For many years, it was believed that the first and most reliable sign of perimenopause was a change in the menstrual cycle.
However, new research suggests that symptoms may begin much earlier – while the menstrual cycle is still completely regular.
A large study conducted by Monash University, published in 2025 in The Lancet Diabetes & Endocrinology, challenges the traditional diagnostic model. The research analyzed data from more than 5,500 women between the ages of 40 and 69.
The appearance of symptoms – often more severe than those experienced during menopause itself – long before the menstrual cycle becomes irregular or stops can create significant challenges for women’s health. The study shows that many women do not receive adequate care, while others receive incorrect diagnoses.
A lack of awareness among healthcare professionals can lead to symptoms such as hot flashes, sleep disturbances, or vaginal dryness being overlooked or attributed to stress, aging, or lifestyle factors.
The reason?
Women who still have a regular menstrual cycle are often considered “too young” for perimenopause, which delays both recognition of the condition and access to appropriate and timely care.
What the Research Shows
The findings reveal that hot flashes, for example, are nearly five times more common in women in early perimenopause who still have regular cycles than in women who have already reached menopause.
Another important indicator of perimenopause – even when cycles remain regular – is vaginal dryness, which occurs about 2.5 times more frequently during this transitional phase.
Because of this, nearly 40% of women receive no medical care or expert support for the hormonal changes occurring in their bodies.
The study clearly demonstrates that changes in the menstrual cycle are not the earliest or most reliable indicator of perimenopause. Other symptoms may appear earlier and are often more common during the initial stages of the transition.
These findings are prompting experts to reconsider how perimenopause is identified, placing greater emphasis on unusual or new symptoms – even when menstrual cycles remain regular.
Track Your Symptoms with the Womeno App
The Womeno mobile app allows you to easily track not only your menstrual cycle but also the various symptoms associated with hormonal changes.
Based on the expertise of our specialists, each symptom is clearly explained. Once you record it in your digital health calendar, you receive evidence-based guidance on how to manage it.
For the most reliable insights, it is recommended to track your symptoms for at least three months. This will provide meaningful data that you can easily share with your doctor or healthcare professional.
Source:
This article is based on findings from a new study by Monash University, published in 2025 in The Lancet Diabetes & Endocrinology. Read the full study here: https://www.thelancet.com/journals/landia/article/PIIS2213-8587(25)00138-X/abstract