How do I know I’ve entered perimenopause?

Changes to periods in your mid-forties often feel alarming because perimenopause happens in fits and starts. Menopause itself is a single moment — 12 months after a person’s last period — and is diagnosed only in retrospect, once the ovaries have stopped making the estrogen that drives the cycle.

Knowing you’ve entered perimenopause can matter because a formal diagnosis makes it easier to get treatment if symptoms are affecting work or relationships. Perimenopause typically begins around age 47 and usually starts with a changing menstrual pattern. Early on, periods become less regular — often early or late by at least a week — and people commonly skip cycles; flow may be lighter or heavier and about 40% experience hot flashes.

Later in the transition, periods can be as much as two months apart, hot flashes affect roughly 80%, and new problems such as depression, sleep disturbances and genital or bladder symptoms may appear. The underlying cause is falling estrogen levels.

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