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Perimenopause

Perimenopause is the transitional stage leading up to menopause, when the ovaries gradually produce less oestrogen and prosterone. It usually begins in the 40s but can start earlier or later. This phase can last for several years until menopause is reached (defined as 12 months after the final period).

Symptoms & Causes Treatment Find A Specialist

Perimenopause typically lasts several years and ends 12 months after your final menstrual period (menopause).

It is a normal life stage, but the hormonal changes can cause a wide range of symptoms that vary from person to person and may affect quality of life. 

How is Perimenopause Diagnosed? 

Diagnosis is usually based on your symptoms and menstrual changes. Your doctor may also consider: 

  • Discussion of menstrual patterns – irregular or skipped periods are often the first sign 

  • Blood tests – may be used to check hormone levels, although results can vary from day to day 

  • Physical examination – to exclude other causes of symptoms 

Not everyone will experience the same symptoms, but common ones include: 

  • Irregular or changing menstrual cycles 

  • Hot flushes and night sweats 

  • Sleep difficulties or insomnia 

  • Mood swings, anxiety, or low mood 

  • Vaginal dryness or discomfort during sex 

  • Reduced libido (sex drive) 

  • Difficulty concentrating or memory changes (“brain fog”) 

  • Fatigue 

  • Weight gain or bloating 

  • Joint or muscle aches 

Perimenopause Treatment

Treatment is available if symptoms are troublesome. Support and treatment can help manage symptoms, improve wellbeing, and protect long-term health.

Plans are individualised depending on your age, health, and personal preferences. 

Perimenopause can be a challenging time, but support and treatment are available. Talking with a specialist gynaecologist about your symptoms and concerns can be very helpful. With the right management, many people find ways to maintain their quality of life and wellbeing. 

There is no need to struggle alone. Your specialist will work with you to find the treatment and support options that are right for you. 

Medications

  • Menopausal Hormone Therapy (MHT): replaces oestrogen (and sometimes progesterone) to ease symptoms such as hot flushes, night sweats, and vaginal dryness. MHT can also support bone health and reduce risk of osteoporosis. 

  • Non-hormonal medicines: some antidepressants, blood pressure medicines, or epilepsy medicines may reduce hot flushes and mood symptoms. 

  • Vaginal oestrogen creams, rings, or tablets: effective for vaginal dryness and discomfort. 

Lifestyle Approaches

  • Eating a balanced diet rich in calcium and vitamin D 

  • Regular exercise, including weight-bearing activity for bone health 

  • Improving sleep routines and reducing stress (mindfulness, yoga, relaxation techniques) 

  • Limiting caffeine, alcohol, and smoking, which can worsen symptoms 

Find A Specialist

View All Staff

  • Dr Kate van Harselaar

    Gynaecologist