Perimenopause

Perimenopause is the transition leading up to menopause, when ovarian hormone patterns change and periods may become less predictable. Hot flushes, sleep disruption, mood changes and vaginal symptoms can occur. Pregnancy remains possible during this stage, and new or unusual symptoms still need assessment rather than being automatically attributed to hormones.

Is a hormone test the best way to know?

Hormone levels fluctuate, so a single result may not explain the whole picture. A clinician usually considers age, symptoms and menstrual changes, and decides whether testing is useful. Other causes of fatigue, irregular bleeding or temperature symptoms may need to be considered.

Record when periods occur, how heavy they are and which symptoms affect daily life. Mention contraception and any possibility of pregnancy. If bleeding is unusually heavy, occurs after sex or changes significantly from your usual pattern, describe that specifically rather than calling it irregular periods.

For the Australian guidance behind this explanation, see Healthdirect Australia: Perimenopause - Healthdirect Australia.

What help is available?

A doctor can discuss symptom management and whether medical treatment is appropriate. Your priorities may be better sleep, managing hot flushes, vaginal comfort or maintaining work and relationships. The plan should fit your health history and preferences, with a clear time for review.

Ask how contraception fits with the proposed approach. Treatment for menopausal symptoms and pregnancy prevention are not automatically the same thing. Avoid changing established contraception or buying hormonal products online without advice. If a treatment is started, ask which changes should prompt earlier review.

When should I seek prompt care?

Heavy bleeding with dizziness, collapse or severe pelvic pain needs urgent assessment. Persistent unusual bleeding also needs investigation. Telehealth can support a careful history, but examination or tests may be required. A useful appointment ends with a plan for both symptom relief and any unresolved questions about the cause of your symptoms.

Where to go next

Read online doctor consultations to understand the relevant service. A doctor decides whether a consultation, examination, referral or another pathway is appropriate for your situation.