The Truth About Perimenopause: 10 Myths and Facts Explained

Have you ever found yourself lying awake wondering, “Is this normal?”. I hear this all the time from women who feel like their bodies are changing in ways they weren’t prepared for. We’re not taught what to expect, and what we do hear is often filtered through fear, shame, or outdated clichés. Let’s change that.

In this article, I’ll walk you through the most common perimenopause myths and facts. Because the more you understand what’s happening in your body, the more empowered you’ll feel to navigate this phase with confidence. After all, it’s all biology, Baby!

What are common perimenopause myths and facts?
Many people believe perimenopause starts at a specific age, lasts only a year or two, or only causes hot flashes—but these are myths. In reality, perimenopause can start in your late 30s, last up to a decade, and cause a wide range of symptoms, including mood swings, brain fog, and sleep issues.

Top 10 Perimenopause Myths and Facts

There’s no shortage of confusing, outdated, or just plain wrong information about perimenopause. These myths can leave you feeling unprepared or even doubting yourself. That’s why it’s time to separate fact from fiction.

Myth 1: Perimenopause Begins at a Specific Age

Truth: There’s no single “correct” age when perimenopause starts. It typically kicks in around the mid-40s, but it can happen as early as the late 30s or as late as the early 50s. Factors like genetics, lifestyle, and overall health influence timing.

Myth 2: Pregnancy Isn’t Possible During Perimenopause

Truth: Surprise pregnancies can (and do) occur during perimenopause. Until menopause is officially confirmed (12 consecutive months without periods), ovulation can still happen unpredictably, so contraception remains important. Pregnancies after age 40 are becoming increasingly common in many developed countries. In Spain, for instance, one in ten women giving birth is now aged 40 or older1. 

Myth 3: Perimenopause Only Lasts a Year or Two

Truth: Perimenopause isn’t a quick phase, it typically lasts around four years but can extend up to a decade. Setting realistic expectations helps you manage symptoms proactively.

Myth 4: Hot Flashes Are the Only Symptom

Truth: While hot flashes are common, perimenopause can also bring irregular periods, mood swings, anxiety, sleep disturbances, vaginal dryness, joint aches, brain fog, and more.

Myth 5: Perimenopause Makes Everyone Emotionally Unstable

Truth: Hormonal fluctuations can affect mood, causing irritability or even depressive symptoms for some. However, severe emotional distress isn’t inevitable, and most women experience manageable mood changes.

Myth 6: Hormone Tests Are the Best Way to Diagnose Perimenopause

Truth: Hormone levels fluctuate significantly during perimenopause, making single tests unreliable. Diagnosis typically relies on symptoms, age, and menstrual cycle changes, rather than hormone testing alone.

Myth 7: You Should Just Endure Symptoms Without Medical Help

Truth: Perimenopause symptoms can and should be managed. Consulting healthcare providers helps confirm symptoms, rule out other conditions, and discuss effective treatments.

Myth 8: Lifestyle Changes Won’t Help With Symptoms

Truth: Healthy habits like regular exercise, balanced diet, adequate sleep, and stress management can significantly ease symptoms, improving overall well-being during perimenopause.

Myth 9: Perimenopause Symptoms Are Always Severe

Truth: Symptoms vary greatly among women. While some women face severe symptoms, others experience only mild discomfort. It’s an individual experience, and severity can differ widely.

Myth 10: Perimenopause Means the End of Your Sex Life

Truth: Hormonal shifts may affect libido and comfort during sex, but perimenopause does not end your sex life. Many women maintain satisfying intimacy with simple adjustments like lubricants or other medical interventions.