How do I know if I'm in menopause?

Bottom lineMenopause is confirmed in hindsight after 12 consecutive months with no period; before that you're in perimenopause. Over 45 it's diagnosed from age, symptoms, and cycle changes rather than blood tests, since FSH fluctuates and is unreliable; testing is mainly used under 45 (or under 40 for premature ovarian insufficiency). You can still ovulate in perimenopause, so continue contraception until you've completed the 12 period-free months.

Menopause is confirmed in hindsight: when you've gone 12 consecutive months without a period (with no other cause). Before that point, you're in perimenopause.

How it's recognized

• Mainly from your age, symptoms, and cycle changes, not a blood test
• In people over 45, clinicians usually diagnose perimenopause and menopause from symptoms alone, without testing
• A blood test for FSH is unreliable in perimenopause because levels fluctuate day to day, so it's generally not recommended as a routine diagnostic over 45

Signs you're in the transition

• Irregular or skipped periods moving toward stopping
• Hot flashes and night sweats
• Sleep and mood changes
• Vaginal dryness

Once 12 period-free months pass, you've reached menopause; the years after are postmenopause.

When testing may be used

• If you're under 45 with menopausal symptoms
• If you're under 40 (to check for premature ovarian insufficiency)
• To rule out other causes of missed periods

Important

You can still ovulate during perimenopause, so don't stop contraception until you've completed the 12 period-free months (guidance on how long to continue varies with age - ask your clinician).

Read our perimenopause and menopause guide and are at-home menopause tests accurate.

Femora helps you track the cycle changes that mark the transition toward menopause.