5 phases of perimenopause: Which one are you at?

Dr Jerilynn C. Prior, MD and founder of The Centre for Menstrual Cycle and Ovulation Research (CeMCOR), has identified 5 phases of perimenopause. Very instructive if you want to know where you’re at with the menopausal hickups. I mean, my doctor just asked me one question: are you still regular. On my yes, he stated: “Then you’re not in menopause just yet!”. Okay. Thank you for that quick assessment, doctor, but haven’t you seen the list of complaints that accompany the perimenopause. Isn’t it just plausible I’m in peri? If you’re curious about the phases or like to know which one you’re at, please read on. Dr. Prior work did clarify more than my own doctor could.

Phase A
Regular cycle, but may shorten during this period
Tender breasts
Mood swings
Your first hot flashes (yeah! Get used to them, they won’t be the last!)
Weight gain
migraine headaches
Estrogen levels are fluctuating
FSH levels are normal

Phase B
Regular cycle
Heavy flow may occur
PMS symptoms increase
Menstrual cramps
Estrogen levels high
FSH level is intermittently elevated

Phase C
Unpredictable flow
Hot flashes more common
Night sweats
FSH slightly elevated
Estrogen levels will fluctuate

Phase D
Irregular or infrequent menstrual periods
Skipped periods
More hot flashes
Estrogen levels high
FSH level persistently elevated

Phase E
Final menstrual period till exactly one year after
Hot flashes
Night sweats
No more PMS
No more cramps
Lesser pain in breasts
Lesser mood symptoms
Estrogen levels low or normal
FSH level is high

I do suspect I am in Phase B. That means I still have 3 of them to go. And sadly, Dr. Prior did say nothing of the length of the periods. My guess is there is nothing sensible to say on that subject. It will be different for everyone. I think. Not everyone will experience the different phases exactly the same, nor will they experience the phases for the same length of time. We will have to endure. Don’t we always? In the meantime I will take this list to my doctor to educate the good man on female physiology.


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