Perimenopause library · Symptoms
Cycle changes in the 40s: what tracking can show
STRAW+10 simplified the bleeding criteria that researchers use. Early menopausal transition is persistent cycle-length change of seven days or more. Late transition is amenorrhea of 60 days or more, or two skipped cycles; it often lasts one to three years. Those are staging rules for cohorts, not a home test.
Hormones underneath that map are messy. Su and Freeman (2009) summarize the usual sequence: AMH falls first, inhibin B falls, FSH rises, and estradiol can stay up or even spike before it drops late. There is no validated cutpoint that diagnoses the transition or predicts the final period for one person.
What a tracker can show is the pattern you actually had: start dates, gap lengths, flow that felt heavier or lighter than your usual. That description helps a clinician decide what is worth investigating.
What it cannot show is whether a given bleed is “normal for perimenopause.” Persistent heavy bleeding, bleeding after sex, and bleeding after twelve months without a period are clinical flags. Log them. Do not let an app close the question.
What this article cannot tell you
- Whether your cycles “count” as early or late transition.
- Whether a heavy month is expected or a reason for investigation.
- What your next period date will be.
Questions worth taking to a clinician
- Here are my cycle start dates. Does this look like a transition pattern, something to investigate, or both?
- What bleeding change should make me book sooner than the next routine visit?
Sources
- Harlow SD, Gass M, Hall JE, Lobo R, Maki P, Rebar RW, Sherman S, Sluss PM, de Villiers TJ, STRAW 10 Collaborative Group. Executive summary of the Stages of Reproductive Aging Workshop + 10: addressing the unfinished agenda of staging reproductive aging. Menopause / Journal of Clinical Endocrinology & Metabolism (simultaneous). 2012. doi:10.1097/gme.0b013e31824d8f40
- Soules MR, Sherman S, Parrott E, Rebar R, Santoro N, Utian W. Executive summary: Stages of Reproductive Aging Workshop (STRAW). Fertility and Sterility. 2001. doi:10.1016/s0015-0282(01)02909-0
- Su HI, Freeman EW. Hormone changes associated with the menopausal transition. Minerva Ginecologica. 2009. PMID 19942836