What is perimenopause?
Perimenopause is the time leading up to menopause, while the ovaries are gradually producing less oestrogen. Menopause itself is confirmed when you have had no period for 12 months, which for most women happens between the ages of 45 and 55. Perimenopause can begin several years before that.
What are the symptoms of perimenopause?
- Periods that become irregular, heavier, lighter, closer together or further apart
- Hot flushes and night sweats
- Difficulty sleeping
- Low mood, anxiety or irritability
- Poor concentration or memory, sometimes called brain fog
- Vaginal dryness and discomfort during sex
- Needing to pass urine more often, or bladder leaks
- Aching joints and lower energy
How is perimenopause diagnosed?
For women over 45, perimenopause is usually diagnosed from your symptoms and changes in your periods. Blood tests are not always helpful because hormone levels change from day to day, but they may be used for younger women or when the picture is unclear. Your doctor will also check for other causes, such as thyroid problems or anaemia.
What are the treatment options for perimenopause?
- Hormone replacement therapy (HRT): replaces oestrogen to relieve hot flushes, night sweats and other symptoms. Women who still have a womb also take a progestogen. The benefits and risks depend on your age and health, and are discussed with you individually.
- Non-hormonal medicines: an option for women who cannot or prefer not to take HRT.
- Vaginal oestrogen and moisturisers for dryness and urinary symptoms.
- Lifestyle measures: regular exercise, good sleep habits, limiting alcohol and caffeine, and attention to bone and heart health.
Do I still need contraception?
Yes. You can still become pregnant during perimenopause. Contraception is generally advised until you have had no periods for 12 months if you are over 50, or for two years if you are under 50. Hormonal contraception can mask your natural periods, so your doctor may advise continuing it until age 55, when most women can stop. Your doctor can also suggest options that help with heavy or irregular periods.
When should I see a doctor?
This article is general information and does not replace a consultation with a doctor. If you are worried about your health, please book a visit or, in an emergency, call +65 6535 8833.
