Perimenopause is a time of significant change in your whole body and genitourinary system. It’s a unique opportunity to enhance your sense of health and well-being now and for the rest of your life. If you’re experiencing bothersome symptoms and not sure where to start, our Menopause Toolkit is designed to give you practical solutions that you can start today or discuss later with your doctor.
What are the first signs of perimenopause?
Perimenopause is the transition leading to menopause when your ovaries stop producing estrogen and you have not had a period for one year. Perimenopause typically starts in your 40s, even though menopause occurs on average at age 51.
Women experience perimenopause in different ways and at different ages, so the first signs of perimenopause can vary. Symptoms can last 4 to 8 years or more. There is no definitive test for perimenopause, but you can recognize the signs of perimenopause based on your symptoms.
Irregular periods
During perimenopause, you might notice irregular periods. However, you can have regular periods and still be in perimenopause. Symptoms and signs can include:
- Shorter cycles
- Longer cycles
- Lighter bleeding
- Heavier bleeding
Any vaginal bleeding outside of your menstrual cycle could indicate a serious condition and should be evaluated by a medical doctor.
Vasomotor symptoms
Vasomotor symptoms are temperature dysfunctions that stem from loss of estrogen. Vasomotor symptoms are a strong sign of perimenopause because they are not usually related to other conditions. Symptoms can include:
- Hot flashes
- Night sweats
Hot flashes and night sweats can lead to sleep disturbances, mood changes, and fatigue. Vasomotor symptoms tend to go away as you transition through menopause and beyond.
Genitourinary symptoms
During perimenopause you might notice genitourinary symptoms. These symptoms stem from a loss of estrogen in the vagina, urethra, bladder and vulva. Symptoms can include:
- Vaginal dryness, itching, burning, or pain
- Inadequate vaginal lubrication
Vaginal dryness can lead to loss of libido and pain with sex which can be very distressing, especially for younger women. Other commonly reported genitourinary symptoms include unusual discharge, unusual vaginal odor, urgency to pee, and pain with peeing. Genitourinary symptoms tend to get worse with time and without treatment.
How do I test for perimenopause?
There is no simple hormone test for perimenopause. A medical doctor can diagnose it on the basis of your symptoms and menstrual cycle.
There are tests out there that can help measure estrogen levels. But hormone testing is unhelpful in diagnosing perimenopause. During perimenopause, estrogen levels fluctuate dramatically. Because of these fluctuations, blood or urine tests for perimenopause are not recommended by any professional medical organization.
Hormone testing
There are some cases when hormone testing can be helpful.
If you have had a hysterectomy or use hormonal contraception, it can be harder to tell if you are in perimenopause or menopause since there’s no menstrual pattern to refer to. In these cases, an FSH test can confirm menopause. If the FSH level is over 50, it can indicate you are post-menopausal.
If you are under the age of 45 and not having periods, then you might consider hormone testing. You could simply be in menopause a little earlier than the average age of 51. But no periods at 45 could also indicate a serious health concern that should be evaluated by a medical provider.
How to use this perimenopause quiz
This quiz is designed to help you identify the symptoms and menstrual patterns that might indicate perimenopause. Recognizing the signs of perimenopause can create a unique opportunity to enhance your sense of well-being, initiate a discussion with a healthcare provider, or seek treatment for bothersome symptoms.
This quiz is a preliminary tool and should not replace professional medical advice. Always consult with a healthcare provider for a definitive diagnosis and personalized treatment plan.
Need help right away? At Interlude, we offer an easy and convenient online consult for common perimenopause concerns.