Menstria · the last period
Perimenopause and menopause.
Menopause is a single day, identified only in hindsight. What most people call "going through menopause" is perimenopause, the transition before it, which commonly runs for years.
Perimenopause does not begin at 50. Start keeping a record of your period dates at 35.
Not because anything is happening at 35. Because perimenopause is diagnosed from the pattern of your own cycles rather than from a blood test — and in a few years someone will need to know what normal looked like for you. Only you can supply that, and only if you started before you needed it.
In this section
4 short pages
01
Why to start keeping a record at 35
The transition is diagnosed from your own cycle pattern, not a blood test, and what each test does answer.
2 min read →02
Perimenopause, menopause and the four stages
Menopause is a single day. Perimenopause is the transition before it, staged with STRAW+10.
1 min read →03
What changes, beyond hot flashes
Sleep, mood, bone, heart, genitourinary tissue, and the bleeding changes that need evaluation.
1 min read →04
The FDA removed the boxed warnings from menopausal hormone therapy
What changed in November 2025 and February 2026, what did not, and what it means.
1 min read →Tools · the transition
Find out where you are
Cycle Change Tracker
Start at 35. · Track from 35
Perimenopause Stage Finder
Maps your cycle changes and symptoms onto the STRAW+10 staging system — the framework your clinician uses — so you can name the stage you are in rather than guess at it. · Staging
Could I Be in Perimenopause or Menopause?
The starting point if you are not yet sure the question applies to you. · Symptom check
Menopause Treatment Navigator
Treatment options matched to your symptoms and health history — hormonal and non-hormonal — with the evidence behind each, in a form you can take to your appointment. · Treatment options
Hormone Therapy Decision Aid
Your personal benefit–risk picture for menopausal hormone therapy, built on the post-WHI reanalysis and current society guidance rather than the withdrawn warnings — with the numbers, and the questions to bring to your clinician. · Decision aid
HRT Candidacy & Timing Navigator
Clinician-level decision support: the timing window, absolute and relative contraindications, route and progestogen selection, and evidence-graded non-hormonal alternatives. · For clinicians
Perimenopause & Menopause — 100 Questions
One hundred questions across ten areas — symptoms, hormone therapy, bone, cardiovascular risk, labs, cancer screening — each opening in Claude or ChatGPT with a citation-constrained prompt, in a patient or a clinician version. · AI question set
Menopause Symptom Tracker
A structured record of symptoms over time, so an appointment starts from data rather than recollection. · Tracker
Menopause Competence
Structured education on menopause care for clinicians, and for patients who want the clinician-level version. · Education