How to know if you're in perimenopause? Start by tracking your symptoms

Last updated: 10/19/2026

Key facts

• Perimenopause is the transition leading to menopause and often begins in a woman’s 40s.
• Symptoms and timing vary from woman to woman and may overlap with other health conditions.
• Tracking symptoms over time can help you and your physician identify patterns, discuss possible causes and make more informed decisions about your care.

Perimenopause and menopause do not look the same for every woman.

Changes in menstrual cycles, sleep, mood, or physical health may be mild for some women and more disruptive for others. They can also overlap with symptoms of other health conditions.

That is why Nithyasri Sundar, a Health Coach at Capital Blue Cross, encourages women to track what they are experiencing before meeting with their doctor.

“When you meet with your doctor, you may remember only how you’ve felt recently,” Sundar said. “Tracking symptoms can provide a clearer picture of changes over time.”

A record covering several weeks or months can give a woman and her physician more information to discuss and decide appropriate ways to address health concerns.

What are perimenopause and menopause?

Perimenopause is the transition leading to menopause. It often begins in a woman’s 40s.

As hormone levels change, periods may become less predictable. Possible symptoms include hot flashes, night sweats, sleep problems, mood changes, and difficulty concentrating.

Women reach menopause after 12 consecutive months without a menstrual period, bleeding, or spotting.

However, symptoms and timing vary considerably. “Every individual experiences it differently,” Sundar said. “That’s why awareness is so important.”

Sundar said recording symptoms does not need to be complicated. Using a notebook, calendar, or a women’s health app like Ovia, consider recording:

• The dates, length, and flow of menstrual periods.
• Hot flashes or night sweats.
• Sleep quality and energy levels.
• Changes in mood or ability to concentrate.
• Physical changes or discomfort.
• How symptoms affect work, exercise, or everyday activities.

Include when each change occurs, how long it lasts, and whether anything appears to make it better or worse. Sundar recommends tracking for at least a few weeks, and preferably a couple of months, before visiting a physician.

How can tracking help your physician?

A written record of your symptoms can give you and your physician a starting point for discussing what has changed. It may help you describe patterns, explain how symptoms affect daily life, and identify the concerns that matter most to you.

It is also important not to assume that every change is caused by perimenopause, said Sundar. For example, thyroid conditions can cause symptoms resembling those of menopause.

Blood tests are not always needed to diagnose menopause, but a healthcare professional may recommend testing based on a patient’s symptoms and medical history.

Consider asking your physician:

• Could these changes be related to perimenopause?
• Are there other possible causes we should consider?
• What lifestyle changes may best support my health?
• What treatment options, if any, could be appropriate based on personal history and symptoms?

Take small steps to prepare

Tracking can also help women identify one manageable place to begin. Depending on their needs, that might involve developing better eating habits, increasing physical activity, building strength, improving sleep, or managing stress.

“You don’t have to focus on everything all at once,” Sundar said. Start with one realistic habit, then use what you learn to guide the next conversation with a healthcare professional.

If you notice that certain changes affect you more than others, Sundar said to focus first on the area that matters most to your daily life. Setting a specific, achievable goal can make the process feel less overwhelming.

Support for your next step

You do not have to navigate this transition alone. Eligible Capital Blue Cross members can use an enhanced version of the Ovia Health app to track symptoms, receive personalized health information, and connect with a team of health coaches.

These resources can help you better understand what you are experiencing, but they are not a substitute for medical care.

If you have questions about your symptoms, start by writing down what is changing and scheduling an appointment with your physician. Combining your own observations with medical guidance can help you identify the care and resources that are right for you.

FAQ

How do you know if you’re in perimenopause?

Irregular or skipped periods are often the first sign, along with changes like hot flashes, night sweats, sleep problems or mood changes. There is no single test, so tracking your symptoms and reviewing them with your physician is the best way to find out.

Is there a blood test for perimenopause?

The Mayo Clinic says tests most often aren’t needed. Hormone levels fluctuate during perimenopause, which makes blood tests hard to interpret. Your physician may still recommend testing to rule out other causes, like a thyroid disorder.

What else can cause symptoms that feel like perimenopause?

Thyroid disorders can cause similar symptoms. Cleveland Clinic notes that fatigue, poor sleep, hot flashes and brain fog can point to either condition, and a simple blood test can help tell them apart.