The menopause is a retrospective clinical diagnosis which may be confirmed after 1 year of amenorrhoea in women that are not using hormonal contraception. In healthy women over the age of 45 that have been amenorrhoeic, there is a history of perimenopausal symptoms such as irregular periods and vasomotor symptoms1.
Perimenopausal women in their 40s and 50s may present with less frequent and irregular periods. In the perimenopause there may be anovulatory cycles as well as intermittent ovulation. An increase in serum FSH level may indicate a degree of ovarian failure but it is not predictive of the menopause in itself1.