Turning 45 With Perimenopause: A Health Checklist to Guide You
A practical perimenopause health checklist for women turning 45. Know which health checks to book, symptoms to watch for, and habits to build in your mid-40s.
Why 45 Is a Meaningful Health Milestone
For many women, 45 is when perimenopause symptoms first become noticeable enough to prompt questions. Cycle irregularity, sleep disruption, mood shifts, and brain fog can all start appearing in the mid-40s. Some women have been experiencing symptoms since their late 30s without knowing they were perimenopausal. Either way, 45 is an excellent time to take stock of where you are, what needs attention, and what habits will serve you through the years ahead.
Medical Checks Worth Booking
At 45, it is worth scheduling a general health review with your GP if you have not had one recently. Ask specifically about: a thyroid function test (thyroid issues are common in women over 40 and mimic perimenopause symptoms), a blood pressure check, a cholesterol panel, a fasting blood glucose test, and a review of your cervical screening status. If you are experiencing significant symptoms, ask about a perimenopause assessment. You do not need to wait until your periods have stopped to have this conversation.
Bone and Muscle Health
Estrogen plays a significant role in bone density maintenance. As levels begin to fluctuate in perimenopause, protecting bone and muscle health becomes a priority. If you have not been doing any resistance or weight-bearing exercise, now is the time to start. Aim for two to three sessions a week. Talk to your GP about vitamin D and calcium intake, as many women are deficient without realising it. If you have risk factors for osteoporosis, a DEXA bone density scan may be appropriate.
Reviewing Your Mental Health
Mood changes in perimenopause are not simply emotional. They have a clear hormonal basis. If you have noticed increased anxiety, low mood, or irritability that is new or worse than before, it is worth documenting and discussing with your doctor. Many women are diagnosed with depression when perimenopause is the underlying driver. Knowing this does not mean medication is wrong, it means the full picture should be considered before a treatment plan is decided.
Sleep, Alcohol, and Lifestyle Adjustments
Perimenopause sleep disruption typically worsens through the 40s and 50s. Prioritising sleep hygiene earlier rather than later pays dividends. Alcohol disrupts sleep architecture significantly and its effects tend to be more pronounced as estrogen declines. Even modest reductions can improve sleep quality. A sustainable exercise routine, adequate protein intake, and stress management all become more impactful in your mid-40s than they were a decade before.
Start Tracking Your Symptoms Now
One of the most valuable things you can do at 45 is start keeping a consistent record of your symptoms. This gives you useful information about your own patterns and gives any healthcare provider you see a much clearer picture than memory alone can provide. The PeriPlan app lets you log symptoms and track changes over time, which can be genuinely helpful both for your own understanding and for medical conversations ahead.
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