Short answer
Track the start date and flow of each period, plus hot flashes, night sweats, sleep and mood. In perimenopause, cycles first become more variable and then further apart, and you reach menopause after 12 months with no period. A dated record helps you and your doctor see the pattern and decide on treatment.
Key facts
- Most women begin the menopausal transition between ages 45 and 55.[1]
- The transition usually lasts about seven years, but it can take as long as 14 years.[2]
- You have reached menopause when you have had no period or spotting for a full year; the average age in the US is 52.[1]
- In the SWAN study, frequent hot flashes or night sweats lasted a median of 7.4 years in total.[3]
How do periods change in perimenopause?
The STRAW+10 staging system, used by researchers and clinicians, describes two steps before menopause:[4]
| Stage | Cycle pattern |
|---|---|
| Early menopausal transition | Cycle length becomes variable: consecutive cycles differ in length by 7 days or more, and this keeps happening |
| Late menopausal transition | Gaps of 60 days or more without a period |
| Menopause | No period or spotting for 12 months in a row[1] |
Periods may also get lighter or heavier, and you may skip some.[5]
What should you track, and why?
| What to log | Why it helps |
|---|---|
| Period start dates and flow | Shows when your cycle length starts to vary and when gaps reach 60 days |
| Hot flashes and night sweats | How often and how bad they are helps you and your doctor judge whether treatment is worth trying[1] |
| Sleep | Trouble sleeping is a common symptom of the transition[1] |
| Mood and focus | Moodiness, irritability, forgetfulness and trouble concentrating can all happen[1] |
| Spotting or unusual bleeding | Some bleeding changes need a check-up (see below)[5] |
Hot flashes can last for years: in the SWAN study, women whose frequent hot flashes started before or early in the transition had them for a median of more than 11.8 years.[3]
Which bleeding changes need a doctor?
Some change is expected, but ACOG says to talk with your ob-gyn about bleeding changes and lists these as not normal:[5]
- Bleeding or spotting between periods
- Bleeding or spotting after sex
- Heavy bleeding during your period
- Bleeding that is heavier or lasts more days than usual
- Any bleeding after menopause
Can you still get pregnant in perimenopause?
Yes. NIA advises that anyone who doesn't want to get pregnant should keep using birth control for at least a full 12 months after their last period.[1] Preeo is not a method of birth control and must not be used to prevent pregnancy.
How Preeo can help
Preeo's Perimenopause mode lets you track hot flashes, sleep and mood as your cycle changes, alongside your period dates and flow. Predictions for irregular cycles are shown as a date range, and charts show how your cycle length, symptoms and mood change over time. With Preeo Premium you can create a doctor-ready PDF report.
Free to download. Preeo Premium is an optional subscription. See all features.
Frequently asked questions
At what age does perimenopause start?
Most women begin the menopausal transition between ages 45 and 55, though it can start earlier or later.
How long do hot flashes last?
In the SWAN study, frequent hot flashes or night sweats lasted a median of 7.4 years in total, and longer for women whose symptoms began before or early in the transition.
How do I know I've reached menopause?
You have reached menopause when you've had no period or spotting for 12 months in a row.
Is it normal to go 60 days without a period in perimenopause?
Gaps of 60 days or more are a sign of the late menopausal transition. Still mention long gaps to your doctor, and take a pregnancy test if pregnancy is possible.
Related questions
Sources
- National Institute on Aging (NIH). What Is Menopause? www.nia.nih.gov
- NIH MedlinePlus Magazine. Menopause: What you need to know. magazine.medlineplus.gov
- Avis NE, Crawford SL, Greendale G, et al. Duration of menopausal vasomotor symptoms over the menopause transition (Study of Women's Health Across the Nation). JAMA Internal Medicine, 2015. pubmed.ncbi.nlm.nih.gov
- Harlow SD, Gass M, Hall JE, et al. Executive summary of the Stages of Reproductive Aging Workshop + 10 (STRAW+10). Menopause, 2012. pubmed.ncbi.nlm.nih.gov
- ACOG. Perimenopausal Bleeding and Bleeding After Menopause (patient FAQ). www.acog.org
This guide was drafted with AI assistance. Each statistic links to the source listed above. Spotted an error? Email support@preeo.app.