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Based on the clinical STRAW+10 framework — used in real menopause research. Ten short questions about your cycles and symptoms. Plain-English answer at the end.
Your answers are saved to this browser only. Nothing is sent to ClearedRx or stored on any server.
What each stage means
You're in what STRAW+10 calls the late reproductive stage. Periods are still on a predictable schedule. Hormones are starting to wobble in the background, but you haven't crossed into perimenopause yet. If you do have symptoms — sleep trouble, mood changes, fatigue — it's worth ruling out thyroid issues, iron, sleep apnea, stress, and depression before assuming hormones.
The transition into perimenopause usually starts in the early-to-mid 40s. You may be 1-5 years away.
HRT is generally premature here. Lifestyle, sleep, and a doctor's workup come first.
Next step: Read perimenopause vs. menopause →
Your cycles are varying by 7+ days from your old normal — that's the clinical marker for the start of perimenopause. Estrogen is yo-yoing, which is why hot flashes, sleep changes, and mood swings often show up first here. The good news: this is also when HRT works best, especially for women who start within 10 years of their final period.
Perimenopause lasts about 4-10 years on average. You're likely in the first half.
HRT is appropriate if symptoms are bothersome. NAMS guidelines support starting now.
Next step: Perimenopause vs. menopause → · HRT types explained →
You're skipping months or your cycles are highly irregular. STRAW+10 calls this the late menopausal transition. Hormone swings are at their biggest right now — which is why symptoms often peak here. HRT is highly appropriate at this stage and tends to bring the fastest relief. There's no clinical reason to wait until your periods stop completely.
Final menstrual period usually within 1-3 years. Symptoms often peak in this window.
HRT is well-supported. Both estrogen-only (after hysterectomy) and combined (with intact uterus) options work.
Next step: Perimenopause vs. menopause → · HRT types explained →
You haven't had a period in 12 months or more — that's the clinical definition of menopause being complete. Symptoms often ease in late postmenopause but can stay for years. HRT remains an option for healthy women under 60 or within 10 years of their final period (this is the NAMS "timing hypothesis"). Vaginal estrogen is also a good fit if dryness or urinary symptoms are the main issue.
Hot flashes can last 7+ years on average. Vaginal/urinary symptoms tend to get worse without treatment.
Systemic HRT for under-60s within 10 years of final period. Vaginal estrogen at any age.
Next step: Is HRT safe? The 2026 evidence → · HRT types explained →
When both ovaries are removed (bilateral oophorectomy), estrogen drops overnight instead of over years. The Endocrine Society recommends HRT until at least the natural age of menopause (~51) for women who had this surgery before that age. Skipping HRT after early oophorectomy is linked to higher rates of heart disease, bone loss, and cognitive decline. This is one of the few situations where the medical answer is fairly clear-cut.
Symptoms usually start within days of surgery. They are often more intense than natural menopause.
HRT until at least age 51 if surgery was earlier — unless a specific medical reason makes it unsafe.
Next step: Surgical menopause & early menopause guide →
This usually shows up if you've had a hysterectomy with ovaries kept, or if your answers don't fit a single clear pattern. STRAW+10 explicitly recommends a symptom-based read plus an FSH blood test in this case. Your symptom answers above point to whether HRT is worth a real conversation.
An FSH blood test, drawn at the right time, can confirm where you are. A telehealth doctor can order it.
If symptoms are bothersome, HRT is on the table. The FSH test helps confirm timing.
Next step: Perimenopause vs. menopause → · After hysterectomy →
This tool doesn't diagnose anything. It gives you and your doctor a shared, validated way to talk about where you are in the menopause transition.
Bring your result into a 3-minute consultation. A ClearedRx Medical Network physician reviews your intake within 24 hours, orders an FSH test if it would help, and recommends a specific treatment plan. From $19/mo, no insurance needed.
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Source & methodology
For decades, "am I in menopause yet?" was treated as a yes-or-no question. STRAW+10 changed that. In 2012, an international panel of menopause researchers published a 7-stage framework that maps the entire transition from late reproductive years through postmenopause — based on cycle pattern, with hormone levels and symptoms as supporting evidence.
This tool asks the same questions a menopause specialist would. Cycle pattern is the strongest single signal: if your periods are still on schedule in your early 40s, you're probably not in perimenopause yet. If they're varying by 7+ days from your old normal, you've crossed in. If you're skipping months, you're well into the transition. Symptom answers add texture, especially when cycles can't be used (hysterectomy, surgical menopause).
We built this because most "perimenopause quizzes" online are sales funnels in disguise. They count symptoms and tell every woman over 40 she needs HRT. STRAW+10 is more honest — and more useful. If you're in the late reproductive stage, we say so. If you're well into the transition, we say so. The treatment guidance follows the 2022 NAMS Position Statement and the Endocrine Society's recommendations on early menopause.
Disclaimer. This self-check is an educational tool, not a medical diagnosis. It does not replace a conversation with a licensed doctor. ClearedRx's Medical Network — board-certified MDs licensed in all 50 states — reviews each patient's intake before any prescription is written.
Embed this tool
The self-check works as a standalone iframe with no header, no footer, just the tool. Free to embed. We'd love a link back to clearedrx.com/tools/perimenopause-self-check.
Tip: bump the height to 1900px if your site is narrow — the panel stacks vertically below ~960px wide.
FAQ
STRAW+10 stands for Stages of Reproductive Aging Workshop +10. It's the consensus clinical system used by menopause specialists to stage where a woman is in her reproductive transition — from late reproductive years through perimenopause into postmenopause. It was published in 2012 by an international panel and is the standard staging tool in menopause research and OB-GYN practice.
No. This tool gives you a working estimate of your stage based on cycle pattern and symptoms — the same inputs a clinician uses. A formal diagnosis still needs a doctor's review, sometimes plus an FSH blood test. But the answer here is usually right and gives you a real starting point for the conversation.
Cycle pattern is the strongest single signal in STRAW+10 — more reliable than blood tests in most women under 50. The 2012 panel made cycle changes the primary criterion exactly because hormone levels swing wildly during perimenopause and a single blood draw can mislead. Symptoms add useful texture. The combination is what menopause specialists actually use.
Yes, but with a caveat. If your uterus was removed but your ovaries are still in place, you can't use periods to stage yourself. The tool flags this and recommends a symptom-based read plus an FSH blood test through a doctor. If both ovaries were removed, that's surgical menopause and the tool routes you to that result directly.
Your answers stay on your device. They're saved to your browser's local storage so you can come back to them later. Nothing is sent to ClearedRx or to any server.