“You’re doing all these things for all these other people, but you actually need to put your own oxygen mask on too.” —Dr Karina Severin, GP, Jean Hailes for Women’s Health
Key points
- Perimenopause is the transition period leading up to menopause.
- Symptoms can include irregular periods, mood changes, sleep problems and hot flushes.
- Support options include lifestyle changes, hormone therapy and non-hormonal treatments.
As a result, symptoms such as poor sleep, mood changes, low energy and reduced resilience can easily be dismissed as stress, burnout or simply having too much on your plate.
Understanding what perimenopause is—and how to recognise the signs—can help you access the support you need to navigate this stage of life with greater confidence.
What is perimenopause?
Perimenopause is the transition period leading up to menopause. It most commonly begins in a woman’s mid-to-late 40s. However, it can start earlier, so it’s important not to dismiss changes simply because you think you’re “too young”.
According to Dr Karina Severin, a GP at Jean Hailes for Women’s Health, the medical definition is based on changes to the menstrual cycle.
“The start of perimenopause is when someone’s menstrual cycle is varying by more than one week, month to month,” she explains.
For example, a cycle that was previously regular may become consistently more unpredictable, arriving after three weeks one month and five weeks the next.
Perimenopause continues until menopause, which is officially reached after 12 consecutive months without a period.
Signs of perimenopause
Irregular periods are one of the signs of perimenopause, but they’re rarely the only symptom.As hormone levels become less predictable, many women experience a range of physical and emotional changes.
Common perimenopause symptoms include:
- changes to menstrual cycles and bleeding patterns
- hot flushes and night sweats
- sleep disturbances and insomnia
- mood changes, irritability and emotional sensitivity
- worsening migraines
- joint aches and pains
- dry or itchy skin.
It’s important to note that the experience can vary significantly from person to person. While some women move through perimenopause with relatively mild symptoms, others find it has a much greater impact on their wellbeing.
Karina believes this is partly because the symptoms of perimenopause often arrive during such a demanding stage of life, and having the right “scaffolding” around you can make a real difference to how manageable they feel.
That could include supportive relationships, healthy coping strategies or simply enough practical help.
“What I typically say to people is that you’ve got these hormonal changes and you’ve got these life stresses, and when you put them together, it might tip things over in terms of how much you can manage,” Karina says.
“That’s why some people are absolutely fine. For one thing, maybe their symptoms aren’t so bad. But they might also have a lot of scaffolding that helps them to get through this time.”
How is perimenopause diagnosed?
There is no single blood test that can definitively diagnose perimenopause, and while hormone levels can be measured, the results often aren’t particularly useful because hormone levels naturally fluctuate during this stage.“You could do a blood test and it could show literally anything,” Karina says. “It could show low hormone levels; it could show high hormone levels—and a lot of the time it just shows normal hormone levels.”
Instead, diagnosis is usually based on a combination of symptoms, menstrual changes and age. Remember, too, that if you’re not having regular periods (for example, because you’ve had a hysterectomy, or are on contraception), you may need to rely on your symptoms.
However, blood tests may still be used to rule out other conditions, such as thyroid disorders or other causes of irregular periods, particularly in younger women or when symptoms don’t fit the typical pattern.
Perimenopause treatment and lifestyle strategies
Not everyone needs treatment for perimenopause.“If someone is managing fine and it’s not affecting their day-to-day function, you don’t actually need to treat it at all,” says Karina.
However, if symptoms begin affecting your relationships, work, sleep or overall quality of life, support is available.
Karina explains that treatment options generally fall into three categories:
- lifestyle strategies
- hormone therapy
- non-hormonal medications.
Lifestyle changes such as prioritising good sleep, eating a balanced diet, staying physically active and finding healthy ways to manage stress can play an important role in supporting your physical and emotional wellbeing throughout perimenopause.
Of course, those things are easier said than done when life feels chaotic. But Karina is adamant that regularly carving out time for a little self-care can help you better navigate this transition—and that there is nothing selfish about making that commitment to yourself.
“Sometimes you have to actually make time for yourself,” she says. “You’re doing all these things for other people, but you actually need to put your own oxygen mask on too.”
If lifestyle strategies alone aren’t enough—or your symptoms are significantly affecting your quality of life—medical treatment may help.
Options include hormone therapy to address the underlying hormonal fluctuations that drive many symptoms, and non-hormonal medications, which are often used to manage specific concerns, such as mood changes or hot flushes.
“There’s no one-size-fits-all approach,” says Karina. “It really depends on your individual preferences and circumstances.”
Seeking support
One common misconception is that women need to wait until their periods have stopped completely before seeking treatment.“If you are experiencing symptoms that are affecting your daily life, it’s worth having a conversation with your GP,” she says. “And if you feel your concerns aren’t being heard, there’s nothing wrong with seeking a second opinion.”
If possible, consider discussing your symptoms with a GP like Karina, who specialises in women’s health or menopause. You can find one via the Australasian Menopause Society, which provides a searchable directory of healthcare professionals with expertise in this area, along with reliable information about perimenopause and menopause.
If you live in a rural or regional area—or simply can’t access a specialist locally—Karina points out that many menopause specialists also offer Medicare-supported telehealth consultations.
Most importantly, remember that you aren’t in this alone and you don’t have to simply “put up with” troublesome symptoms.
Disclaimer: Information provided in this article is of a general nature. Australian Unity accepts no responsibility for the accuracy of any of the opinions, advice, representations or information contained in this publication. Readers should rely on their own advice and enquiries in making decisions affecting their own health, wellbeing or interest. Interviewee names and titles were accurate at the time of writing.
