Your cycle usually changes first
The Menopause Society describes the order: at first, cycles often get a little shorter than usual and the number of bleeding days changes. As perimenopause goes on, cycle length can vary by 7 days or more, and in the late transition you can go 60 days or more between periods.[2]
That's why period dates matter so much here. The Menopause Society suggests tracking bleeding on a calendar or an app so a clinician can review it.[2] 3 cycles in a row, with the lengths written down, are easier to compare than one odd month.
The checklist
Tick what you notice, and note the date. These come from the NHS symptom list; you won't have all of them, and they can change over the years.[1]
| Sign | What to note |
|---|---|
| Cycle length changes | First day of each period; the app counts the days between |
| Heavier or lighter flow | Flow on each day, and any spotting between periods |
| Hot flashes | Time of day and how strong, from mild to severe |
| Night sweats | Which nights, and whether they woke you |
| Sleep | Bedtime, wake-ups, how rested you felt |
| Mood | Low, anxious or irritable days, and where they fall in your cycle |
| Brain fog | Days with trouble concentrating or finding words |
| Aches | Joint pain, muscle aches, headaches |
| Vaginal dryness | Discomfort, and whether it affects sex |
How long should I track before seeing a doctor?
2 or 3 cycles let you compare one cycle length with the next. If symptoms are making daily life hard, go sooner and bring whatever you have: even 2 weeks of dated hot flashes helps.
See a doctor without waiting for a pattern if you have:[1][3]
- heavy bleeding, or bleeding that's heavier or lasts more days than usual
- bleeding after sex or between periods
- any bleeding after 12 months with no period
Periods that start less than 21 days apart count as irregular on the NHS definition, so bring those dates to your next visit.[5]
Why there is no simple test
In perimenopause the ovaries make hormones erratically,[2] so one blood test is a snapshot of one day. NICE in the UK tells doctors to identify perimenopause in otherwise healthy women aged 45 or over from their symptoms and periods, without lab tests. Between 40 and 45 it says a doctor may consider an FSH blood test, and under 40 separate guidance on premature ovarian insufficiency applies, which does use blood tests.[4]
Putting it on one page
Her Good Days keeps the dates for you. In perimenopause the Log button puts Hot flash, Period, Sleep, Mood and Brain fog first, and the doctor report turns a month of entries into a few pages: cycle lengths, symptom counts by week, and sleep next to night sweats. The app never tells you what stage you're in. You choose it, and you can change it.
For the bigger picture of this stage, see perimenopause in Her Good Days.