The journey through menopause is a natural stage of life, not an illness that needs fixing. However, understanding the early signs of perimenopause and knowing when to consult a healthcare provider can help you navigate this transition with confidence. In this guide, we’ll explore how to identify these changes, discuss how diagnosing perimenopause is assessed, and clarify when it’s time to take action.

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Early signs of perimenopause

Perimenopause, meaning "around menopause," is the transition period leading up to menopause. It can begin in the forties or even mid-thirties and typically lasts around four years, though the range varies from two to ten years. During this phase, hormonal fluctuations cause noticeable changes, including:

• Irregular periods (cycles becoming shorter or longer, or changes in flow)
• Hot flashes or sudden sensations of warmth
• Sleep disturbances or insomnia
• Mood swings, increased irritability, or anxiety
• Vaginal dryness and changes in libido
• Brain fog and difficulty concentrating

These symptoms vary widely among women, both in type and severity. Because hormone levels fluctuate significantly during perimenopause, a one-time perimenopause blood test is not a reliable diagnostic tool. However, tracking symptoms over time, along with hormone testing and discussing changes with a healthcare provider, can provide valuable insights.

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Signs of early menopause at 35

While menopause typically occurs between ages 45-55, some women experience early menopause before age 40 due to factors like genetics, autoimmune conditions, or medical treatments (e.g., chemotherapy). Signs of early menopause at 35 include:

• Absence of periods for three consecutive months (not due to pregnancy)
• Vaginal dryness or discomfort during intercourse
• Sudden and intense hot flashes
• Emotional changes, such as anxiety or depression

If you suspect early menopause, consult a healthcare provider for a comprehensive evaluation, which may include a detailed medical history and, in some cases, a perimenopause blood test to rule out other causes of symptoms.

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Diagnosing perimenopause

There is no single test to confirm diagnosing perimenopause. Instead, healthcare providers evaluate symptoms in the broader context of menstrual cycle changes, medical history, lifestyle, and age. A discussion with a qualified healthcare provider can help determine the best path forward.

While perimenopause blood test (such as FSH, estrogen, and thyroid hormones) can provide some insights, they are not definitive due to the natural fluctuations of hormone levels during this transition. The focus should be on symptom management and overall well-being rather than specific hormone levels. Additionally, underlying health conditions that mimic perimenopausal symptoms, such as thyroid disorders, should be ruled out.

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When does perimenopause start?

A common question is, when does perimenopause start? Perimenopause usually begins in the early to mid-forties but can start as early as the mid-thirties. Factors like genetics, smoking, stress, and overall health can influence its onset. It progresses in two phases:

1. Early perimenopause: Menstrual cycles become increasingly irregular, varying by more than seven days. Symptoms may include mood changes, sleep disturbances, and vaginal dryness. This phase can last several years.

2. Late perimenopause: Menstrual cycles become even more sporadic, with periods occurring more than two months apart. Symptoms may intensify, including more frequent and severe hot flashes, night sweats, and vaginal dryness. This phase typically lasts 1-3 years before menopause officially begins (defined as 12 consecutive months without a period).

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When to take action

Consult a healthcare provider if you experience:

• Heavy or prolonged menstrual bleeding
• Missed periods for three months (if not pregnant)
• Severe mood swings, anxiety, or depression
• Symptoms that significantly disrupt your daily life (e.g., frequent hot flashes or insomnia)
• Signs of early menopause at 35 or younger

While perimenopause is a natural process, support from a healthcare provider can help manage symptoms effectively. Treatment options may include lifestyle modifications, hormone therapy, non-hormonal medications, or alternative therapies tailored to your needs.

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Empowering your menopause journey

Perimenopause is a unique experience for every woman. Recognizing the early signs of perimenopause and seeking guidance can help you manage this transition more comfortably. If you're experiencing symptoms and need support, partnering with a healthcare provider can provide clarity and relief.

Want to connect with a menopause expert? Get started with Evernow today to access specialized menopause care tailored to your journey.

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