Perimenopause is the natural transitional phase leading up to menopause, marking the gradual end of a woman's reproductive years. During this time, the ovaries begin to produce less estrogen and other hormones, causing menstrual cycles to become irregular-periods may lengthen, shorten, or be skipped altogether. This phase can start as early as the mid-30s but typically begins in the 40s and lasts on average about four years, though it can range from a few months to up to ten years

. Symptoms of perimenopause arise due to fluctuating hormone levels and often include irregular periods, hot flashes, night sweats, vaginal dryness, sleep disturbances, mood swings, memory problems, and weight gain. Fertility declines during this time, but pregnancy is still possible until menopause is reached, which is defined as 12 consecutive months without a menstrual period

. Perimenopause is a normal biological process caused by the gradual decline in ovarian function. It ends when menopause begins, after which the ovaries stop releasing eggs and estrogen levels stabilize at a low level

. Treatments are available to help manage symptoms during this transition