The Female Atlas
By Yolene
Published 2026-11-15 · Updated 2026-11-15
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Perimenopause articles: what is perimenopause and where do I start?

Perimenopause usually starts in your 40s and lasts until 12 months after your final period. If you are wondering where to start, the evidence points to three things first: enough protein, heavy lifting and short HIIT, with the figures in the facts box below.

This page lists each perimenopause article as it is published, on the themes this stage keeps raising: training that suddenly stops working, protein, sleep and mood. Think of it as a map rather than a rulebook. The facts box below holds the figures those articles build on, each with its source, so you can take them as sensible starting points and come back when something changes.

Facts

Perimenopause usually starts in your 40s and lasts until 12 months after your final period. 40s; +12 months
WHO, Menopause fact sheet (12-month definition) · 2024
Most women reach menopause between about 45 and 55, and some before 40. The NHS (UK) gives the same usual range. 45–55 years of age
WHO, Menopause fact sheet · 2024
Symptoms usually last 7 to 9 years, sometimes longer (NHS, UK wording). 7–9 years
NHS, Menopause symptoms · 2023
Pregnancy is still possible in perimenopause. NHS (UK) guidance is contraception for 2 years after the final period at ages 40 to 49, and for 1 year from 50. 2 / 1 years after final period
NHS, Menopause symptoms · 2023
Protein of 1.2–1.6 g/kg every day, spread over 3–4 meals of 25–40 g, to protect muscle. 1.2–1.6 g/kg/day
Bauer et al. (PROT-AGE) and ISSN position stands on protein and creatine · 2013
Lift heavy 2–4 times a week, using compound lifts with progressive load, for muscle and bone. 2–4 sessions/week
Watson et al., Journal of Bone and Mineral Research: LIFTMOR trial of heavy and impact training for bone · 2018
Short HIIT 1–2 times a week is particularly effective against visceral (belly) fat. 1–2 sessions/week
Maillard et al., Sports Medicine: HIIT and abdominal and visceral fat (meta-analysis) · 2018
Adults are advised 150 minutes of moderate aerobic activity a week (or 75 minutes vigorous) plus muscle strengthening on at least 2 days. 150 / 75 min per week; 2 days
CDC, Adult Activity: An Overview (Physical Activity Guidelines) · 2023

Common questions

What age does perimenopause start?

There is no single age. Most women reach menopause between about 45 and 55, in WHO and NHS (UK) figures alike, and perimenopause is the run-up to that. Some reach menopause before 40; if your periods change that early, it is worth raising with your OB-GYN (GP in the UK) rather than waiting it out.

How long does perimenopause last?

The NHS (UK) says symptoms usually last 7 to 9 years, sometimes longer. It is not the same for everyone: the NHS also notes that women of Black ethnic background are more likely to have severe hot flashes (hot flushes in the UK) that last longer. If symptoms are wearing you down, your OB-GYN (GP in the UK) is the person to ask about options.

Can I still get pregnant in perimenopause?

Yes, you can. The NHS (UK) advice is to keep using contraception for 2 years after your last period if you are 40 to 49, and for 1 year if you are 50 or over. Which method suits this stage is a conversation for your OB-GYN (GP in the UK), and it is worth having early rather than late.

How much protein is a sensible target in perimenopause?

A sensible target is 1.2 to 1.6 grams of protein per kilogram of body weight a day. To find your own range, take your weight in kilograms (convert from pounds if you need to) and multiply it by 1.2 and then by 1.6. That total fits neatly into 3 to 4 meals of 25 to 40 g. A registered dietitian, or your doctor, can tailor the number if you have a health condition.

How often should I lift and do HIIT?

The evidence supports lifting heavy 2 to 4 times a week and short HIIT 1 to 2 times a week. That sits on top of the CDC guideline for all adults, not against it: muscle strengthening on at least 2 days a week plus 150 minutes of moderate or 75 minutes of vigorous aerobic activity. Two heavy sessions already meet the strength line, so many women begin there and build up through trial and error.

Next steps

A lovely first step is to pick one row from the facts box that fits your week, perhaps the protein one or the lifting one, and give it a few weeks of trial and error. It is also worth booking a conversation with your doctor if bleeding is so heavy you feel faint, dizzy or constantly tired, or if you have any bleeding 12 months or more after your last period. Take what is useful and leave the rest, because this is not one size fits all and you get to decide what fits you.

Sources

The guidelines and studies this page draws on.

  1. Menopause fact sheet, WHO (2024)
  2. Menopause overview, NHS (2023)
  3. Menopause symptoms, NHS (2023)
  4. Adult Activity: An Overview (Physical Activity Guidelines), CDC (2023)
  5. Watson et al., 2018: LIFTMOR trial of heavy and impact training for bone, Journal of Bone and Mineral Research (2018)
  6. Maillard et al., 2018: HIIT and abdominal and visceral fat (meta-analysis), Sports Medicine (2018)
  7. Bauer et al., 2013 (PROT-AGE) and ISSN position stands on protein and creatine, Bauer et al.; ISSN (2013)