Perimenopause's First Sign Is Cycle Variability, Not Hot Flushes — What to Track and When to See a GP
Perimenopause's first sign isn't hot flushes — it's cycle length variability, with reliably predictable cycles becoming erratic over 2-10 years before the final period. Here's how declining ovarian reserve drives follicular phase variability, why anovulatory cycles cause heavier periods, the specific tracking patterns that indicate perimenopause vs thyroid issues or PCOS, and why fertility doesn't reach zero until 12 months after the final period.