Perimenopause quiz: am I in perimenopause?
Perimenopause usually starts in your mid-40s, sometimes earlier, and is recognized mainly by changing periods: cycles that shift by seven days or more, skipped periods, or heavier or lighter bleeding. Hot flushes, night sweats, poor sleep and new mood changes often join in. Doctors usually go by your age and symptoms, not a blood test. Use the checklist below to see your picture.
The perimenopause self-check
Go through the list and count how many have been true for you over the past 6 to 12 months, and were new or clearly different from before. Be honest; nobody else sees this.
Your cycle
- My cycle length now changes by 7 days or more from one cycle to the next.
- I've skipped a period, or had a gap of 60 days or more.
- My periods are noticeably heavier, longer, lighter or shorter than they used to be.
- My PMS feels stronger or lasts longer than it did a few years ago.
Your body
- I get hot flushes: sudden waves of heat in my face, neck or chest.
- I wake up sweating at night.
- I sleep worse, or wake at 3 or 4 am and can't get back to sleep.
- I've noticed vaginal dryness, discomfort during sex or more urinary urgency.
- I have new joint aches, headaches or heart palpitations.
- My sex drive has changed noticeably.
Your mood and mind
- I feel more anxious, irritable or teary than I used to, sometimes out of nowhere.
- My mood swings feel bigger or less predictable.
- I have brain fog: losing words, forgetting why I walked into a room (see period brain fog).
- I feel low or flat more often, or less like myself.
- My confidence has dipped without a clear reason.
What your answers might mean
| What you ticked | What it might suggest |
|---|---|
| None or one or two, cycle unchanged | Probably not perimenopause yet, or very early. Keep an eye on your cycle. |
| Item 1 (cycles varying by 7+ days), plus a few others | Possibly early perimenopause, especially in your 40s. |
| Item 2 (60+ day gaps), plus body symptoms like flushes | Possibly late perimenopause. |
| Several mood items, cycle unchanged | Could be perimenopause, PMS getting stronger, or something else entirely, like stress, thyroid or depression. Worth a doctor's view. |
Those cycle markers come from the STRAW+10 staging system researchers use: a persistent difference of 7 days or more between consecutive cycles marks the early menopausal transition, and 60 days or more without a period marks the late stage. Menopause itself is confirmed after 12 months with no period.
Many of these symptoms have other causes. Only a doctor can tell you what's going on, and they'll want to rule out things like thyroid problems, anemia, pregnancy and depression.
How doctors work out perimenopause
In the UK, NICE guidance says that for people over 45 with symptoms, perimenopause is usually diagnosed on symptoms and cycle changes alone, without blood tests, because hormone levels swing so much from day to day in this stage. Blood tests are more likely if you're under 45. The average age of menopause is 51, and perimenopause typically lasts about four years, though it can be much longer.
- Bring a record: period dates, flow, sleep, flushes and mood across two or three months.
- Say what bothers you most. Treatment is chosen by symptoms, and there are good options, including HRT.
- Ask about contraception. You can still get pregnant in perimenopause.
Lulu has a perimenopause mode for cycles that are starting to change. Log your periods, symptoms and a one-tap daily mood, and you'll build the months-long record a doctor finds most useful.
When to see a doctor
See a doctor if symptoms affect your daily life, if you're under 45 with these changes, if you bleed between periods or after sex, if periods become very heavy (soaking a pad or tampon every 1 to 2 hours), or if you bleed at all after 12 months without a period. If your mood is affecting your life, talk to a doctor; if you feel unsafe, call your local emergency number or 988 in the US.
Frequently asked questions
What are usually the first signs of perimenopause?
Changes in your cycle are often first, with periods coming closer together or further apart. Sleep problems and mood changes can start around the same time. See first signs of perimenopause.
Can a blood test tell if I'm in perimenopause?
Not reliably over 45, because hormone levels swing day to day. Doctors usually go by symptoms and cycle changes.
What age does perimenopause start?
Most often in the mid-40s, but it can begin in the late 30s. More in what age perimenopause starts.
Can I get pregnant during perimenopause?
Yes. You may still ovulate some months, so use contraception until a doctor says you no longer need it.
Sources
- NICE: Menopause: identification and management (NG23)
- Harlow SD et al. Executive summary of the Stages of Reproductive Aging Workshop + 10. Fertil Steril (2012)
- Cleveland Clinic: Perimenopause
- NHS: Menopause symptoms
This page is for information only and isn鈥檛 medical advice. If something worries you, please talk to a doctor.
Keep reading
Perimenopause: what it is, when it starts and how it feelsPerimenopause explained kindly: what's happening to your hormones, when it usually starts, how long it lasts, how it can feel, and what really helps.
Perimenopause symptoms: the full list, and what helps each onePerimenopause symptoms explained: cycle changes, hot flushes, sleep, mood, brain fog and body changes, with what helps each one and when to see a doctor.
How to track perimenopause: what to log and why it helpsHow to use a perimenopause tracker: the few things worth logging every day, how long to track, how to spot patterns, and how to bring it all to your doctor.
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