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Perimenopause: The Transition to Menopause
Quick answer: Perimenopause is the transition before menopause, often starting in the 40s, when hormone levels fluctuate. Common signs are changes in period timing and flow, hot flashes, sleep problems, and mood changes. At Eunice Women's Clinic near Seongsu Station, Dr. Eun Mi-na, an English-speaking female OB-GYN, checks for other causes of bleeding changes and discusses symptom relief and contraception.
What is perimenopause?
Perimenopause, also called the menopause transition, is the time leading up to menopause. During this time, the ovaries work less regularly, and estrogen and progesterone levels rise and fall unpredictably. Perimenopause usually starts in the 40s, but it can begin in the late 30s. It lasts on average about 4 years, but it can be shorter or much longer. It ends when a person has gone 12 months without a period (menopause).
What are the symptoms of perimenopause?
- Changes in periods: shorter or longer cycles, skipped periods, or heavier or lighter bleeding
- Hot flashes and night sweats
- Sleep problems
- Mood changes, anxiety, irritability, or worse premenstrual symptoms
- Breast tenderness
- Vaginal dryness and lower sex drive
- Headaches or migraines that change in pattern
- Difficulty concentrating
What causes perimenopause?
Perimenopause is a natural stage of life. As the number of eggs in the ovaries decreases, ovulation becomes irregular and hormone levels fluctuate. Smoking and some medical treatments can make it start earlier. Family history also plays a role in timing.
When should I see a doctor?
Some changes in periods are expected, but not every bleeding change is due to perimenopause. See a gynecologist if you have:
- Very heavy periods, or bleeding lasting more than 7 days
- Periods closer together than 21 days
- Bleeding between periods or after sex
- Symptoms that affect sleep, work, or mood
- Periods that stop before age 40
Seek emergency care (call 119) if you have very heavy bleeding with dizziness or fainting, chest pain, or sudden shortness of breath. If you have thoughts of harming yourself, call 119 or go to an emergency room right away.
How is perimenopause evaluated at the clinic?
Perimenopause is usually recognized from your age, symptoms, and period pattern. Hormone levels change from day to day, so a single blood test often cannot confirm it. Dr. Eun may recommend:
- A pregnancy test if a period is late, because pregnancy is still possible
- A transvaginal ultrasound to check for fibroids, polyps, or a thick uterine lining if bleeding has changed
- Blood tests for thyroid function, anemia, or hormones when needed
- Up-to-date screening such as a Pap smear and a women's health checkup
What are the treatment options for perimenopause?
- Hormonal contraception: low-dose combined pills (for suitable non-smokers) or a hormonal IUD can regulate bleeding, reduce heavy periods, and provide contraception.
- Menopause hormone therapy: may be used for hot flashes and other symptoms, often combined with a progestogen or hormonal IUD to protect the uterine lining.
- Non-hormonal options: certain antidepressants or other medicines for hot flashes and mood symptoms.
- Heavy bleeding: tranexamic acid, NSAIDs, or a hormonal IUD.
- Lifestyle: regular exercise, sleep routines, limiting alcohol and caffeine, and bone-healthy habits.
Individual results vary.
Getting care in English near Seongsu Station
Eunice Women's Clinic is on the 8th floor of Bethel Place, 120 Achasan-ro, Seongdong-gu, Seoul. The building is across the crosswalk from Seoul Subway Line 2 Seongsu Station Exit 3, about a 1-minute walk ( directions). Dr. Eun Mi-na, a female board-certified OB-GYN, holds consultations about perimenopause in English.
| Day | Hours |
|---|---|
| Mon, Wed, Fri | 10:00–19:00 (lunch 13:30–14:30) |
| Tue, Thu | 10:00–20:00 (lunch 13:30–14:30) |
| Sat | 10:00–14:00 (no lunch break) |
| Sun and public holidays | Closed |
Booking is recommended. You can book through Naver Booking, the KakaoTalk channel (search "유니스산부인과"), or by phone at +82-2-467-3100 ( how to book). Call or message to check same-day availability.
Book an appointment in English
Eunice Women's Clinic · 8F Bethel Place, 120 Achasan-ro, Seongdong-gu, Seoul · Seongsu Station (Line 2) Exit 3
Phone: +82-2-467-3100 · KakaoTalk channel · Naver Booking
Mon, Wed, Fri 10:00–19:00 · Tue & Thu 10:00–20:00 · Sat 10:00–14:00 · Lunch 13:30–14:30 · Closed Sundays & public holidays
Frequently asked questions
Can I get pregnant during perimenopause?
Yes. Ovulation becomes irregular but still happens, so pregnancy is possible. Contraception is generally recommended until you have gone 12 months without a period after age 50, or 24 months if you are under 50.
How do I know if I am in perimenopause?
Common signs in your 40s are changes in cycle length, skipped periods, hot flashes, and sleep or mood changes. Because other conditions can cause similar changes, a doctor visit helps rule out thyroid problems, pregnancy, and structural causes of bleeding.
Is an AMH test useful for perimenopause?
AMH reflects ovarian reserve and falls with age, but it cannot predict exactly when menopause will happen or confirm perimenopause. It is mainly used in fertility planning. The doctor will explain whether it is useful for you.
Why are my periods heavier in my 40s?
Irregular ovulation in perimenopause can cause the uterine lining to build up and shed heavily. Fibroids, adenomyosis, and polyps are also more common at this age. Persistent heavy bleeding should be checked with an ultrasound.
Does perimenopause affect mood?
Yes. Fluctuating hormones can cause irritability, anxiety, low mood, and sleep problems, and can worsen premenstrual symptoms. Treatment options include hormonal and non-hormonal medicines and talking therapy. Tell the doctor if mood changes affect your daily life.
Related pages
This page provides general health information for patients and does not replace a consultation with a doctor. Individual results vary. If you have severe pain, heavy bleeding, fainting or other urgent symptoms, call 119 or go to the nearest emergency room. Page updated September 2026.