Menopause cannot be reliably determined through hormone tests. When you think you are approaching perimenopause, it may make sense to be tested for other causes of symptoms, such as thyroid disease. It is also an excellent time to have a complete medical examination. The doctor may be able to diagnose perimenopause by reviewing your medical history, your menstrual history, and your other signs and symptoms. Normal signs of perimenopause include irregular periods, hot flashes, vaginal dryness, sleep disturbances, and mood swings, all results of changing levels of estrogen in your body.

Contraception options during perimenopause

Shifting hormone levels also allow the possibility of pregnancy, so birth control of some kind is recommended until a year after your last period.
Effective options include:

Birth control pills, patches, or rings
Progestin pills, implants, and injections
Intrauterine devices (IUDs)
Sterilization (tubal ligation, fallopian tube inserts, vasectomy)
Barrier methods (condoms, diaphragm, spermicide)

Early menopause

Ovarian surgery and primary ovarian insufficiency (POI) can give menopause-related symptoms, with lower estrogen levels and negative effects on your bone density and possibly your brain and sexual functions.

Natural menopause not caused by medical treatment

When you have not had your period for 12 consecutive months, you may be in natural menopause, typically between ages 40 and 58. Although smokers may get there about two years earlier than nonsmokers, fertility medications, use of birth control pills, age at first period, and race do not seem to be determining factors.


After menopause, your estrogen levels will continue to decrease, and vaginal dryness and hot flashes may linger, while your risk for related diseases like osteoporosis increase.

All menopausal women must consider their bone health, smoking cessation, alcohol use, their cardiovascular risk, and cancer screening and prevention. These will be addressed with your doctor, and together you will discuss possible lifestyle changes you must make to maintain your health and vitality. For menopausal symptoms like hot flashes, we offer hormone replacement therapy. We will take into consideration concerns of cardiovascular risk and breast cancer, and personalize your treatment to you.

For more information, see The North American Menopause Society site.

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