How Do I Know When I’ve Started Perimenopause?
If you’re confused about perimenopause, you’re not alone. You may start experiencing symptoms in your forties, first noticing changes in your menstrual period. During this time, hormone levels fluctuate, causing a number of symptoms – some say up to 34 – such as hot flashes, night sweats, erratic periods, and mood swings. The trick is figuring out if you have perimenopause or some other condition.
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How Much Do You Know About Perimenopause?


Kara Smythe, MD
Medical Reviewer
Kara Smythe, MD, has been working in sexual and reproductive health for over 10 years. Dr. Smythe is a board-certified fellow of the American College of Obstetricians and Gynecologists, and her interests include improving maternal health, ensuring access to contraception, and promoting sexual health.
She graduated magna cum laude from Florida International University with a bachelor's degree in biology and earned her medical degree from St. George’s University in Grenada. She completed her residency in obstetrics and gynecology at the SUNY Downstate Medical Center in Brooklyn, New York. She worked in Maine for six years, where she had the privilege of caring for an underserved population.
Smythe is also passionate about the ways that public health policies shape individual health outcomes. She has a master’s degree in population health from University College London and recently completed a social science research methods master's degree at Cardiff University. She is currently working on her PhD in medical sociology. Her research examines people's experiences of accessing, using, and discontinuing long-acting reversible contraception.
When she’s not working, Smythe enjoys dancing, photography, and spending time with her family and her cat, Finnegan.

Linda Thrasybule
Author
Linda Thrasybule is a former senior editor at Everyday Health, where she oversaw coverage of digestive health, heart health, and cancer. She has more than 20 years of experience covering health, nutrition, lifestyle and wellness trends, and science. Her work has appeared in Reuters Health, LiveScience.com, NPR’s Shots blog, Yahoo News, and TheWeek.com. She has also written clinical topics and research briefs for a number of government agencies and nonprofit health organizations. She earned a master’s degree in journalism from Columbia University in 2011.
In her spare time, Thrasybule enjoys hiking, taking Pilates classes, and going on the occasional yoga retreat to restore and reset.