Am I in perimenopause? Stage guide

How the stage guide reads your answers

There's no scoring. Each answer selects the part of the published criteria that applies to it:

Your periods over the past year	What STRAW+10 calls that pattern
Regular, varying by fewer than 7 days	Late reproductive stage, before the menopausal transition
Cycle length differing by 7 days or more, again and again	Early menopausal transition (Stage −2), when perimenopause begins
A gap of 60 days or more without a period	Late menopausal transition (Stage −1), on average 1 to 3 years before the final period
No period at all for 12 months or more	Perimenopause has ended; natural menopause is identified looking back

These definitions all come from STRAW+10. The age question matters because NICE handles suspected menopause under 40 (as possible premature ovarian insufficiency) differently from people in their 40s, and the hot flash question matters because NICE uses new hot flashes or sweats alongside period changes to identify perimenopause at 45 and over.

A worked example

Say you're 46, you don't use hormonal contraception, your last two cycles were 24 days and 35 days long, and you've started waking with night sweats. A difference of 7 days or more between consecutive cycles matches STRAW+10's early menopausal transition. And because you're 45 or over with new night sweats and changing periods, NICE advises that a clinician can usually identify perimenopause from that history without blood tests. The guide shows both points so you can raise them at your appointment.

When the guide can't place you

• Hormonal contraception, a hormonal IUD or a hysterectomy: bleeding no longer reflects your natural cycle, so the period-based stages don't apply.
• Under 40: the criteria weren't designed to identify menopause at this age, and NICE advises a specific assessment for premature ovarian insufficiency.

How the STRAW+10 staging criteria work

The Stages of Reproductive Aging Workshop + 10 (STRAW+10) is the international consensus framework used in research and clinics to describe reproductive aging:

• Early menopausal transition (Stage −2): Cycle length varies by 7 days or more in consecutive cycles, and that difference recurs within 10 cycles.
• Late menopausal transition (Stage −1): An interval of 60 days or more without a period. On average, this stage lasts 1 to 3 years before the final menstrual period.
• Perimenopause: Begins at the start of the early transition and ends 12 months after the final menstrual period.

For more on each stage, read our guide to the stages of perimenopause, how perimenopause differs from menopause, and what irregular periods in perimenopause can look like.

Why blood tests are rarely used at 45 and over

In the UK, NICE guideline NG23 advises that for otherwise healthy people aged 45 or over, perimenopause can be identified from recently started vasomotor symptoms (hot flashes and sweats) together with a change in menstrual cycles, without laboratory tests. At 45 and over, NICE specifically advises against using anti-Müllerian hormone (AMH), inhibin A or B, oestradiol, antral follicle count or ovarian volume to identify perimenopause. See questions to ask your doctor about perimenopause for when blood tests are considered, such as under 45.

When to get help now

Your answers stay on this device

Your answers are kept in this browser on this device, with no account. Save a dated copy whenever you update them and you'll build a simple record of how your period pattern has changed, which you can reopen, print or delete. Nothing is sent to us, to analytics or to advertisers. Clearing your browser data or using a private window removes saved answers, so export a copy if you want a backup.

Next steps

• Tick everything else you've noticed with the printable perimenopause checklist.
• If your periods have stopped, count toward the 12-month mark with the no-period day counter.
• Log cycles and symptoms over several weeks in the daily and weekly symptom log.