Perimenopause

Early Perimenopause

Variable cycles

Cycle length begins to shift, often becoming shorter, while periods continue. Oestrogen fluctuates erratically. Symptoms may emerge years before any obvious cycle change.

Late Perimenopause

Skipped periods

Gaps of 60 days or more between periods signal late perimenopause. Oestrogen and progesterone levels drop more steeply. Symptoms often intensify during this stage.

Menopause

12 months without a period

Menopause is confirmed retrospectively, defined as 12 consecutive months without menstruation. The average age in Australia is 51 to 52, but the range is wide.

Postmenopause

All years that follow

Oestrogen remains at a consistently low level. Many symptoms ease, but long-term effects on bone density, cardiovascular health, and cognition become relevant considerations.

The transition is not a steady decline.

Oestrogen levels in perimenopause rise and fall unpredictably, sometimes dramatically within a single cycle or even within days. This hormonal volatility, rather than simply low oestrogen, drives many of the most disruptive symptoms. It also means that standard hormone blood tests taken on a single day can be misleading and are rarely sufficient to guide diagnosis on their own.

Common symptoms

• Hot flushes and night sweats
• Sleep disruption
• Irregular or heavy periods
• Mood changes, anxiety, low mood
• Brain fog and concentration difficulties
• Vaginal dryness and discomfort
• Reduced libido
• Joint and muscle aches
• Heart palpitations
• Headaches and migraines
• Urinary urgency or frequency
• Changes in skin, hair, and nails

Comprehensive Assessment

A thorough history, symptom review, and targeted investigations to understand where you are in the transition and what is driving your symptoms.

Menopausal Hormone Therapy

Evidence-based MHT tailored to your stage, symptom profile, and medical history, including body-identical oestrogen and progesterone options.

Non-Hormonal and Herbal Options

For women who prefer or require alternatives to hormones, we discuss evidence-informed options including prescribed non-hormonal medications, herbal supplements, dietary approaches, and mind-body therapies such as cognitive behavioural therapy and mindfulness.

Ongoing Management

Perimenopause is not static. We provide regular review and adjustment of your treatment as your hormonal picture evolves over time.