ACOG Released New Guidance for Perimenopause Care
A new clinical toolkit helps doctors better manage the hormonal changes that typically begin around age 47.
Updated on Sept. 23, 2026 in Women’s Health
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The American College of Obstetricians and Gynecologists has published a clinical toolkit in the journal Obstetrics & Gynecology to improve the management of perimenopause. The resource provides a framework for clinicians to help midlife patients manage symptoms before they become severe.
Why it matters
Perimenopause is a hormonally dynamic and clinically complex stage of life that is physiologically distinct from menopause. This new guidance aims to improve care access by encouraging clinicians to provide anticipatory support during routine visits.
The toolkit, published in Obstetrics & Gynecology, outlines a clinical framework for addressing the hormonal continuum of perimenopause. While it synthesizes existing strategies, authors acknowledge that better evidence is needed to determine the most effective treatment approaches.
The players
American College of Obstetricians and Gynecologists
A professional association of physicians specializing in obstetrics and gynecology that sets clinical practice standards for reproductive health.
The details
The guidance focuses on managing the hormonal shifts that define perimenopause by using ovarian suppression through hormonal contraception and systemic estrogen supplementation. Clinicians are encouraged to assess a patient's bleeding patterns, contraceptive needs, and underlying medical risk factors to create tailored plans. The framework also allows for combining contraceptive methods with menopausal hormone therapy to address both symptom control and reproductive health.
Timeline
The Stages of Reproductive Aging Workshop +10 system was introduced in 2012.
The clinical toolkit was published in Obstetrics & Gynecology on September 23, 2026.
Health Landscape
This toolkit builds upon the diagnostic framework established by the 2012 Stages of Reproductive Aging Workshop +10 system. It marks a shift toward standardized management of the hormonal continuum as clinicians work to bridge the gap in care before patients reach menopause.
If you are in your mid-40s and experiencing symptoms or changes in your cycle, it is worth discussing your concerns and potential treatment options with your doctor. Early conversations can help you identify a personalized approach, such as hormonal contraception or hormone therapy, before symptoms intensify.
The takeaway
Perimenopause is a distinct hormonal phase that often begins around age 47, yet it currently lacks FDA-approved, targeted treatments. Keep track of your symptom patterns and cycle changes to facilitate a more effective, proactive conversation with your primary physician or gynecologist.
Further reading
For more on managing midlife hormonal changes, explore our guide to Women’s Health.
Source note: This article includes information reported by Medscape.
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Do you trust clinical guidelines to improve the care women receive during the menopause transition?
