I'm not sure when perimenapause started for me, but I do know I had night sweats and maybe an occasional hot flash. I'm on the other side of menopause now and still freeze my boyfriend out at night with the A/C. . He can put on more covers; I can't remove more clothes! Anyway, it's all been pretty much a breeze for me EXCEPT I just realized my migraines started early to mid 50's with menopause, and I've put on 3 or 4 pounds the last 3 years. I still love sex, too, if that helps you