At what age does perimenopause typically start and how long does it last?


Dr. Susan Hutchinson discusses the typical age of onset of perimenopause, and the markers that define it in blood tests.


“The typical starting age would be about 47 years old. Some women it starts earlier. It's about a four-year period, and again this is an average. So around the age of 51, 52 it usually becomes what's called menopause. Now the definition of menopause is, no spontaneous bleeding for one full year, or there's a set of blood tests women can have and typically it would be an FSH and an estradiol. FSH stands for follicle stimulating hormone, it comes from the pituitary. And estradiol comes from the ovary. So, if a woman is now completely menopausal, think about her ovaries as going to sleep, then you would expect the estradiol, the estrogen level to be quite low and the FSH to be high. Because the pituitary is now sensing there is not enough estrogen. So to give an example, let's say I have a woman who hasn't had a period in three or four months, and she's wondering, ‘Am I menopausal, Dr. Hutchinson?' Well, she had a period three or four months ago, so I can't go by the absence for one full year. So that's when I might order the FSH and the estradiol.”

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Susan Hutchinson, MD

Author - The Women's Guide to Managing Migraine
Orange County Migraine & Headache Center

Dr. Susan Hutchinson is a headache specialist and board-certified family practice physician. In February 2007, she founded Orange County Migraine & Headache Center, dedicated to serving patients with headache and mood disorders. Although she is not a psychiatrist, she has developed a special interest in treating mood disorders as well as headache. The mood disorders she treats include depression; anxiety; bipolar disorder; ADHD; and panic attacks. Dr. Hutchinson suffers from migraine headaches which gives her an empathy with her patients.

She felt such a calling to help patients with headache and mood disorders that she decided to specialize and devote her career to alleviating the suffering caused by both headaches and mood disorders. She lectures nationally on the subject of headache; has written dozens of articles for medical journals; participated in headache research projects and is very active in numerous professional organizations such as the American Headache Society and the National Headache Foundation.

She is the immediate post-chair of the Women’s Issues section of the American Headache Society after serving in the chair position for 5 years. Dr. Hutchinson is a dynamic and sought-after speaker. She speaks for community groups as well as professional groups. In 2010 she became the President of The Orange County Chapter of the California Academy of Family Physicians.