No period for 4 months: am I in menopause?

Menopause is reached after twelve months without menstrual bleeding when no other explanation accounts for the change. Before that point, periods may become less predictable, lighter, heavier, or widely spaced. Pregnancy remains possible during the transition if ovulation has not fully stopped. Changes in thyroid function, prolactin, body weight, intense exercise, stress, some medicines, and conditions affecting the ovaries can also interrupt periods. Symptoms such as hot flushes, night sweats, vaginal dryness, sleep disruption, or mood changes may support a menopause transition, but symptoms alone cannot establish the cause.

If pregnancy is possible, take a home pregnancy test according to its instructions; a clinician can advise when to repeat it if the result is negative and bleeding still does not return. Record the date of your last period, any bleeding changes, medicines, symptoms, and recent weight or exercise changes. Arrange a medical appointment to review the pattern. Depending on your age, history, and examination, assessment may include a pregnancy test, blood tests, or evaluation for another hormonal or pelvic cause. Use contraception if you do not want pregnancy, because ovulation can occur before the final period.

Seek urgent care for severe lower-abdominal pain, fainting, marked dizziness, shoulder-tip pain, or heavy bleeding, especially if pregnancy is possible. Contact a clinician soon for new milky nipple discharge, severe headaches or vision changes, troublesome hot flushes, or persistent absent periods. Any bleeding after twelve months without periods should be assessed.

Could pregnancy, thyroid changes, medicines, or another condition explain my missed periods? Which tests fit my age and medical history? Should I continue contraception? What symptoms would mean I should contact you sooner?