Perimenopause and menopause: symptoms, myths and when to talk to a GP

Menopause has moved from something rarely spoken about to one of the most discussed topics in women's health in Australia, helped by a national Senate inquiry and growing public conversation. Yet many women still wonder whether what they are feeling is normal, and whether it is worth seeing a doctor. This guide covers the basics and helps you plan the conversation.

Perimenopause and menopause: what is the difference

Menopause is your final menstrual period, confirmed once you have had no periods for 12 months. In Australia the average age is around 51, although it can happen earlier. Perimenopause is the transition leading up to it, when hormone levels fluctuate. It often starts in the 40s and can last several years.

Because hormones rise and fall unpredictably during perimenopause, symptoms can come and go and change over time, which is one reason the transition can feel confusing.

Common and less talked about symptoms

Hot flushes and night sweats are the best known symptoms, but they are only part of the picture. Many women notice changes in sleep, mood, anxiety, concentration and memory (often described as brain fog), joint aches, headaches, vaginal dryness, changes in libido and irregular or heavier periods.

Not everyone has troublesome symptoms. For some women they are mild; for others they affect work, relationships and quality of life. Both experiences are common, and support is available for both.

Common myths

One myth is that you simply have to put up with symptoms. In reality, there are a range of approaches that may help, and many women benefit from discussing them. Another is that perimenopause cannot start until your late 40s; symptoms can begin earlier.

It is also a myth that every symptom in midlife is menopause. Thyroid problems, iron deficiency, depression and other conditions can cause similar symptoms, which is one reason a proper assessment is worthwhile.

Lifestyle approaches that may help

Regular physical activity, including strength training, supports mood, sleep, heart health and bone strength, which becomes more important after menopause. Limiting alcohol and caffeine, keeping a cool bedroom, layering clothing and practising relaxation techniques can help some women manage hot flushes and sleep disruption.

A balanced diet with adequate calcium and protein supports bone and muscle health. Keeping a symptom diary for a few weeks can help you notice patterns and triggers.

Treatment options to discuss

There are several medical and non-medical options for managing menopause symptoms, and the right choice depends on your symptoms, health history and preferences. A GP can talk through the benefits and risks of each option for you personally, and update you on current Australian guidance.

Bring questions about anything you have read or heard. A good consultation is a two-way discussion, and it is reasonable to take time to decide.

Menopause and long-term health

After menopause, lower oestrogen levels can affect bone density, increasing the risk of osteoporosis and fractures, and can change cholesterol levels and heart disease risk. This is why midlife is a good time to review your overall health, not just your symptoms.

A health review may include blood pressure, cholesterol and blood sugar checks, a discussion about bone health and calcium and vitamin D, and making sure cervical, breast and bowel cancer screening is up to date.

Early and premature menopause

Menopause before age 45 is called early menopause, and before 40 is called premature ovarian insufficiency. It can happen naturally or after surgery, chemotherapy or other treatments. Women who experience early menopause may have specific health needs and benefit from discussing them with a doctor.

If your periods stop or become very irregular before 45, or you notice menopause symptoms at a younger age, it is worth booking an appointment.

Menopause at work

Symptoms such as poor sleep, hot flushes and brain fog can affect work, and many Australian workplaces are now developing menopause policies. Practical adjustments may include access to fans or cooler areas, flexible start times, breathable uniforms and the option to work from home on difficult days.

You may find it helpful to talk to your manager or human resources team about what support is available. A medical certificate is not usually needed to have this conversation.

Preparing for your appointment

Note your symptoms, how often they happen and how they affect you, along with the date of your last period, your cycle pattern, current medicines and any family history of heart disease, breast cancer, blood clots or osteoporosis.

A longer appointment can be helpful for menopause discussions. Ask reception for the right appointment length when booking through HotDoc or by phone.

Frequently asked questions

This article provides general health information only and is not a substitute for individual medical advice. Everyone's situation is different. Please book an appointment to discuss your own health. In an emergency, call 000.