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Menopause · 5 min

Perimenopause: early notes

Cycles can get closer, farther apart, heavier, or lighter long before the last period.

What perimenopause is

Perimenopause is the transition toward menopause (12 months without a period). It can begin in the 40s, sometimes earlier. Hormone levels wobble; sleep, mood, hot flashes, and cycle length may change.

Tracking still helps

A record of cycle length, flow, hot flashes, and sleep is a useful document for a clinician. Unexpected heavy bleeding still needs evaluation — “you’re just perimenopausal” should never skip a workup when bleeding is extreme or one-sided pain appears.

Sources

  1. Mayo Clinic Staff. Perimenopause — Symptoms and causes. Mayo Clinic, 2026.
  2. Office on Women's Health (U.S. Department of Health and Human Services). Your menstrual cycle. womenshealth.gov, 2025.
  3. Jerilynn C. Prior, MD, FRCPC. CeMCOR profile and menstrual cycle / ovulation research program. Centre for Menstrual Cycle and Ovulation Research (UBC).
  4. Jen Gunter, MD, OB/GYN. Blood: The Science, Medicine, and Mythology of Menstruation. Citadel / Kensington, 2024.

Educational information for general awareness. This article has not been individually reviewed by a clinician for you, and it is not medical advice.