Perimenopause is the stage leading up to menopause, when hormone levels start to change and periods become less predictable. For most women it begins in their 40s, and it can last several years. In Australia, the average age of menopause, your final period, is around 51.
Common signs of perimenopause
- Changes to your periods: shorter or longer cycles, heavier or lighter bleeding, or skipped periods
- Hot flushes and night sweats
- Poor sleep, often waking during the night
- Mood changes: irritability, low mood or anxiety
- Brain fog and trouble concentrating
- Joint and muscle aches
- Vaginal dryness or discomfort during sex
- Lower libido
- Headaches or worsening migraines
- Tiredness that doesn't match how much you're doing
Not everyone has all of these, and symptoms can come and go. Many of them can also have other causes, such as thyroid problems or low iron, which is one reason it's worth talking to your GP.
Do I need a blood test?
Usually not. Hormone levels go up and down a lot during perimenopause, so a single blood test often doesn't give a clear answer. For women over 45, perimenopause and menopause are usually diagnosed from your age, your symptoms and your periods. Your GP may still suggest tests to rule out other causes.
Treatment options
There is no single right approach. Options your GP may discuss include:
- Lifestyle measures: regular exercise, good sleep habits, limiting alcohol and caffeine, and a healthy weight
- Menopausal hormone therapy (MHT), which for many women is the most effective treatment for hot flushes and night sweats. Your GP will explain the benefits and risks as they apply to you
- Non-hormonal medicines for hot flushes, mood or sleep
- Vaginal treatments for dryness
- Support for mood, including counselling or a mental health care plan
When to see your GP
- Symptoms are affecting your sleep, work, relationships or wellbeing
- Very heavy or prolonged bleeding
- Any bleeding after your periods have stopped for 12 months, which should always be checked
- Symptoms starting before 45, or periods stopping before 40
Tip: keep a simple diary of your periods, sleep, mood and hot flushes for a few weeks before your appointment. It helps your GP see the pattern.
Want to talk it through? Dr Syed sees patients at Medicross Brygon Medical Centre, Upper Coomera, and Runaway Bay Medical & Dental.
Book online Menopause care with Dr Syed →Common questions
What age does perimenopause start?
Usually in your 40s, although it can start earlier. Symptoms can begin several years before your final period.
How long does perimenopause last?
It varies, but perimenopause often lasts several years. Menopause is confirmed when you have had no period for 12 months.
Can a GP treat perimenopause symptoms?
Yes. GPs commonly assess and manage perimenopause and menopause, including lifestyle advice, hormonal and non-hormonal treatments, and referral when needed.
Further reading: Australasian Menopause Society · Jean Hailes for Women's Health · healthdirect Australia
This article is general information only and is not a substitute for advice about your own health. In an emergency, call 000.
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