Perimenopause is the transition leading up to menopause. Periods may become less predictable and symptoms such as hot flushes or sleep disruption can begin. This transition varies widely: some people notice little change, while others find symptoms affect work, relationships and daily wellbeing.
What changes are common?
Cycles may become shorter or longer, and bleeding can be lighter or heavier. Hot flushes, night sweats, mood changes, vaginal dryness and joint or muscle symptoms may occur. These symptoms have other possible causes too; no one symptom proves menopause.
For otherwise healthy people aged 45 or over, NICE advises that typical perimenopause can often be identified from symptoms and cycle changes without routine hormone blood tests. In younger people or when the picture is unclear, the assessment may differ. Hormonal contraception can also make cycles harder to interpret.
Which bleeding changes need review?
Perimenopause is not a reason to ignore heavy bleeding, spotting between periods or bleeding after sex. These changes may need an examination or further tests. Once periods have stopped for 12 months, any new bleeding should be assessed, even a small amount.
Keep a short record of period dates, bleeding amount, sleep, hot flushes and medicines. Bring it to a consultation with Dr. Rina. The plan can include symptom support, checking for other health concerns and gynaecology referral if needed.