01
Understanding the issue
Perimenopause and menopause are related, but they do not mean exactly the same thing.
Perimenopause
Perimenopause is the transitional time before menopause. During this stage, the ovaries gradually change how they produce hormones such as oestrogen and progesterone.
Periods may become less regular. They may occur more or less often, and bleeding may become lighter or heavier. Some people also experience hot flushes, night sweats, sleep problems, mood changes, anxiety, reduced concentration, headaches, joint discomfort or vaginal dryness.
Perimenopause usually begins in the 40s, although it can start earlier. It may last for several years, and the symptoms and menstrual changes can vary considerably from one person to another.
Menopause
Menopause is the point at which you have not had a menstrual period for 12 consecutive months, provided that there is no other medical reason for your periods to have stopped.
Natural menopause commonly occurs between the ages of 45 and 55. After menopause, the following stage is known as postmenopause.
The important difference
Perimenopause is a period of transition during which periods and hormone levels are changing. Menopause is confirmed retrospectively, after 12 months without a period.
It is still possible to become pregnant during perimenopause because ovulation may still occur. Hormone replacement therapy, commonly called HRT, does not provide contraception.
02
Practical next steps
• Keep a simple record of your periods, including changes in timing, flow or spotting.
• Note any symptoms such as hot flushes, night sweats, sleep disturbance, mood changes, headaches or vaginal discomfort.
• Consider how the symptoms are affecting your sleep, work, relationships and everyday wellbeing.
• Maintain regular physical activity, a balanced diet and a consistent sleep routine where possible.
• If you need contraception, continue using an appropriate method and discuss your individual circumstances with a GP or other qualified healthcare professional.
• Speak with your GP, practice nurse or pharmacist if symptoms are troubling you or you would like to discuss treatment and support options.
03
When to seek further help
Speak with your GP if menopause or perimenopause symptoms are affecting your daily life, or if you would like advice about diagnosis, contraception or treatment options.
You should also seek medical advice if:
• your periods become much heavier than usual or the bleeding pattern concerns you;
• you experience bleeding after sex or between periods;
• you have symptoms of menopause before the age of 45, particularly if you are under 40;
• you have palpitations or other symptoms that may need a separate medical assessment; or
• you have any vaginal bleeding after having no periods for 12 months or longer.
Changes to periods can occur during perimenopause, but they should not automatically be assumed to be caused by hormonal changes. A healthcare professional can assess whether further investigation is needed.
