What should you know about first symptoms of perimenopause?

Perimenopause is the transition before menopause. Hormone levels fluctuate, so ovulation and periods may become less predictable. Some cycles may be closer together, further apart, lighter, or heavier. Hot flushes, night sweats, poor sleep, irritability, low mood, reduced sexual desire, and difficulty concentrating may also appear.

These changes are not specific to perimenopause. Pregnancy, thyroid conditions, fibroids, medicines, stress, and other health problems can affect bleeding or mood. A clinician can interpret the pattern rather than relying on one symptom.

Record each period, its flow, missed cycles, flushes, night sweats, sleep, mood, and possible triggers. Keep the record long enough to show a pattern, and bring it to an appointment. Cool layers, regular movement, steady sleep habits, and stress support may reduce disruption. If symptoms affect work, intimacy, or daily tasks, discuss treatment choices and contraception.

Do not assume a missed period is perimenopause if pregnancy is possible. A pregnancy test and clinical advice may be appropriate.

Arrange assessment for very heavy bleeding, bleeding after sex, bleeding between periods, persistent pelvic pain, or a change that is interfering with life. Seek urgent help for severe pain, fainting, or bleeding that makes you feel weak or unwell. Sudden symptoms or changes that begin earlier than expected should also be reviewed.

Does my bleeding pattern fit perimenopause? Could pregnancy or another condition explain it? Do I need an examination or tests? Which options can help flushes, sleep, mood, or heavy bleeding? What contraception is appropriate?