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

Dr. Mehmet Oz, MD
Cardiology (Cardiovascular Disease)
You may or may not know if you are in the menopausal transition period because, for most women, hormones decline slowly. In fact, estrogen usually begins its decent when a woman is in her late 30s. Of course not everyone will notice the difference or experience symptoms. A woman who is transitioning into menopause is considered perimenopausal. That's the time span right before menopause and it can last many years, but on average four years. Women might suspect they are transitioning because their periods may become irregular, heavier or lighter or the monthly menstrual flow may stop abruptly. You may also experience hot flashes, night sweats, or notice more vaginal dryness with sexual intercourse becoming more painful. Things also vary within the perimenopausal period. You can have fluctuations in the levels of estrogen (and progesterone) from day to day and even from hour to hour.
You may know you are in menopausal transition, also known as perimenopause, when you experience symptoms such as hot flashes, fatigue, worsening premenstrual syndrome, vaginal dryness, irregular periods, mood swings, breast tenderness, or difficulty sleeping. Menopausal transition lasts four years on average, and ends when you have not had your period for 12 months.

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.

Our Bodies, Ourselves: Menopause

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Our Bodies, Ourselves: Menopause

FROM THE EDITORS OF THE CLASSIC "BIBLE OF WOMEN'S HEALTH," A TRUSTWORTHY, UP-TO-DATE GUIDE TO HELP EVERY WOMAN NAVIGATE THE MENOPAUSE TRANSITION For decades, millions of women have relied on Our...

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Important: This content reflects information from various individuals and organizations and may offer alternative or opposing points of view. It should not be used for medical advice, diagnosis or treatment. As always, you should consult with your healthcare provider about your specific health needs.