It is stage and symptoms which characterise peri-menopause, or which warrant further investigation if you are young.
There is quite a strict medical definition of peri-menopause in UK which contrasts with the sometimes somewhat looser definition in general use which is the few years leading up to menopause when women start to notice changes in their periods and experience some symptoms. This is what makes the whole thing confusing
The definition used in the NICE Guidelines on menopause is: “The time in which a woman has irregular cycles of ovulation and menstruation leading up to menopause and continuing until 12 months after her final period (also known as menopausal transition or climacteric)”
This is based on what is known as the STRAW criteria (Stages of Reproductive Ageing Workshop) which categorised these stages from observations of thousands of women to establish certain well-defined stages.
The final stage before peri-menopause is known as the “Late Reproductive Phase” in which ovarian function is maintained but subtle changes in some of the hormones involved begin to take place and in which periods are regular or shortening. This has two sub-stages – and involve differences in some of the other hormones responsible for controlling the menstrual cycle (so in addition to FSH – inhibin, anti-Mullerian hormone – which most of us know nothing about). Specifically the later of the two sub-stages is characterised by the following changes: Women begin to notice (subtle) changes in cycles, Shorter cycles begin, Early follicular phase (Days 2-5) FSH increases and becomes more variable, AMH, Antral follicle count, Inhibin B - low, Subtle changes on flow/length. This phase is when many women begin to experience worsening pms and sometimes even classic menopausal symptoms – hence thinking they are in peri-menopause.
Fine if it is just a question of semantics or definition – but the NICE Guidelines are specific that if a woman experiences unpleasant symptoms having entered peri-menopause then HRT is recommended as the first line of treatment. Some women who start HRT in the late repro phase are surprised when HRT does not work and then give up never to start again. For some though it can work.
So – your doctor friend is right and wrong – right that you are probably not yet in peri-menopause (if based on your cycle) but it probably won’t be long now, wrong that you would be too young if you experienced cycle changes + symptoms whatever age you are.
Some gynaes suggest that women under 50 at this point start the CCP because this will regulate the cycle and prevent the mood swings so worth thinking about. There are a couple of gentler types more suitable for women approaching menopause.
Not wanting to minimise the effect of your symptoms and the need to consult your doc about some of the symptoms you mention.