What should you know about start of perimenopause?

During perimenopause, ovarian hormone production becomes less predictable. Periods may arrive earlier or later, last differently or occasionally be missed. Hot flushes and night sweats can disturb sleep; mood changes, reduced sexual desire and vaginal symptoms may also occur. Symptoms vary widely and can overlap with thyroid problems, pregnancy, stress or medication effects, so a new change should not automatically be attributed to perimenopause.

Track bleeding, sleep, temperature symptoms, mood and medicines in a simple diary. Regular meals, movement, a cool sleeping environment and a consistent bedtime may reduce disruption. Book a medical review if symptoms interfere with work, relationships or rest, or if bleeding changes are difficult to manage. Discuss contraception if pregnancy remains possible, because ovulation can continue during the transition.

Seek prompt advice for very heavy bleeding, bleeding after sex, bleeding after twelve months without a period, or symptoms causing marked weakness or breathlessness. Urgent care is appropriate for severe pain, fainting or bleeding that feels uncontrollable. A clinician can assess other causes and discuss options for symptom relief.

Ask which symptoms fit the menopause transition, whether another condition should be checked, and which treatments suit your health history. Ask how to manage heavy or irregular bleeding and how long contraception should continue.