When Fiona Byrne entered her 30s, her body started to change. Despite never experiencing acne as a teen, she suddenly had cystic pimples at 32. Then, a few years later, by her mid-30s, her nails became unusually brittle, she started getting dizzy on escalators, her skin itched, and her periods fell closer together.
Around 40, she was waking up at 3 a.m. with night sweats, and her hair, which had always been silky, was inexplicably dry. At that point, she started doing some research to connect the dots of this growing constellation of symptoms, and when she finally met with a menopause expert, she got her answer: she was in perimenopause. If I knew in my late 30s, I would have been on hormone replacement therapy (HRT) immediately,” says Byrne, now 49—and still in perimenopause.
Most women hit menopause around age 51 or 52, says Mariya Rozenfeld, DO, an ob-gyn and Menopause Society Certified Practitioner (MSCP)—the gold standard certification for physicians who treat patients with menopause—at NYU Langone. Once a woman hasn’t gotten her period for a year, and thus “runs out” of her egg stores, she is considered to be menopausal. Perimenopause isn’t as black and white: it’s the time before you hit menopause marked by fluctuations in hormone levels that cause an array of symptoms.
And, they may appear a lot earlier than you’d expect. Until recently, the median time women spend in perimenopause has been considered to be about four years, but newer studies suggest that the symptoms can last a lot longer and start as early as your thirties. One 2025 study published in NPJ Women's Health on 4,400 American women ages 30 and older found that roughly 55 percent of women 30 to 35 reported perimenopause symptoms that met the criteria for “moderate” or “severe” based on the Menopause Rating Scale.
That number rose to just over 64 percent for women 36 to 40 years old. Despite this, most women didn’t seek treatment until they were 56 or older. It's not a short period of time, no matter what,” says Rajita Patil, MD, MSCP, an ob-gyn and director of the Comprehensive Menopause Program at UCLA.
In other words, it’s way more common than you might think to be a perimenopause long-hauler. In the past few years, the conversation around perimenopause and menopause has exploded, fueled, in part, by celebs like Naomi Watts, Penelope Cruz, and Halle Berry sharing their experiences. Social media, too, has allowed women to share resources, stories, and symptoms to better understand this life phase.
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