Many women are unsure when to seek medical help for perimenopause or menopause symptoms. Here is practical guidance.

When to make an appointment:

  • Symptoms are affecting your quality of life (sleep, work, relationships)
  • You experience new, severe, or concerning symptoms
  • Your periods are very heavy or prolonged (soaking through pads/tampons hourly)
  • You have bleeding after intercourse or between periods
  • You are under 40 and suspect perimenopause (possible primary ovarian insufficiency — POI affects 1-2% of women by age 40)
  • You want to discuss treatment options, including HRT
  • You have risk factors for osteoporosis or cardiovascular disease

How menopause is diagnosed:

  • Clinical diagnosis (cycle history + symptoms) is sufficient in most cases
  • FSH levels above 25-30 IU/L suggest menopause transition
  • FSH fluctuates during perimenopause — a single test can be misleading
  • Thyroid function tests (TSH) are recommended — thyroid disease mimics menopause symptoms
  • AMH can indicate ovarian reserve but is not routinely recommended for menopause diagnosis
  • Laboratory panels are essential to rule out thyroid dysfunction, which can mimic menopausal symptoms

How to prepare for your appointment:

1. Track your symptoms for 2-4 weeks (the app can generate a report to share)

2. Note your cycle pattern (length, flow, skipped months)

3. List your main concerns and questions

4. Bring your medical history (surgeries, medications, family history)

5. Ask specifically about:

  • Whether HRT is appropriate for you
  • Vaginal health (if applicable)
  • Bone health screening
  • Cardiovascular risk assessment
  • Mental health support if needed

Finding the right doctor:

  • Not all doctors are equally experienced in menopause care. The Menopause Society maintains a directory of certified practitioners
  • A gynecologist or endocrinologist with menopause training is ideal
  • If your doctor dismisses your concerns, seek a second opinion. UK studies show ~1 in 3 women feel their GP lacks menopause knowledge, and non-binary and transgender individuals face additional barriers