Menopause
Why to start keeping a record at 35
2 min read
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.
The transition is usually recognised late, and the reason is structural rather than anyone's fault. Conventional practice is triggered by periods stopping, but the hormonal fluctuation that produces the symptoms — heavier or erratic cycles, worsening premenstrual symptoms, disrupted sleep, mood change — begins years earlier, commonly in the forties. During that window symptoms are explainable and treatable. The years in which treatment does the most good are the years most likely to be spent without it.
Why the answer is not simply "test earlier". Perimenopause is not usually diagnosed by a blood test. During the transition the hormones themselves are unstable — that instability is the transition — so FSH can read menopausal one month and normal the next. ACOG, NICE and The Menopause Society all direct that the diagnosis be made clinically in women over 45, from age, symptoms and cycle change.
Blood tests are not useless, though. Each answers a narrow question: FSH between 40 and 45 with symptoms, or under 40 where premature ovarian insufficiency is suspected; TSH and ferritin at any age, because thyroid disease and iron deficiency imitate the whole picture and are treatable; AMH for fertility planning but not for predicting your own menopause, where individual accuracy is too poor to act on. What each test actually measures is here — alongside the cycle record that makes any of those conversations productive.