How to Know When You Need Treatment for Perimenopause
Perimenopause is often characterized by slight symptoms, such as irregular menstrual cycles, mood changes, and difficulty sleeping. Yet, when the symptoms start to interfere with day to day functioning, it is appropriate to seek help. In Australia, there are resources available to help manage the condition. Understanding when it is appropriate to contact a specialist is important in getting timely and efficient help.What is Perimenopause — and Why It is Important
Perimenopause marks the gradual dwindling of ovarian function and production of hormones (especially oestrogen) that characterizes the menopause transition.
Perimenopause usually begins during the late 40s, although the start may vary among individuals.
Most people will undergo this stage for about 4-6 years, but the duration can be shorter or longer.
The hormonal changes occurring during this stage can produce a complex mix of physical and mental symptoms that may be difficult to manage.
Symptoms that Suggest You may Benefit from Treatment
The first sign of perimenopause is usually a change in menstrual cycle regularity. But, at this stage, you may start to feel some of the symptoms, which can include the following:
- Changes in the menstrual cycle: The frequency and duration of periods can become random, and some may include very heavy or very light bleeding.
- Hot flashes and night sweats — are sudden waves of heat that can lead to excessive sweating and are also common during sleep.
- Sleep problems: It may become difficult to fall asleep or stay asleep, which can lead to fatigue or low energy.
- Mental and emotional symptoms: Changes in hormones may lead to depression or excessive anxiety, and also make it difficult to think clearly or concentrate.
- Physical issues include pain in the joints or muscles, modifications to the skin, vaginal dryness, tenderness in the breasts, and various other issues.
- Unexplained weight gain, with no shifts in food or activity level.
Many of these changes can be mild or manageable, but in some cases, the issues can impact quality of life, relationships, sleep, work, or emotional wellness.
When to Consult with a Doctor or a Perimenopause Specialist
There are no specific tests that show if someone is experiencing perimenopause or not, since it is unique to each person. Diagnosis is typically an integration of a person’s age, menstrual history, and existing symptoms.
If the following describes you, it may be appropriate to seek care from a physician:
- If your symptoms (examples include but are not limited to hot flashes, mood swings, sleep issues, or vaginal dryness) are persistent and affecting quality of life in terms of sleep, work, relationships, and emotional wellbeing.
- There are notable changes in your period, such as it becoming heavier or lighter, your cycles becoming irregular or unpredictable, or there being longer gaps between your cycles.
- Lifestyle modifications (sleep changes, diet, or exercise) have not been enough to relieve your symptoms, or your symptoms are severe enough that changes are needed.
- During perimenopause, there are several additional perimenopause-related health concerns, including changes in the bones, cardiovascular system and overall metabolism.
- Mental and emotional health concerns are also prevalent. These include constant anxiety, depression, memory loss, and changes in mood.
Australian healthcare recommends for patients, with significant symptoms, to seek assistance from a general practitioner, a gynaecologist, an endocrinologist, or a menopause specialist.
Support and Treatment Options in Australia
Once help is sought, there are a number of therapeutic options available depending on the symptoms, medical history and the individual’s choices.
- Hormone Replacement Therapy (HRT): Systemic estrogen (grade A recommendation) remains the gold standard in the treatment of vasomotor symptoms (hot flushes and night sweats) and is most effective when combined with progesterone. It is available in the following formulations: tablets, patches, gels, creams and sprays, and is fully customisable.
- Non-Hormonal Prescription Medications: With respect to mood changes, sleep problems, and some other symptoms, some patients may have to consider non-hormonal options if they do not wish to or cannot use HRT.
- Lifestyle and Behavioral Strategies: These are often the first-line treatment and include a healthy diet, regular exercise (including strength training for bone health), good sleep hygiene, and stress management using mindfulness or relaxation techniques, while avoiding excess caffeine or alcohol.
- Vaginal and Sexual Health Supports: For treatment of vaginal dryness and/or discomfort, local (lubricants and low-dose vaginal estrogen) and other options may also help.
- Mental Health and Emotional Well-Being: Counselling or therapy is a reasonable recommendation if there are significant symptoms of agitation, anxiety and/or depression, and so-called ‘brain fog’.
The first set of treatment options available are a direct result of the individual and personal nature of perimenopause. A majority of women find all three aspects of treatment – hormone therapy, lifestyle changes, and emotional support – to be of the most benefit.
Why Early Recognition & Specialist Care Matters
- Quality of life: Early treatment of perimenopause symptoms during the perimenopause phase can help restore functionality to one’s work, relationships, sleep, and mental health during this phase of life rather than allow them to dictate one’s quality of life.
- Long-term health: Hayward and Golomb noted that the hormonal fluctuations that occur during the perimenopause stage can increase one’s overall health, cardiovascular, and bone density risk. Specialized care can help continue monitoring and help mitigate risks.
- Tailored care: A perimenopause specialist (or GP / gynecologist with knowledge in this field) can help thoughtfully individualize treatment, whether that’s an appropriate balance of the hormone, therapy type, other hormonal or non-hormonal treatment, or supportive solution.
- Support & validation: A lot of women report that they feel dismissed or attribute their symptoms to stress or the process of simply getting older, and this is where a specialist can help validate your journey with practical supportive care.
How to Prepare — What to Track Before You Consult
Before you book an appointment, it can help to track certain information.
- Keep a menstrual record — dates of each period, the flow of blood (light or heavy), whether or not cycles are skipped, and record cycles that are skipped.
- Keep a record of symptoms — Are there hot flashes, and if so, are they frequent? What is the quality of sleep? How is mood? What is energy like? Are there any vaginal symptoms? Joint pain, memory or concentration issues?
- Contemplate the symptoms — are they getting in the way of sleep, work, relationships, or mood? Are you worse or better overall with a longer period of time?
- Please provide health history — are there any other issues (thyroid, bone health, risk for cardiovascular issues), and what medications are you taking? How’s your lifestyle, in terms of smoking, drinking, exercising, dieting?
Having this information available for your consultation also aids your doctor or a perimenopause specialist in Australia in tailoring their recommendations to best suit your needs and support needs.
Final Thoughts
Perimenopause is a stage of life like any other, but that doesn't allow for simply "enduring" the symptoms. If you are experiencing symptoms that forever change the your body, how you feel, or how you go about your day, you should look for help. You can find reliable resources like Noosa Longevity Health in Australia who provide experienced perimenopause specialists with supportive, evidence-based treatments. Getting the help you need and recognizing the need early will allow you to achieve the confidence and ability to go through this life stage with ease.