How do I know when I am in the menopausal transition?

The most reliable way to estimate where you are in the menopause transition is to keep track of your periods on a menstrual calendar for a few months. Each day, you can mark on the calendar whether you have had bleeding (B) or spotting (S). You can identify when you are in the early menopausal transition stage when the length of your menstrual cycles differs by a week or more from one cycle to the next, but you have not yet started skipping periods. Of course, some women have irregular cycles all their lives. They will not find using a menstrual calendar helpful for identifying where they are in the menopausal transition. Keeping track of your cycles may be useful for other reasons, such as pregnancy planning, fertility treatment, or tracking very heavy periods before you consult your health care provider for help.

After a few months of tracking your period on a menstrual calendar, follow these steps:

• Examining the calendar for your last few menstrual cycles, count the length of your cycle by beginning with the first day marked B for bleeding. Then, count all the days with a B marked, plus the days that have either an S (spotting) or a blank until the start of the next bleeding days (marked B). Repeat this for at least two cycles.

• Subtract the number of days for the second cycle from the number of days for the first cycle. (It doesn't matter if you get a positive or negative number).

• If the difference in the number of days between cycle one and cycle two is seven or more, you may be in the early stage of the menopausal transition. (Note: This will not work well if you have had irregular cycles for most of your life.)

• If there are sixty days or more between the start of menstrual bleeding in one cycle and in the next, or if the days are about double your usual cycle length, you may be in the late menopausal transition stage. When you reach this stage, chances are that you are within two years of your last menstrual period. This is more likely to be the case if you have had a pattern that looks like the early menopausal transition earlier.