Doctors say diagnosis is usually clinical and doesn’t rely on a blood test, with symptoms often starting in the mid-40s There’s a special frisson to period changes in your mid-forties. Every deviation from your usual pattern can feel like a harbinger of the menopause transition, also known as perimenopause. One might spend years staring at their underwear, wondering: am I or aren’t I? Keren Landman MD is an independent health reporter who is also trained as an infectious disease physician and ep