How can I tell if I am in perimenopause if I still get periods?
Reviewed by Dr. Ana Lisa Carr, MD, MBA · Last reviewed May 10, 2026
Answer published
Perimenopause is diagnosed clinically — by symptoms and cycle changes — not by a single blood test. FSH levels fluctuate so much during this phase that one snapshot is rarely useful. Common signs while still cycling include shorter or longer cycles, heavier or lighter bleeding, more PMS-like symptoms, hot flashes, sleep disruption, brain fog, and mood shifts. A structured symptom history with a menopause-trained clinician is the most reliable way to confirm perimenopause and decide on a treatment plan.
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