Perimenopause is a change that happens gradually and cannot be determined by one test. Your age, previous menstruation history, and any symptoms or physical changes you’re noticing are just a few of the factors your doctor will take into account.

Your hormone levels may be tested by some doctors. Hormone testing, however, is rarely required or helpful to assess perimenopause other than to examine thyroid health, which might alter hormone levels.


Treatment for perimenopausal symptoms frequently involves medication.

  • Hormone therapy. The most effective treatment for perimenopausal and menopausal hot flashes and night sweats is still systemic estrogen therapy, which can be administered as pills, skin patches, sprays, gels, or creams. Your doctor may suggest estrogen in the lowest amount required to relieve your symptoms, depending on your personal and family medical history. You will require progestin in addition to estrogen if your uterus is still present. Estrogen in the body can stop bone loss.
  • Vaginal estrogen. The vagina can get estrogen directly by a vaginal pill, ring, or cream. Only a tiny amount of estrogen is released during this procedure, and it is absorbed by the vaginal tissue. Vaginal dryness, discomfort during sexual activity, and some urinary symptoms can all be helped by it.
  • Antidepressants. Menopausal hot flashes may be lessened by a subset of antidepressants known as selective Serotonin Reuptake Inhibitors (SSRIs). Women who need an antidepressant for a mood problem or who are unable to take estrogen may find relief from hot flashes with an antidepressant.
  • Gabapentin. Gabapentin has been demonstrated to help lessen hot flashes in addition to being approved to treat seizures. Women who suffer from migraines and are unable to take estrogen therapy can benefit from this medication.

Consult your doctor about your options and the risks and benefits of each before deciding on a course of therapy.