Perimenopause / Menopause Transition

The perimenopause / menopause transition begins from onset of the first menopausal symptom or menstrual irregularity and ends 1-2 years after the last menstrual period depending on age. The length of the perimenopause differs from woman to woman and can last several years.Women might notice a change in their period cycle with periods becoming shorter, heavier or lighter with a longer gap in between. Women might also experience the beginning of other symptoms caused by the fluctuation of hormones during this period, particularly due to a drop in circulating oestrogen. This decrease in oestrogen causes the symptoms associated with menopause such as:

  • Hot flushes
  • Night sweats
  • Insomnia and poor sleep
  • Palpitations
  • Cognitive symptoms such as“brain fog”, forgetfulness and poor concentration
  • Psychological symptoms such as anxiety, depression, irritability, mood swings (also caused by fluctuating levels of progesterone)
  • Lethargy and lack of energy
  • Joint pains
  • Vaginal dryness
  • Painful sex
  • Reduced libido (also potentially caused by low testosterone)
  • Urinary frequency and incontinence
  • Loss of bone mineral density
  • Dry eyes, skin, hair and nails
  • Headaches

Therefore, “menopausal symptoms” can start in the perimenopause period, before a woman can be considered to have “gone through” the menopause or be postmenopausal. On average, symptoms last for approximately 3-7 years, but can be worse in the first 2 years after the last period. 1/3 of women will experience symptoms lasting longer than 7 years and 70% of women will experience 1 or more symptom. Because hormones can fluctuate during the menopause transition, and the diagnosis of menopause is not firmly made until 12-24 months after a woman’s last period, usually interpretation is made on history and assessment, and not interpretation of blood tests.

Treatment Options

Treatment options include both hormonal and non-hormonal options such as:

  • Hormone Replacement Therapy
  • Non-Hormonal Oral Therapy
  • Complementary therapies
  • Lifestyle changes
  • Psychological therapies