You’ve begun to feel a bit hotter than usual at times and you suddenly have unexplained muscle pain. You also skipped a period last month. Sound familiar?

However, while these symptoms are common, everyone’s experience of perimenopause is different. Typically, perimenopause is gradual, and symptoms can fluctuate. They may even intensify as you get closer to menopause.

While not all people have symptoms during this phase, the 2023 National Women’s Health Survey found that one-quarter of Australian women aged 45-64 experienced menopause-type symptoms that made it hard to do daily activities.

One third of these people didn’t see a doctor.

The more you know about perimenopause, the better you can manage your symptoms. If you haven’t already, it’s an important time to see your doctor. Not only can they help you with symptoms, such as hot flushes and night sweats, they can advise you on silent health issues, such as bone loss and increased cardiovascular risk.

What are the first symptoms of perimenopause?

One of the first symptoms of perimenopause can be irregular periods. Your periods can become more or less frequent. But you can have other symptoms during perimenopause, which include:

• hot flushes and night sweats
• sleep problems
• breast tenderness
• itchy, dry skin
• exhaustion
• trouble concentrating
• vaginal dryness and loss of sex drive
• migraines
• mood changes and pronounced pre-menstrual tension
• weight gain, despite no changes to diet or exercise
• muscle and joint pain

Is there a test for perimenopause?

Blood tests are not usually helpful in working out if you’re going through perimenopause. Your doctor can diagnose you by the symptoms you’re experiencing, such as irregular periods, hot flushes, night sweats, insomnia, muscle and joint pain, mood changes and vaginal dryness.

Seeing a doctor around this time in your life is beneficial. They can give you a full health check-up that may involve a mammogram, pelvic examination, and other checks, such as blood pressure, cholesterol, sugar levels, thyroid function, kidney and liver function, iron levels and faecal occult blood testing.

How can I manage my perimenopause symptoms?

There are different medicines that may be able to help you with your symptoms, such as hormone therapy.

Menopausal hormonal therapy (MHT) can be used to treat symptoms, especially hot flushes and night sweats. About 1 in 4 women have symptoms that need treatment with these hormone medicines.

Making changes to your lifestyle may also help to ease your symptoms:

• get a good night’s sleep
• reduce stress
• exercise regularly
• eat well
• maintain a healthy weight
• reduce alcohol and caffeine
• don’t smoke

For more support

• Download the NSW Health perimenopause and menopause symptom checklist in your language.
• Read about menopause in your language from Jean Hailes.
• Listen to podcasts by NSW and Jean Hailes on common questions about perimenopause.
• Download the NSW Health easy-to-read fact sheets on perimenopause.
• Get nutrition tips from the CSIRO.