What you need to know about Perimenopause

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Perimenopause can take many women by surprise. Often women in their 40s (which is a common time for perimenopause to begin) are so busy with work, children, caring for elderly parents, planning dinners, paying bills, and planning the family’s appointment calendar that they are not really paying attention to their menstrual cycle or bodily changes.

Learning about perimenopause can help us cope better when we do notice changes are occurring. It will also be a time to remind ourselves that we are capable, confident, enlightened, and powerful women.


What is perimenopause?

For up to 40 years, women experience a monthly menstruation cycle, and then that starts to change as women approach what is known as menopause (when menstruation ends).  A woman’s body starts to produce less estrogen (one of the sex hormones) towards the end of her reproductive years (most commonly in a woman’s late 30s or in their 40s). Symptoms vary between women; however, examples might include muscle cramps, period changes, foggy thinking/memory loss, or trouble sleeping.

This stage is called perimenopause and it can start to occur eight to 10 years ahead of menopause. Symptoms can come and go, over a duration of a few months or for as long as 4-6 years.



Perimenopause is when your ovaries are starting to wind down. Some months you might ovulate, while in other months no egg will be released. Hormonal fluctuations are quite common. Night sweats and flushes can happen, triggered by a drop in oestrogen and then the oestrogen could shoot back up again and cause issues such as swollen or tender breasts.

Most women do not notice perimenopause much at all, but about 20% of women might experience moderate to severe symptoms.

Symptoms of perimenopause can include:

  • Hot flushes
  • Night sweats
  • Problems falling asleep, staying asleep or sleep quality issues
  • Breast tenderness
  • Itchy/crawly/dry skin
  • Trouble concentrating
  • Irregular periods
  • Vaginal dryness
  • Loss of libido (sex drive)
  • Exhaustion
  • Mood changes
  • Migraines
  • More pronounced pre-menstrual tension
  • Weight gain due to a slowed metabolism
  • Menstrual fluctuations.

With menstrual fluctuations such as lighter bleeding, heavier bleeding, spotting, etc, and other symptoms it is important to see a doctor to ensure other problems such as fibroids, or some cancers can be ruled out.


Perceptions and misconceptions

Unfortunately, in Australian society there is so much obsession with looking young that women can suffer terrible mental angst just by the thought of approaching menopause. They can associate this time with being “old” or “no longer relevant”. In other cultures throughout the world, it can represent wisdom, freedom, and great respect. As one of our menopause specialists used to say: “The way we view menopause in our society is sadly outdated, awash with information and in dire need of a sexy new makeover!”

Another sad truth is that so many of the approximate 50% of women who experience menopausal symptoms in Australia simply think they need “to put up with it”. This is a myth. There are many options that do not involve medications in the first instance, including a focus on having a Mediterranean diet. Such diets are high in fruits, vegetables, Omega 3 fats and adequate protein. Combine this diet with regular exercise to maintain healthy bones and lift hormones.

There is also fear around hormone replacement therapy, known as HRT. There is a general misconception HRT is not safe, however it is wise to talk to your doctor about your body, medical history, and the risks and benefits impacting you as an individual. In so many cases the benefits far outweigh the risks, and it is best to know all the facts so that you can make an informed decision about treatment. The misconception about HRT has given rise to women using so-called “natural hormone supplements” which may lack safety guarantees, so please check these over with your GP first if that is your preferred approach.

It is important to remember contraception is also still needed during perimenopause, as you can still fall pregnant.


Symptoms management

As mentioned, there are treatments available to provide relief as well as lifestyle changes. Sometimes lifestyle changes are the only change to make. Hormone therapy or taking the contraceptive pill may be options your doctor will talk to you about, based on your medical history, other medications, and your symptoms.


How we can help 

Eve Health is committed to excellence in women’s healthcare in Brisbane. We help women to better manage their perimenopause and menopausal symptoms. We believe in personalised, expert, and comprehensive care for girls and women of all ages.

For our full range of gynaecology, fertility, obstetrics, and allied health services please visit us at www.evehealth.com.au.


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