Late perimenopause
You're skipping periods for longer stretches — you're likely in the final phase before menopause. For many women, this is when symptoms peak.
What's happening in your body
You're now experiencing gaps of 60 days or more between periods, and FSH is rising significantly (often reaching or exceeding 25 IU/L). Your final menstrual period is typically near. Hot flashes and night sweats are often at their most intense in this window.
The signal that defines this stage
A stretch of 60 days or more with no period — the longer gaps that mark the run-up to menopause.
What women commonly notice here
- Gaps of 60+ days between periods
- Hot flashes and night sweats, often more intense
- Sleep disruption; mood and cognitive changes
- Vaginal dryness may begin
Worth raising now: if you're a healthy candidate, this is the part of the timeline where the "window of opportunity" for hormone therapy is most relevant. It's a conversation worth having before symptoms peak — see your options, explained honestly.
Questions to bring to your doctor
- What are the evidence-based options for my hot flashes and sleep?
- Am I a candidate for hormone therapy's "window of opportunity"?
- I'm noticing vaginal or urinary changes — what are the targeted, low-dose options?
- Here's my symptom tracker — can we use it to focus the visit?
Walk into this one prepared.
Know your options before you go, and bring numbers from the tracker.