PerimenopauseMenopause transition

Perimenopause is the transition leading up to menopause, when oestrogen fluctuates unpredictably and cycles become irregular. Menopause itself is identified once someone has gone twelve months without a period and is not using hormonal contraception.

It matters because the fluctuating phase — not the endpoint — is when most symptoms appear: hot flushes and night sweats, sleep disruption, mood and concentration changes, and shifts in training recovery and body composition. UK guidance identifies it clinically in people aged 45 and over from symptoms and cycle changes, explicitly without blood tests, since fluctuating hormones make single results unreliable.

In practice, blood tests are reserved for younger people in whom menopause is suspected; if symptoms are disrupting life, that is a reason to see a clinician rather than to buy a home hormone panel.

Sources

• NICE guideline NG23: Menopause — identification and management (clinical identification without laboratory tests aged 45+; menopause after 12 months without periods)