PeriHow to keep a perimenopause symptom diary
A symptom diary turns “I haven’t felt right for months” into dates, patterns and examples you can show a clinician. Here’s a simple way to keep one, on paper or in an app.
On this page
Why a diary helps
Perimenopause doesn't look the same for everyone. Some people have few symptoms; others have many that affect work, sleep and relationships, and the mix often changes over the years.14 When symptoms come and go, it's hard to describe them from memory in a ten-minute appointment.
For people aged 45 or over, NICE guidance says clinicians can usually identify perimenopause from symptoms and changes to periods, without blood tests.2 That makes your own record useful context. A diary doesn't diagnose anything. It gives you and your clinician something concrete to look at.
What to write down each day
Keep it short enough that you'll still be doing it in a month. One line per day is plenty:
| Record | How |
|---|---|
| Symptoms | Each symptom you had, rated 1 to 5. Leave it blank if you didn't have it. |
| Bleeding | Period start or end, spotting, and flow: light, normal or heavy. See tracking period changes. |
| Sleep | Roughly how many hours, and whether night sweats woke you. |
| Mood, energy, stress | A quick 1 to 5 for each. |
| Medicines | HRT doses or anything else you took. See how to keep an HRT log. |
| Note | One sentence: what helped, what made it worse, or what you missed because of it. |
A simple 1 to 5 scale
Use the same meaning every day so the numbers can be compared:
- Barely noticed it
- Noticeable but easy to ignore
- Got in the way a bit
- Hard to get through the day
- Stopped me doing something
Which symptoms to include
The NHS lists a wide range of symptoms linked to perimenopause and menopause, including:1
- changes to periods: more or less often, heavier or lighter
- hot flushes and night sweats
- trouble getting to sleep or staying asleep
- mood swings, low mood, anxiety, poor memory or concentration (brain fog)
- vaginal dryness, discomfort, or pain during sex
- more urine infections, or needing to pee more often
- palpitations, headaches, muscle aches and joint pain
- hair thinning, dry or itchy skin, and a lower sex drive
You don't need to track all of them. Pick the five to eight that bother you most, and add one if something new starts. A shorter list you keep up beats a long one you abandon.
How long to keep it
A few weeks is usually enough to show a pattern. If you still have periods, covering two or three cycles shows how symptoms line up with bleeding. Keep going if you start a new treatment, so you have a before and after.
When you look back, count how many days each symptom appeared, its usual rating, and whether it is getting better, worse or staying the same. Those three numbers are easier to talk through than a page of daily ticks.
Don't wait for the diary if…
The NHS advises contacting a GP if you think you have perimenopause symptoms and want to know your options. It also advises a GP if you have palpitations, if your bleeding has changed and you're bleeding more, not less, or if you have any vaginal bleeding after 12 months without a period.1 If you're under 45 and think you have menopause symptoms, the NHS also suggests seeing a GP.3
For anything severe or sudden, use your usual urgent care or emergency services.
On paper or in an app
Both work. Paper is quick to start: our printable symptom diary lets you choose your symptoms and print a 7, 14 or 28-day grid.
Peri keeps the same diary on your phone: one check-in per day, 34 built-in symptoms plus your own, each rated 1 to 5, with mood, energy, stress, sleep and a note. It counts the days and averages for you. You can export everything as a CSV file for free, and Premium adds a PDF report for appointments.
Sources
We link to the original pages so you can read them in full. Guidance differs between countries; your own clinician's advice comes first.
- NHS. Symptoms of menopause and perimenopause. Page last reviewed 19 May 2026. Accessed 20 October 2026.
- NICE. Menopause: identification and management (NG23): Recommendations. Published 12 November 2015, last updated 15 April 2026. Accessed 20 October 2026.
- NHS. About hormone replacement therapy (HRT). Page last reviewed 7 February 2023. Accessed 20 October 2026.
- ACOG. The Menopause Years. Last reviewed December 2025. Accessed 20 October 2026.
