How do you know if you're in perimenopause?
Seeking a diagnosis for your symptoms makes sense — you want to better understand what’s happening inside your body. But getting a yes or a no can be complicated.
Even though the average age of menopause is 52, when you get to your 40s, there’s a buzz in the air about the process that can feel reminiscent of a whispered question in middle school: “Do you have it yet?” Because just like there was a time range for when different girls’ periods started, so too will there be a wide range for when our periods end.
You also may be experiencing new symptoms, and typically, when that happens, you’d go to the doctor and get testing to find out a definitive diagnosis. Most women have grown accustomed to peeing on a strip to see if you’re pregnant, getting swabbed for a sore throat to see if you have strep or Covid, or getting blood drawn to check if you’re anaemic.
We’re used to years of tests to provide conclusive results. So it only makes sense that we’d want to know what’s going on in our bodies during the menopause process. If you’re still getting regular periods but are having hot flushes and mood swings, are you in perimenopause? If you’re still getting periods at 50, why aren’t you caught up with your friends? A definitive answer would be nice.
Why there isn’t a simple test
Hormones are tricky, and the frustrating truth is that there isn’t really a “test” to diagnose you as perimenopausal. Blood tests can be unreliable since there are such major variations in hormones from day to day. “We could do the same test two days in a row and get completely different results,” says Dr. Stephanie Faubion, M.D., the director for the Centre for Women's Health at the Mayo Clinic, medical director for The Menopause Society, and member of the WeightWatchers Scientific Advisory Board.
As a result, your age, periods, and symptoms are the best indicator of where you are in the transition.
Learn more about the three phases of the menopause transition process
When to see your healthcare provider
You should talk with your doctor or healthcare provider if you’re experiencing any bothersome symptoms, including:
Anxiety and depression
Hair loss
Hot flushes
Irregular and/or heavy periods
Low libido, vaginal dryness, pain with sex
Mood swings
Trouble sleeping
Weight gain
Due to the variety of symptoms associated with perimenopause and the whole the menopause transition, and the fact that they can often mimic other health conditions (such as thyroid disease), it’s a good idea to seek care when you experience any of them, even if you think you’re too young for perimenopause. Your doctor will be able to recommend lifestyle changes or medications that can help you feel better.
“We can treat your symptoms no matter where you are in the transition. If you're in your 40s and having the occasional hot flush, we don't need a blood test to tell you’re in perimenopause,” says Faubion. The exception is if you’re not in the average age range — for example, if you’re experiencing hot flushes and missing your period in your early 30s, that would merit a closer examination from your docs.
Faubion says that most of the time, if you’re in the right age range and your symptoms aren’t coming from a different underlying cause, then she’ll proceed with treatment. So you don’t actually need a "diagnosis" of being in perimenopause, because that doesn’t dictate whether you’d receive treatment — your age and symptoms do.
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