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Perimenopause
5-minute read
Key facts
- Perimenopause is the stage leading up to your final period (menopause).
- During perimenopause, your periods may become irregular and you may have other symptoms such as hot flushes and vaginal dryness.
- Tests are usually not needed to confirm perimenopause.
- A healthy lifestyle can help ease your symptoms.
- Treatments are available to help you manage your perimenopausal symptoms.
What is perimenopause?
Perimenopause is the stage leading up to menopause. It begins when your periods become irregular and lasts until 12 months after your final period.
Perimenopause usually happens between 45 and 55 years of age and lasts about 4 to 8 years.
You have reached menopause when you have not had a period for 12 months. The next life stage is known as postmenopause.
If menopause happens before 40 years of age, it is called premature menopause. If it happens between 40 and 45 years of age, it is called early menopause.
Read more on premature and early menopause.
What are the symptoms of perimenopause?
A common symptom you may experience during perimenopause is irregular periods.
Your periods may:
- come more or less often
- be longer or shorter than usual
- be lighter or heavier than usual
Some months you may have no period at all.
What other perimenopausal symptoms could I get?
Perimenopause may lead to physical and emotional changes as your hormone levels rise and fall.
Common physical symptoms include:
- hot flushes and night sweats
- trouble sleeping and tiredness
- headaches
- muscle aches and joint pain
- vaginal dryness and sore breasts
- changes in sexual desire
- weight gain
Emotional symptoms of perimenopause may include:
- mood swings
- low mood or depression
- anxiety
CHECK YOUR SYMPTOMS — Use the Symptom Checker and find out if you need to seek medical help.
What causes perimenopause?
Perimenopause happens as your body transitions towards menopause — your final period.
During this time, your ovaries make less oestrogen and progesterone, the hormones that control your menstrual cycle. Hormonal changes lead to perimenopausal symptoms.
Some people may have sudden menopause because of surgery or cancer treatment.
When should I see my doctor?
See your doctor if perimenopausal symptoms are bothering you or affecting your daily life.
Even though changes in your periods are normal, you should see your doctor if:
- your bleeding is very heavy or lasts longer than usual
- you bleed between your periods
- you bleed after sex
Your doctor may refer you to a:
- gynaecologist (specialist in female health)
- psychologist
- endocrinologist (hormone specialist)
- dietitian
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How is perimenopause diagnosed?
Perimenopause is usually diagnosed based on your age, symptoms and period changes.
Your doctor may ask about your:
- periods
- symptoms
- medical history
They may also do a pregnancy test if you are sexually active and have not had a period recently.
A blood test may be used to check your hormone levels. If you are under 45 years of age, a follicle-stimulating hormone (FSH) test may help diagnose menopause. A high FSH level can mean you are nearing menopause.
ASK YOUR DOCTOR — Preparing for an appointment? Use the Question Builder for general tips on what to ask your GP or specialist.
How is perimenopause treated?
Your treatment depends on your symptoms and preferences. Your doctor will talk with you about different options, such as:
- menopause hormone therapy (also known as hormone replacement therapy) — may reduce symptoms such as hot flushes, night sweats and sleep problems
- non-hormonal prescription medicine — may help if hormone replacement therapy is not right for you
- lifestyle and behavioural changes — regular exercise, healthy eating, good sleep and stress management can ease your symptoms and improve wellbeing.
Some people try supplements or herbal remedies. There is no strong evidence that these work for perimenopausal symptoms.
If you have vaginal dryness, you can use lubricants to feel more comfortable.
Talk with your doctor about contraception, as it is still possible to become pregnant until menopause is confirmed.
Living with perimenopause
Perimenopause is a natural part of life, but symptoms may affect your mood, sleep and daily activities.
Understanding what is happening in your body and talking openly with your doctor can help you find the right support.
Healthy habits can make this time easier and improve your wellbeing.
What are the complications of perimenopause?
Perimenopause can cause changes in your body that affect your bones, heart and reproductive system.
You may experience:
- bone thinning (osteoporosis)
- bladder changes, such as needing to urinate more often or feeling pain when urinating
- weight gain, which may increase your chance of heart disease
Pregnancy
You can still become pregnant until you reach menopause.
If your period stops, take a pregnancy test to check.
Use contraception during perimenopause if you do not want to become pregnant.
Can perimenopause be prevented?
Perimenopause is a natural stage of life and cannot be prevented.
Lifestyle changes can help reduce symptoms during this time.
Resources and support
NSW Health has a list of perimenopausal symptoms. The list is available in English and other languages, including an easy-read version.
There is also a checklist for Aboriginal and/or Torres Strait Islander females.
Partners and families can learn more at:
- Jean Hailes — information for partners
- NSW Health — understanding menopause for partners and families
Jean Hailes also has easy read fact sheets and videos in an accessible format to help people living with disabilities understand information.
You can also call the healthdirect helpline on 1800 022 222 (known as NURSE-ON-CALL in Victoria). A registered nurse is available to speak with you 24 hours a day, 7 days a week.