Understanding Perimenopause
Perimenopause is the transition leading up to the last period, and it commonly begins in the early to mid forties, sometimes earlier. Hormone levels fluctuate rather than simply declining, which is why symptoms come and go and why so many women are told there is nothing wrong.
Cycles become unpredictable, periods may be heavier or lighter, and hot flushes, night sweats, disturbed sleep, mood changes, joint aches and reduced concentration are all common. These are real, hormonally driven symptoms, and there is a good deal that can be done about them.
How We Help
Care is individualised, and we are careful not to attribute everything to hormones without ruling out other causes.
- Assessment and exclusion of other causes - thyroid disorders, anaemia and other conditions produce similar symptoms.
- Evaluating abnormal bleeding - heavy or erratic bleeding in this phase always deserves proper assessment.
- Managing hot flushes and night sweats - hormonal and non-hormonal options, with the benefits and risks explained plainly.
- Menopausal hormone therapy - discussed honestly, with individual suitability assessed rather than a blanket recommendation.
- Sleep and mood support - practical strategies, and referral where anxiety or low mood needs dedicated attention.
- Bone health - calcium, vitamin D, weight-bearing exercise and bone density testing where indicated.
- Heart health screening - blood pressure, lipids and glucose, since cardiovascular risk rises after menopause.
- Contraception advice - pregnancy is still possible during perimenopause, and this is often overlooked.
Periods that become very heavy, cycles closer than 21 days apart, or bleeding between periods should not be put down to perimenopause without being properly assessed first.
