These days, it’s great to see more conversations happening around perimenopause. But the reality is, many women and people assigned female at birth still have their symptoms misdiagnosed or misunderstood.

This often leads to confusion about what perimenopause actually is and whether you’re experiencing it yourself. So let’s take a moment to talk about perimenopause, that transitional stage before menopause when, for many of us, life starts to feel noticeably different.

First of all, what is perimenopause?

Perimenopause is the lead-up to menopause – your body’s way of winding down its reproductive years. It’s a totally natural phase, but it can come with some changes.

Think: irregular periods, shifts in mood or sleep, and a variety of other symptoms. Most people in Australia reach menopause around age 51 or 52, but perimenopause often starts in your 40s. It can last anywhere from one to 10 years, though four to eight is the average.

What are some other symptoms I may experience?

For some people the start of perimenopause begins with hot flushes, for others its heavy bleeding, or irregular periods, for some its feelings of anxiety or depression, for many it’s a combination of the above topped off with other symptoms to boot!  Symptoms can include:

• Hot flushes
• Lightheaded feelings
• Headaches
• Irritability
• Depression
• Unloved feelings
• Anxiety
• Mood changes
• Breast tenderness
• Difficulty concentrating or brain fog
• Sleeplessness
• Unusual tiredness
• Backache
• Muscle and Joint pains
• New facial hair
• Dry skin
• Crawling feelings under the skin
• Less sexual feelings
• Dry vagina
• Uncomfortable intercourse
• Urinary frequency

OK, so how is perimenopause diagnosed?

Perimenopause is a clinical diagnosis that is based on your symptoms and the age at which you started to experience symptoms. There is no single test or investigation which is used to diagnose perimenopause. Your health professional may use self-assessment tools and questionnaires like a “symptom checker” to help document your symptoms and provide helpful management advice.

Is there a blood test to see what my hormones are doing?

While you can have your hormone levels checked, it is not recommended we use blood tests as an accurate measure of perimenopause. This is because oestradiol (oestrogen), progesterone, FSH (Follicle-Stimulating Hormone), LH (Luteinising Hormone), testosterone, AMH (Anti-Müllerian Hormone) levels fluctuate significantly day-to-day. So, while you can request this test; the results might not always be helpful. Check out this chart below to see how your hormones can affect you during perimenopause.

What can I do about my symptoms?

There is no ‘right’ or ‘best way’ of managing perimenopausal symptoms if they bother you. Lifestyle changes can help some, whilst others may need to discuss medication options with a health professional. There are both non-hormonal and hormonal prescription medicines available to help you depending on your symptoms. You may wish to discuss Menopause Hormone Therapy (MHT) which used to be known as HRT with your doctor. Your periods don’t have to have stopped for you to start MHT and sometimes this may be the most appropriate management option.

What about natural remedies?

There are many ways to help you deal with perimenopause without needing to take medication. These lifestyle changes can also improve overall health and wellbeing. Regular exercise, a balanced diet rich in calcium and vitamin D, avoiding smoking and alcohol, managing stress, and getting good sleep can all ease the transition. Psychological tools like CBT and mindfulness can help with mood and anxiety symptoms. The perimenopause is also a good time to talk to your health professional about bone, heart, breast and metabolic health.

Let’s talk about it!

Take away the taboo, talk openly about perimenopause with your friends, family, and community. Sharing stories and strategies can make a real difference. Compare symptoms, explore treatment options, and exchange what you’ve learned. Don’t be afraid to ask questions or admit what you don’t know – chances are, someone else is wondering the same thing. Just remember, this is a completely normal and natural phase of life, and no one should have to go through it alone. The more we talk about it, the more support and understanding we create for ourselves and others.