more frequent and severe.

This intensification of hot flashes is a direct result of the hormonal imbalances, especially the decreased estrogen levels that are a hallmark of this late stage.

Sleep Improvements

Amidst the fluctuating symptoms, there’s a silver lining—sleep improvements. Like finding a comfortable position after tossing and turning, many women report better sleep patterns as they transition from perimenopause to menopause.

The hormonal roller coaster that disrupted your slumber begins to even out, leading to fewer night sweats and a more restful night.

Mood Stability

Perhaps one of the most welcome changes is the return to mood stability. The hormonal tempest that stirred emotional turmoil begins to calm, and with it, the mood swings that might have felt like squalls are less intense and less frequent.

While estrogen’s influence on brain chemistry can make the perimenopause years emotionally turbulent, as you near menopause, there’s a sense of reclaiming an even keel.

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Managing Symptoms During Late Perimenopause

Navigating the perimenopausal symptoms of late perimenopause doesn’t have to be a solo voyage. From the waves of hot flashes to the unpredictable currents of menstrual cycles, there are ways to steer through these changes with grace and ease. If the symptoms significantly interfere with your daily life or if you’re concerned about menstrual irregularities such as heavy bleeding, it’s crucial to consult with a doctor to explore the best treatment options.

Remember, as your journey evolves, so should your management strategies for physical and mental health, which is why an annual review with a healthcare provider is a proactive step in maintaining your wellness.

Hormone Replacement Therapy (HRT)=Menopausal Hormone Therapy (MHT)

Menopausal Hormone Therapy (MHT) can be a beacon of hope for those navigating the choppy waters of perimenopause. Systemic estrogen therapy, in particular, is remarkably effective for quelling hot flashes and night sweats, and can come in various forms like pills, patches, or gels. For those dealing with vaginal dryness or discomfort during intimacy, vaginal estrogen or oral SERMS provides targeted relief.

However, the decision to embark on MHT is not one-size-fits-all; it requires a personalized approach, taking into account individual health history and the severity of symptoms. Regular follow up with healthcare providers are essential to monitor the therapy’s effectiveness and make adjustments as needed.

Lifestyle Changes

Beyond MHT, lifestyle changes can be powerful allies in managing perimenopause symptoms. A diet low in fat and high in fiber, fruits, vegetables, and whole grains not only tackles symptoms but also guards against osteoporosis, colon cancer and heart disease. Regular physical activity, whether it’s a brisk walk or a yoga session, not only strengthens bones but boosts mood and helps to prevent weight gain, a common challenge during this time.

Hydration, avoidance of trigger foods, and consistent sleep schedules also play a pivotal role in smoothing out the rough patches of perimenopause.

Alternative Treatments

For those seeking a course different from MHT, alternative treatments provide other avenues to explore. SSRIs, and a newcomer called Fezolinetant have shown promise in reducing hot flashes, providing non-hormonal options for relief.

Herbal supplements and other natural remedies may also offer benefits, though their effectiveness and interactions with other medications should be discussed with a healthcare provider before embarking on these treatments.

Find out if it might be perimenopause or menopause quiz. Woman using hand fan

Pandia Health’s Role in Menopause Treatment

As you navigate the changing tides of perimenopause, Pandia Health stands as a lighthouse, guiding you through the menopause treatment process with ease and expertise. With specialized online consultations and a supportive community space filled with resources, Pandia Health ensures that you’re never alone on this journey.

The added convenience of free delivery for prescriptions means that managing menopause symptoms can be done from the comfort of your home, without the added stress of pharmacy visits.

Certified Menopause Practitioners

With Pandia Health, you have access to Menopause Society Certified Practitioners who bring world-class expertise in hormonal care for menopause. These specialists craft personalized treatment plans based on your unique health profile that is carefully gathered from a detailed online questionnaire, ensuring that your menopause treatment is tailored to your specific needs.

Convenient Online Consultations

The convenience of Pandia Health’s online consultations cannot be overstated. With no waiting rooms or appointment hassles, you get immediate access to healthcare professionals ready to assist you with your menopause treatment. Support is available Monday to Sunday, and you can make the consultation fit your life since there is no need for video calls, the doctors ensure they provide personalized care at every step of the way.

Free Delivery for Your Prescription

The seamless treatment experience that Pandia Health offers extends to the delivery of your prescriptions. Medications arrive directly at your door, ensuring privacy and convenience, and the company supports a wide range of insurance plans, making treatment accessible.

With automatic refills and reminders for annual renewals, Pandia Health simplifies medication management, allowing you to focus on your well-being rather than logistics.

Ready to start saying goodbye to menopause symptoms? Get started today!


In the unfolding story of your perimenopause journey, understanding the signs of its stages, managing symptoms with care, and seeking the right support are chapters that lead to a new beginning. As you transition to menopause, remember that the upheaval of symptoms will eventually stabilize, marking the end of one phase and the start of another. With personalized treatments, lifestyle adjustments, and the convenience of services like Pandia Health, you’re equipped to navigate this transition with confidence and come out thriving for the rest of your precious lifetime.