Stages of Perimenopause

Early perimenopause may bring subtle changes in cycle length or flow while periods remain fairly predictable. As the transition advances, ovulation becomes less regular and missed periods, heavier bleeding or closer-together periods may occur. Hot flushes, night sweats, mood changes, sleep disruption and lower sexual desire can appear at any point. The transition ends with menopause, defined after twelve consecutive months without a period for another reason. The pattern differs between people, and symptoms do not reliably show which stage you are in.

Keep a record of bleeding, missed periods, temperature episodes, sleep and mood. Use layers, cooling measures and a consistent bedtime routine if heat or night sweats disturb you. For heavy bleeding, note how often you need to change protection and whether it limits normal activities. Discuss contraception if pregnancy is possible, because ovulation can continue during perimenopause. A clinician can explain treatment options and check for anaemia or other causes when symptoms are troublesome.

Arrange medical advice for bleeding after menopause, very heavy bleeding, bleeding between periods, persistent pelvic pain or symptoms that affect daily life. Seek urgent care for fainting, severe weakness, severe pain or bleeding that makes you feel unwell. A missed period is not automatically perimenopause; pregnancy and other medical causes may need checking.

Do my cycle changes fit perimenopause? Should heavy or irregular bleeding be investigated? Do I still need contraception? What can help hot flushes, night sweats or mood changes? Could another condition explain my symptoms?