How do I know when I’ve hit perimenopause?

Doctors say diagnosis is usually clinical and doesn’t rely on a blood test, with symptoms often starting in the mid-40s

There’s a special frisson to period changes in your mid-forties. Every deviation from your usual pattern can feel like a harbinger of the menopause transition, also known as perimenopause.

One might spend years staring at their underwear, wondering: am I or aren’t I?

Keren Landman MD is an independent health reporter who is also trained as an infectious disease physician and epidemiologist, with experience serving as a disease detective at the CDC and conducting HIV and malaria research in resource-poor countries. Her public health newsletter is called Landmansplained