What to know about perimenopause

Ovarian hormone patterns become less predictable, so the menstrual cycle may shorten, lengthen or occasionally be missed. Bleeding can become heavier or lighter. Temperature regulation, sleep, concentration, vaginal comfort, mood and sexual desire may also change. Symptoms can appear in different combinations and may come and go, so a symptom diary is often more useful than a single day’s snapshot.

Perimenopause can overlap with thyroid problems, anaemia, pregnancy or medication effects. A clinician may use your age, cycle pattern and symptoms to decide whether examination or tests are needed.

Record bleeding, sleep, flushes, mood, headaches and medicines for several weeks. Regular meals, movement, a cool bedroom and reducing personal triggers may help some symptoms. Discuss contraception if pregnancy is possible, because ovulation can still occur during perimenopause. Treatment options may include hormone therapy or non-hormonal approaches, chosen around your health history and priorities.

You can read about [Perimenopause](/conditions/perimenopause/) and explore symptom guides for [Hot Flushes](/symptoms/hot-flushes/), [Irregular Periods](/symptoms/irregular-periods/) and [Night Sweats](/symptoms/night-sweats/).

Arrange medical advice for bleeding that is very heavy, lasts unusually long, happens after sex, or returns after a long gap without periods. Seek urgent help for fainting, severe pelvic pain, breathlessness or soaking bleeding with weakness. Persistent low mood, panic, inability to sleep or loss of interest in daily life deserves timely support, not dismissal as a normal transition.

Could another condition explain my symptoms? Do I need an examination or blood tests? Which contraception and symptom treatments fit my history? How should I track bleeding, and what change would need urgent review?