{"id":8800026,"date":"2026-09-09T13:26:28","date_gmt":"2026-09-09T13:26:28","guid":{"rendered":"https:\/\/www.costamedicalservices.com\/spain\/medical-library\/menopause-perimenopause\/"},"modified":"2026-09-09T13:26:28","modified_gmt":"2026-09-09T13:26:28","slug":"menopause-perimenopause","status":"publish","type":"page","link":"https:\/\/www.costamedicalservices.com\/sv\/spain\/medical-library\/menopause-perimenopause\/","title":{"rendered":"Menopause and perimenopause: symptoms, diagnosis and options"},"content":{"rendered":"<style>.entry-title{display:none!important}.cmsarticle{--ink:#103d56;--muted:#647d8b;--blue:#2d78da;--cyan:#1baec5;--green:#16856f;--line:#d9e7ed;--soft:#f3f8fa;--warn:#fff7e8;--rose:#fff3f3;--shadow:0 18px 44px rgba(16,61,86,.11)}\n.cmsarticle,.cmsarticle *{box-sizing:border-box}.cmsarticle html{scroll-behavior:smooth}.cmsarticle{margin:0;background:#fff;color:var(--ink);font-family:Inter,Arial,sans-serif;line-height:1.68}.cmsarticle a{color:#176ecb}.cmsarticle 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h1{font-size:40px}.cmsarticle .dek{font-size:17px}.cmsarticle .layout{gap:26px}.cmsarticle .summary{padding:22px 20px}.cmsarticle article{font-size:16px}.cmsarticle article h2{font-size:28px}.cmsarticle .cards,.cmsarticle .checklist{grid-template-columns:1fr}.cmsarticle .reviewer{grid-template-columns:56px 1fr}.cmsarticle .avatar{width:56px;height:56px;font-size:18px}}\n<\/style>\n<div class=\"cmsarticle\" lang=\"en-GB\">\n<div class=\"page\"><a class=\"back\" href=\"https:\/\/www.costamedicalservices.com\/spain\/medical-library\/\">\u2190 Return to the Medical Library<\/a><\/p>\n<header class=\"hero\" style=\"--hero:url('https:\/\/images.pexels.com\/photos\/7551667\/pexels-photo-7551667.jpeg?auto=compress&amp;cs=tinysrgb&amp;w=1200')\">\n<div class=\"hero-copy\">\n<div class=\"eyebrow\">Women&#8217;s health \u00b7 medical guide<\/div>\n<h1>Menopause and perimenopause: symptoms, diagnosis and options<\/h1>\n<p class=\"dek\">Clear guide to perimenopause, menopause, symptoms, assessment and treatment options.<\/p>\n<div class=\"tags\"><span>menopause<\/span><span>perimenopause<\/span><span>hot flashes<\/span><span>hormone therapy<\/span><\/div>\n<div class=\"byline\"><span><strong>Reading:<\/strong> 12 minutes<\/span><span><strong>Updated:<\/strong> August 30, 2026<\/span><span><strong>Medical review:<\/strong> Dr Paola Blanco<\/span><\/div>\n<\/div>\n<\/header>\n<div class=\"layout\">\n<nav class=\"toc\" aria-label=\"Content\"><b>In this article<\/b><a href=\"#resumen\">Summary and conclusions<\/a><a href=\"#s1\">What changes and how it may feel<\/a><a href=\"#s2\">Diagnosis: when tests are needed<\/a><a href=\"#s3\">Treatment options<\/a><a href=\"#s4\">When to consult more urgently<\/a><a href=\"#fuentes\">Official sources<\/a><\/nav>\n<article>\n<section class=\"summary\" id=\"resumen\">\n<div class=\"summary-label\">Summary and conclusions<\/div>\n<h2>The essentials in less than a minute<\/h2>\n<ul>\n<li>Perimenopause can begin before menstruation stops, and symptoms vary widely from person to person.<\/li>\n<li>In healthy people aged 45 years or older with typical symptoms, the diagnosis is usually clinical and does not require a routine hormonal battery.<\/li>\n<li>Treatment should be tailored to the chief symptom, medical history, individual preferences and risks.<\/li>\n<li>Unexpected bleeding, very early symptoms or diagnostic doubts require a specific review.<\/li>\n<\/ul>\n<\/section>\n<section id=\"s1\">\n<h2>What changes and how it may feel<\/h2>\n<p>Menopause is a vital transition, not a single date. Perimenopause describes the years in which ovarian function and menstrual patterns change. Menopause is identified retrospectively when 12 months have passed without menstruation and there is no other cause.<\/p>\n<p>Hot flashes, night sweats, sleep disturbances, vaginal dryness, urinary discomfort, mood changes, muscle or joint pain, and sexual difficulties may appear. The combination, intensity and duration are not the same in all people.<\/p>\n<\/section>\n<section id=\"s2\">\n<h2>Diagnosis: when tests are needed<\/h2>\n<p>NICE guidance indicates that in otherwise healthy people aged 45 years and over with associated symptoms, perimenopause and menopause are often identified without testing. The situation changes if the symptoms appear between 40 and 45 years old, before 40, if certain hormonal treatments are used or if there is another possible explanation.<\/p>\n<div class=\"table-wrap\">\n<table>\n<caption>Situations that change the valuation<\/caption>\n<thead>\n<tr>\n<th>Situation<\/th>\n<th>Focus<\/th>\n<\/tr>\n<\/thead>\n<tbody>\n<tr>\n<td>45 years or older with typical symptoms<\/td>\n<td>The medical history is usually the main element.<\/td>\n<\/tr>\n<tr>\n<td>40\u201345 years<\/td>\n<td>FSH may be considered depending on the context.<\/td>\n<\/tr>\n<tr>\n<td>Less than 40 years<\/td>\n<td>Premature ovarian failure and its implications must be assessed.<\/td>\n<\/tr>\n<tr>\n<td>unexpected bleeding<\/td>\n<td>It requires reviewing pattern, treatment and warning signs.<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<\/div>\n<\/section>\n<section id=\"s3\">\n<h2>Treatment options<\/h2>\n<p>The plan may include information, changes in habits, cognitive behavioral therapy for certain symptoms, local treatments for genitourinary discomfort, and menopausal hormone therapy when indicated. There is no identical solution for all.<\/p>\n<div class=\"cards\">\n<div class=\"mini\"><b>1<\/b><strong>Vasomotor symptoms<\/strong><span>Hot flashes and night sweats.<\/span><\/div>\n<div class=\"mini\"><b>2<\/b><strong>Genitourinary symptoms<\/strong><span>Dryness, pain, urinary discomfort.<\/span><\/div>\n<div class=\"mini\"><b>3<\/b><strong>Sleep and well-being<\/strong><span>Review coexisting causes and priorities.<\/span><\/div>\n<\/div>\n<p>The decision about hormone therapy requires discussing benefits and risks, type of preparation, presence or absence of uterus, history and preferences. Absolute statements that \u201cit is always safe\u201d or \u201cit is always dangerous\u201d do not reflect an individual assessment.<\/p>\n<\/section>\n<section id=\"s4\">\n<h2>When to consult more urgently<\/h2>\n<p>An evaluation should be sought if there is bleeding after menopause, very heavy bleeding, persistent pelvic pain, mass, unexplained weight loss, neurological symptoms, chest pain or shortness of breath. Bleeding while using hormonal treatment should also be interpreted according to when it started, the regimen, and the course.<\/p>\n<p>An online consultation can sort out the history and options, but some situations require in-person examination, blood tests or referral.<\/p>\n<\/section>\n<section class=\"related\">\n<h2>Continue on the right route<\/h2>\n<p>Related medical guides and service pages. This article provides general information; treatment and prescribing decisions require an individual medical assessment.<\/p>\n<div class=\"related-grid\"><a href=\"https:\/\/www.costamedicalservices.com\/spain\/telehealth\/online-doctor\/\">Online medical consultation<span>Clinical information and consultation<\/span><\/a><a href=\"https:\/\/www.costamedicalservices.com\/spain\/telehealth\/online-doctor\/\">Sleep problems<span>Clinical information and consultation<\/span><\/a><a href=\"https:\/\/www.costamedicalservices.com\/spain\/medical-library\/vaginal-itching-discharge-burning\/\">Vaginal itching, discharge or stinging<span>Clinical information and consultation<\/span><\/a><\/div>\n<\/section>\n<section class=\"reviewer\">\n<div class=\"avatar\">P.B.<\/div>\n<div>\n<h3>Medically reviewed by Dr Paola Blanco<\/h3>\n<p>Medical reviewer for Costa Medical Services. Clinical coherence, safety and source quality reviewed.<\/p>\n<p><span class=\"seal\">\u2713 Spanish medical registration 292891820 \u00b7 Review August 30, 2026<\/span><\/div>\n<\/section>\n<section class=\"sources\" id=\"fuentes\">\n<h2>Official and clinical sources<\/h2>\n<ol>\n<li><a href=\"https:\/\/www.nice.org.uk\/guidance\/NG23\">NICE NG23: Menopause identification and management<\/a><\/li>\n<li><a href=\"https:\/\/www.nice.org.uk\/guidance\/ng23\/chapter\/Recommendations\">NICE: updated menopause recommendations<\/a><\/li>\n<\/ol>\n<p>Regulatory information may change. Before publishing in WordPress, you should double-check the current version of the SmPC and leaflet.<\/p>\n<\/section>\n<section class=\"cta\">\n<h2>Do you need a medical evaluation?<\/h2>\n<p>The consultation is used to review symptoms, history, medication and decide if online management is appropriate or if you need in-person care.<\/p>\n<p><a href=\"https:\/\/www.costamedicalservices.com\/spain\/telehealth\/online-doctor\/\">See medical consultation<\/a><\/section>\n<aside class=\"disclaimer\"><strong>Notice about AI and medical information<\/strong><\/p>\n<p>This article has been prepared with the help of artificial intelligence tools and may contain errors, inaccuracies or omissions. It is provided for general guidance only and is never a substitute for medical advice, examination, diagnosis or the instructions in the package leaflet. Do not start, stop, or modify a medication or delay urgent care based on this content alone.<\/p>\n<\/aside>\n<\/article>\n<\/div>\n<\/div>\n<\/div>\n<p><script type=\"application\/ld+json\" id=\"cms-confirmed-medical-review\">{\"@context\":\"https:\/\/schema.org\",\"@type\":\"MedicalWebPage\",\"@id\":\"https:\/\/www.costamedicalservices.com\/spain\/medical-library\/menopause-perimenopause\/\",\"url\":\"https:\/\/www.costamedicalservices.com\/spain\/medical-library\/menopause-perimenopause\/\",\"inLanguage\":\"en-GB\",\"reviewedBy\":{\"@type\":\"Physician\",\"name\":\"Dr Paola Blanco\",\"identifier\":\"Spanish medical registration 292891820\"},\"lastReviewed\":\"2026-08-30\",\"name\":\"Menopause and perimenopause: symptoms, diagnosis and options\",\"description\":\"Clear guide to perimenopause, menopause, symptoms, assessment and treatment 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