Many women entering perimenopause are told by their clinicians that a single follicle-stimulating hormone (FSH) blood test will determine whether they are in the menopausal transition and whether they are candidates for menopause hormone therapy (MHT). This practice is widespread, but it is not supported by current evidence or by leading menopause guidelines. Understanding why requires a clear look at what FSH is, how it behaves during perimenopause, and what measures actually correlate with both menopausal status and the likelihood of benefit from treatment.

Yesterday, a patient in her early forties sat across from me describing something she had never experienced before: her heart would suddenly race for no apparent reason, jolting her awake at 2 a.m. She could not fall back asleep. She felt foggy at work. She wondered if something was seriously wrong. Nothing was wrong with her heart. What she was experiencing were some of the earliest signals of perimenopause. The purpose of this blog is to walk you through the major body systems affected by perimenopause and to show you what to expect at each phase. My hope is that by understanding these changes, you will feel empowered rather than frightened, and that you will recognize the signals your body is sending you as it moves through this natural, but sometimes disorienting, transition.

The Greene Climacteric Scale is introduced as a critical tool for identifying the right time to seek medical help, highlighting its role in assessing the symptom burden women face during the perimenopausal phase. Perimenopause, a natural transition occurring typically from the late 30s to early 50s, involves a range of physical and psychological symptoms due to decreasing estrogen levels. The blog underlines how these symptoms can vary greatly among women, affecting their daily lives and well-being differently.