How does the perimenopause symptom check work?
- The Menopause Rating Scale (MRS) is a validated questionnaire with 11 symptoms, each rated from none (0) to very severe (4).
- Scores split into physical (somatic), psychological and urogenital areas. Total bands: 0 to 4 none or little, 5 to 8 mild, 9 to 15 moderate, 16 or more severe (Heinemann).
- NICE says perimenopause can be diagnosed from symptoms alone if you're over 45, without blood tests.
- Between 40 and 45, a GP may consider an FSH blood test. Under 40, symptoms and period changes need checking for early menopause (POI).
Hot flushes are often the last thing people notice
Mood changes, anxiety, brain fog, joint pain and sleep problems are common in perimenopause and often come first. Because they overlap with so much else, many people go years without connecting them. A score like this helps you describe what's happening.
What NICE says
For people over 45, NICE says perimenopause can be diagnosed from symptoms, without blood tests. HRT is the most effective treatment for many symptoms. Our guide to HRT basics explains the options.
When to see a doctor
- Symptoms are affecting your life, at any age.
- You're under 40 with menopause-type symptoms or periods stopping (possible early menopause).
- Bleeding after menopause, or very heavy or irregular bleeding: get it checked.
In the UK you can call NHS 111 for advice, any time. In an emergency call 999 (UK) or 911 (US).
Questions people ask
What are the first signs of perimenopause?
Often changes to your periods (closer together, further apart, heavier or lighter), plus sleep problems, mood changes, hot flushes, brain fog or joint aches (NHS).
At what age does perimenopause start?
Usually in your 40s. The average age of menopause in the UK is 51. Symptoms can start years before periods stop.
Do I need a blood test?
Not usually if you're over 45 (NICE). Hormone levels swing a lot in perimenopause, so a single test can mislead.
What can help?
HRT is the most effective treatment for many symptoms, and for most people under 60 the benefits outweigh the risks (NICE). CBT, lifestyle changes and vaginal oestrogen can help too.
Is this a diagnosis?
No. It's a structured way to notice patterns and decide whether, and how soon, to talk to someone. Only a clinician can diagnose, usually with an examination and sometimes tests.
Is anything I enter saved or sent?
No. Everything runs in your browser. Nothing is stored or sent, and the page makes no network requests when you use it.
Sources
Written by the Splash team · Sources checked Oct 2026 · Updated
