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Perimenopause: Understanding Symptoms and Seeking Solutions

Updated: Jun 14

Perimenopause is a crucial phase in a woman's life, marking the transition leading up to menopause. While the medical definition of menopause involves a 12-month absence of periods, the term is widely used to encompass the entire process of change in reproductive capabilities.


1. Pre-menopause: This phase encompasses the time in your life before any menopausal symptoms occur.

2. Perimenopause: During this stage, menopausal symptoms emerge due to hormonal changes, yet menstruation persists.

3. Menopause: This marks the point when you haven't had a period for 12 consecutive months.

4. Postmenopause: The subsequent phase encompasses the rest of your life after reaching menopause.



For most women, perimenopause isn't a fleeting experience; it spans many years, bringing with it a variety of symptoms. The severity of these symptoms can vary greatly, with some enduring only a few months and others persisting for years, even decades. Perimenopause precedes menopause by 4 months to 10 years.


Common Symptoms of Perimenopause:

1. Period Changes: The first sign often involves alterations in menstrual flow and irregular periods, ultimately leading to their cessation.

2. Hot Flushes: Affecting three out of four women, sudden and intense hot flushes are a hallmark symptom.

3. Night Sweats: Many women experience night sweats, leading to disrupted sleep and the need for a change of bedclothes.

4. Mood Changes: Disruptive mood swings may occur, particularly for those with a history of premenstrual syndrome or postnatal depression.

5. Fatigue and Poor Sleep: Insomnia and daytime fatigue can accompany perimenopause, impacting daily life.

6. Brain Fog: Memory slips, poor concentration, and a feeling of mental haziness are common cognitive symptoms.

7. Loss of Sexual Desire: Decreased interest and pleasure in sexual activities are linked to declining testosterone levels.

8. Joint Pains and Muscle Aches: Estrogen decline can lead to joint soreness and aching muscles.

9. Hair and Skin Changes: Lower estrogen levels affect collagen production, resulting in skin changes and alterations in hair texture.

10. Worsening Migraines: Migraines may become more severe and frequent during perimenopause.

11. Vaginal and Urinary Symptoms: Thinning of vaginal tissues, dryness, and urinary changes are common, impacting comfort and daily activities.

These symptoms, while challenging, are part of a natural process. It's crucial to seek professional guidance for navigating perimenopause effectively.


Diagnosing Perimenopause:

If your periods are changing, and you experience one or more symptoms of menopause, a hormone top-up can be beneficial. I often advise women that while I can't pinpoint which symptoms are specifically linked to hormonal imbalances, we can explore balancing your hormones using body-identical hormones to observe the effects. There is no precise blood test for perimenopause. In my experience, during perimenopause, menstrual patterns shift, and women may encounter one or more symptoms of menopause.


Long-term Health Implications:

Perimenopause and menopause can have lasting effects on health, increasing the risk of osteoporosis, cardiovascular disease, and other conditions. Awareness and proactive management are key to mitigating potential risks.


Treatments for Perimenopause:

Hormone Replacement Therapy (HRT) is a highly effective method for managing symptoms. Initiating HRT before or around the onset of menopause proves most beneficial. However, only a small fraction of women who could benefit from HRT opt for it.


In conclusion, understanding perimenopause, acknowledging its symptoms, and seeking appropriate treatments empower women to navigate this natural phase of life with grace and resilience. It's never too early to explore options and prioritize your well-being during this transformative journey.



By Dr Purity Carr

GP & Menopause Doctor

Harvey, WA

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