Premature perimenopause: what to know

During perimenopause, ovarian hormone levels fluctuate. Periods may arrive closer together, become widely spaced, or vary in flow; symptoms may include hot flushes, night sweats, mood changes, sleep difficulty and reduced sexual desire. [Irregular Periods](/symptoms/irregular-periods/) and [Missed Period](/symptoms/missed-period/) can have many explanations, including pregnancy, thyroid conditions, stress and medication effects.

A clinician considers your age, cycle pattern, symptoms, health history and pregnancy possibility. The transition can affect fertility before periods stop completely.

Track bleeding, cycle dates, flushes, sleep and mood for your appointment. Mention headaches, migraines, blood clots, liver disease, smoking and medicines because these details influence treatment choices. Discuss contraception if pregnancy is not wanted, and ask about options for heavy bleeding, sleep problems, vaginal symptoms and bone health.

Lifestyle measures such as regular activity, adequate dietary calcium, sleep routines and reducing personal triggers may ease some symptoms. Treatment should be chosen with a clinician.

Arrange medical review for new cycle changes at an unexpectedly young age, persistent [Heavy Periods](/symptoms/heavy-periods/), bleeding between periods or bleeding after sex. Seek urgent help for soaking bleeding with dizziness, severe pelvic pain, fainting, chest pain or severe breathlessness.

Ask which causes need excluding, whether tests are appropriate, how fertility and contraception are affected, and which hormonal or non-hormonal treatments suit your symptoms and health history.