Understanding perimenopause Perimenopause can begin years before menopause starts, and women often mistake the symptoms for stress or other health issues. Dr. Rachel Reed, an OB-GYN with Columbus Regional Health, discussed the transition during a Health Spotlight segment Thursday at the WISH-T V studio. Reed said perimenopause often happens in a woman’s mid-to-late 40s, but it can begin for some as early as their late 30s. She said the transition can last for several years. Reed said early signs include changes in the menstrual cycle, hot flashes, and night sweats. Other symptoms include sleep disturbances, mood swings, and changes to physical or sexual health. ...read more read less