Perimenopause and menopause: symptoms, stages and support
Perimenopause is the transition leading up to menopause, when hormone levels start to change and periods become less predictable. It’s a normal stage of life, but the changes can affect sleep, mood, energy and how you feel day to day. This page explains the stages, the common symptoms, what tests can and can’t tell you, and when it’s worth talking to a doctor.
Perimenopause and menopause: what’s the difference?
- Perimenopause is the time before your final period. It often starts in your 40s, sometimes earlier, and can last several years.
- Menopause is your final menstrual period. It’s confirmed once you’ve gone 12 months without a period. In Australia the average age is around 51.
- Postmenopause is the time after that.
Menopause before 45 is called early menopause, and before 40 it’s called premature menopause. If either may apply to you, it’s worth talking to a doctor.
Common symptoms
Symptoms vary a lot from person to person. Some people notice very few, while others find them hard to manage. Common ones include:
- changes to your cycle, such as periods coming closer together or further apart, or becoming heavier or lighter
- hot flushes and night sweats
- trouble getting to sleep or staying asleep
- mood changes, irritability, anxiety or low mood
- difficulty concentrating, sometimes called brain fog
- tiredness and low energy
- changes in weight or body shape, especially around the middle
- joint and muscle aches
- vaginal dryness or discomfort, and changes in interest in sex
- headaches
Symptoms can come and go, and many of them overlap with other conditions, such as thyroid problems or low iron. That’s one reason a proper assessment matters.
How perimenopause is assessed
Perimenopause is usually recognised from your age, your symptoms and changes in your cycle. Hormone levels fluctuate significantly from day to day during perimenopause, meaning a single hormone blood test cannot reliably confirm or rule it out on its own.
Blood tests are often more useful for checking other things that can cause similar symptoms, such as thyroid function, iron levels, blood sugar and cholesterol, and for getting a broader picture of your general health.
What happens in a Nexus women’s hormone consultation
- Pathology. Arrange the blood test for your consultation through iMedical.
- Health assessment. Complete the online health assessment about your symptoms, your cycle, your health history and what you’d like help with.
- Telehealth consultation. A registered medical practitioner calls you by phone and goes through your results and health assessment with you.
- A plan, if appropriate. If treatment is clinically appropriate, your doctor will discuss the options and recommend a plan, with follow-up support. Your doctor may also suggest seeing your GP or a specialist where that’s more appropriate.
Your doctor decides what’s right for you, and a consultation doesn’t guarantee a prescription. Find out about the women’s hormone health and weight management consultation.
Sleep, mood and weight
Hormone changes can affect sleep, and poor sleep in turn affects mood, energy and appetite. Many people also find their weight harder to manage in midlife. Alongside your results, your doctor may talk with you about sleep, physical activity, nutrition, alcohol and stress, and how they fit with what you’re experiencing.
When to see a doctor in person
See your GP promptly if you have any bleeding after menopause, very heavy bleeding, bleeding between periods or after sex, or symptoms of menopause before the age of 40. If you’re feeling very low or having thoughts of harming yourself, call Lifeline on 13 11 14, or 000 in an emergency.
Frequently asked questions
What age does perimenopause start?
Most people notice changes in their 40s, and some in their late 30s. It can last for several years before the final period.
Can a blood test tell me if I’m in perimenopause?
Not usually on its own. Hormone levels change from day to day during perimenopause, so doctors look at your age, symptoms and cycle as well. Blood tests are helpful for checking other possible causes of your symptoms.
Do perimenopause symptoms go away?
For many people, symptoms ease in the years after menopause, but the timing varies and some symptoms can last longer. Your doctor can talk with you about what to expect.
Can perimenopause cause anxiety or tiredness?
It can contribute to both, often through disrupted sleep. Other causes are worth checking too, which is why your doctor looks at your results and health history together.
Is the consultation done by telehealth?
Yes. Consultations are by phone with a registered medical practitioner, wherever you are in Australia.
Will I be prescribed something?
Only if your doctor decides treatment is clinically appropriate after assessing you. Booking a consultation doesn’t guarantee a prescription.
This page is general information only and isn’t a substitute for advice from your own doctor.
Clinical review
Clinically reviewed by Dr Built Varinporn Amporndanai. AHPRA registration number: MED0002175812.