The main perimenopause symptoms to track are your periods (dates, flow and gaps), hot flashes and night sweats, sleep, mood, memory and focus, and vaginal or bladder changes. For each one, note when it started, how often it happens and how much it bothers you. Bring that record, your medicines and your questions to your appointment.
This is general information, not medical advice. Talk to your doctor or pharmacist about your own situation.
Perimenopause is the time before menopause when your body is getting ready to stop having periods. Mayo Clinic says periods often become irregular in your 40s, though changes can start in your 30s or 50s. You reach menopause once you have gone 12 months in a row without a period.
There is no single test for perimenopause. Mayo Clinic explains that hormone tests are not usually helpful, apart from thyroid testing, because hormone levels change unpredictably. Instead, your clinician looks at your age, your period history and your symptoms. A clear record gives them a lot more to work with than "I've felt off for a while." The NHS also notes that symptoms usually last 7 to 9 years, sometimes longer, and can change along the way, so notes help you spot patterns over time.
Periods. Write down the first and last day of bleeding and whether flow was light, moderate or heavy. The Menopause Society says cycles may get shorter at first, then later vary by 7 days or more, with skipped periods.
Hot flashes and night sweats. These are the most commonly reported symptoms. Note how often they happen, how strong they feel and how long they last.
Sleep. Trouble sleeping is often linked to night sweats, but it can happen without them. Note how often you wake and why, if you know.
Mood. Irritability, mood swings, low mood and anxiety are all common. Mention any past depression, since it can raise the risk of mood changes now.
Memory and focus. Many people describe brain fog: forgetfulness or finding it hard to concentrate.
Vaginal and bladder changes. Dryness, pain during sex, burning when you pee, needing to pee more often or more urgently, or leaking.
Other changes. The NHS lists headaches and migraines, heart palpitations, joint and muscle aches, changes in sex drive, weight gain around the middle, thinning hair and dry, itchy skin.
Pick your top few. Track your periods plus the two or three symptoms that bother you most. You can add more later.
Keep each note short. Date, symptom, how strong (mild, moderate or severe) and how much it got in the way of your day.
Note the context. Where you are in your cycle, plus any big stresses or life changes. Mayo Clinic suggests including symptoms that seem unrelated, too.
Log changes with dates. If you start, stop or change a medicine, supplement or treatment, write down the date so you can see what happened before and after.
Review before your visit. Turn a few months of notes into a one-page summary.
A quick example entry: "Tue 14 Oct. Woke twice with night sweats, moderate. Foggy at work, lost words in a meeting. Day 19 of cycle." The Menopause Society suggests tracking bleeding on a calendar or a phone app so changes can be reviewed later. Paper works just as well if that is what you will actually keep up with.
Mayo Clinic suggests preparing these before your visit, since appointments can be short:
A record of your periods for the past few months
Your symptoms, including when they started and whether they follow your cycle
Major stresses or recent life changes
Every medicine, herb, vitamin and supplement you take, with the amounts
A written list of questions
It can also help to bring a family member or friend who can remember details you miss. Questions you might ask:
What is likely causing my symptoms, and what else could be causing them?
Do I need any tests?
What are my options, and what are the next steps?
Should I see a specialist?
How will I know if I need to come back?
Expect your clinician to ask whether you still have periods and what they are like, which symptoms you have, how long you have had them and how much they bother you. Your notes let you answer with dates instead of guesses. If you would like a clinician with extra menopause training, The Menopause Society has a searchable directory of certified menopause practitioners.
See your doctor if any perimenopause symptoms bother you. Mayo Clinic says to seek care for very heavy bleeding, bleeding that lasts more than seven days, bleeding between periods, or periods that usually come less than 21 days apart. If you go 12 months without a period and then have any bleeding, talk to a doctor right away. The NHS notes that bleeding after menopause is not usually serious but can be a sign of cancer. The NHS also advises seeing a GP about palpitations, and if you are on HRT and still have irregular or heavier bleeding after 6 months. If low mood or anxiety is getting in the way of daily life, raise it with your doctor rather than waiting.
Changes to your periods are a key sign. Early on, cycles may get shorter. Later they can vary more and periods may be skipped, and flow may get lighter or heavier. Hot flashes, sleep problems and mood changes can come along too.
Usually not. Hormone levels change unpredictably, so Mayo Clinic says hormone testing is not usually helpful, apart from thyroid tests. Diagnosis is based on your age, period history and symptoms.
It varies. The NHS says menopause symptoms usually last 7 to 9 years, sometimes longer. Perimenopause ends once you have gone 12 months in a row without a period.
Yes, if you are still having periods, even irregular ones. Mayo Clinic advises using birth control until you have gone 12 months without a period if you do not want to get pregnant.
My Midlife Story: Menopause is an iPhone symptom journal made for this kind of record. You can log symptoms such as hot flashes, night sweats, sleep and brain fog with one tap, each saved with the date and time, mark "Something changed" when a symptom or treatment shifts, and turn chosen notes and questions into a one-page visit brief you can edit, print or save as a PDF.
It does not diagnose or recommend treatments. There is no account, your records stay on your device, and it is free with an optional Premium upgrade.
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