Women’s health NP here – no need to call your doctor about a missed period when perimenopause is more or less expected to be kicking in . But it’s a great idea to track your period so that if you have questions or concerns and you go in you can be specific about how often they’re coming. A reason to go in is when bleeding patterns get really abnormal and unpredictable (which can be hard to know when you’re starting to skip periods) but if you’re not sure just go have a consultation. “abnormal uterine bleeding” can look different on different people but tends to be on and off and protracted (e.g no bleeding for three months and then on and off spotting for six weeks then nothing for a few weeks and bleeding a few more, that sort of thing. )

FWIW - always worth it to take a pregnancy test. I'm 48 and my husband has some male factor issues as well - we needed donor egg + ICSI to have our children - but my period was late a couple of months ago and it turns out that I was pregnant. Oops! We'd never bothered with birth control since we hadn't had any positives through years and years of trying on our own and several IVF cycles with my eggs.

I miscarried very shortly thereafter, but it was a bit of a shock, to say the least.

I'm 46 and just had my first late period - 39 day cycle after years of my period coming every 25-28 days. I took a pregnancy test too, even though my husband also had a vasectomy. I haven't had any other perimenopause symptoms yet, but I read that peri can lasts on average 5-7 years before you go a full year without a period and enter menopause. So I figure I have a ways to go and plenty of time for other symptoms to start up.

You are just getting started.
I would miss a period here or there in my mid to late 40s. Then skimpier periods, mostly regular sometimes not for another 10 years until my LMP at 56.
I had a hot flash or two but not a lot until after my LMP.
What I did have starting age 52 was weird mood swings, sleepless nights, anxiety.
I suggest you get a gynecologist that has an interest in menopause management. You doc isn't going to be up to that.

Bumping this post. For the first time EVER at 49, I missed a period. I did take a pregnancy test (negative thank the lord). I know I am 49 but I have been so regular that I am very surprised and keep running to the bathroom thinking my period is going to start. I am now 14 days late. Is this really how it goes? No other symptoms and then BAM no period?

I encourage you to use a tracker app like Flo. It's very useful at all stages of life, especially in perimenopause when you're busy with life but need to accurately report cycle changes to your Gyn.


Take a pregnancy test. Get bloodwork, in case something crops up that might make your periods irregular, like thyroid disease or anemia. Think about supplementing with vitamin D, most people in the northern hemisphere are deficient and if you're starting perimenopause you don't want to make your bones brittle.