Here’s What You Should Know About Perimenopause
Because you deserve facts, not guesswork, gaslighting, or “just wait it out”.
Quick Facts
Perimenopause can start up to 10 years before menopause — and it’s normal.
Symptoms aren’t “in your head”; they’re caused by fluctuating hormones.
You don’t have to “push through”. There are evidence-based treatments.
Sexual changes are common and treatable.
Tracking symptoms and speaking up early helps you advocate effectively.
Blood tests can not tell you if you are in perimenopause
Perimenopause is one of the biggest hormonal transitions of adult life but most women hit their 40s with zero preparation. Doctors often dismiss symptoms as “stress”, friends whisper about it like it’s a secret club, and the internet is a minefield of supplements promising eternal youth.
It’s no wonder so many women feel blindsided.
Hot flushes? Maybe.
Insomnia? Possibly.
Mood swings, memory glitches, dry eyes, aching joints, heavier periods, vaginal dryness, anxiety that hits out of nowhere?
That’s perimenopause too — even though nobody mentioned it.
You deserve clarity.
You deserve to understand your body and you deserve support that actually helps.
Let’s break it down, minus the stigma.
What IS Perimenopause
Perimenopause is the transition phase before menopause, when hormone levels (oestrogen and progesterone) start fluctuating wildly. They don’t decrease in a straight line think hormonal roller-coaster, not hormonal slide.
This phase can last 4–10 years, and the average onset is age 40–45, though earlier and later are both normal.
Menopause itself is only one day — the day you’ve gone 12 months without a period. After that, you’re postmenopausal.
Everything before that is perimenopause.
Fluctuating hormones impact almost every body system, mood; sleep; sexual wellbeing; menstrual cycle; brain function; metabolism, and temperature regulation. You’re not imagining it, you are going through the great Eggs-it Strategy / Hormone Hide & Seek / The Oestrogen Exodus. You are heading towards being Eggless and Fabulous.
Here’s what large-scale studies and clinical research consistently tell us:
1. Perimenopause affects the brain just as much as the ovaries.
Oestrogen interacts with neurotransmitters that regulate mood, memory, and sleep. When levels swing, so do symptoms.
2. Hot flushes are common — but not universal.
Around 75% of women experience them, but many don’t get them until late perimenopause or after menopause.
3. Mood changes are hormonally driven.
Anxiety, irritability, and depressive symptoms can all spike due to fluctuating oestrogen and progesterone — especially in people with a history of PMDD or postnatal mood changes.
4. Cycle changes are a major diagnostic clue.
Heavier, longer, or unpredictable periods are often the first sign of perimenopause, not the last.
5. Vaginal dryness and sexual discomfort are treatable.
Local oestrogen therapy and moisturisers can significantly relieve symptoms, yet many women are never told this. You can have a sex life when you are over 40!
6. Hormone therapy is safe for most women.
Modern MHT (menopausal hormone therapy) is considered safe for the majority of healthy women under 60 and within 10 years of menopause onset (North American Menopause Society; Australasian Menopause Society).
Your body is transitioning and there are practical ways to support it.
Managing Perimenopause
1. Diagnose: What symptoms are you experiencing?
Scan across these domains:
• Sleep (waking at 3am? restless legs?)
• Mood (rage or tears that appears out of nowhere?)
• Periods (heavier? closer together? skipping months? spotting all the time?)
• Cognitive changes (brain fog? trouble finding words?)
• Physical changes (dry eyes, dry vagina, painful sex, hot flushes)
• Energy dips
• Libido fluctuations
• Anxiety spikes
• New aches, migraines, or joint pain
You’re gathering clues as to what stage you are at.
2. Define: What actually matters right now?
Define your goals,
“I want to sleep through the night again.”
“I want my mood to feel steadier.”
“I want to enjoy sex without discomfort.”
“I want to understand what my cycle is doing.”
“I want practical support, not dismissal.”
This will give you a direction to focus on.
3. Design: Structures + rituals that support your body
A supportive perimenopause system includes:
Daily rituals:
Gentle movement
Prioritising protein and stable blood sugar
Reducing caffeine in the afternoon
Morning daylight exposure
Magnesium or iron if clinically indicated
Medical support:
GP check-in
Blood tests (to rule out thyroid/iron issues)
Considering MHT
Considering local vaginal oestrogen
Sexual wellbeing:
High-quality lubricant
Vaginal moisturisers
Pelvic floor physiotherapy if needed
External stimulation and longer warm-up
Clear communication with partners
Stress regulation:
Your nervous system becomes more sensitive during hormonal transitions.
Simple patterns help: breathwork, time-out rituals, sensory-friendly evenings.
4. Deliver: Start small and test it
Perimenopause isn’t solved with a single product or protocol. Test one change at a time:
• Adjusting sleep timing
• Introducing local oestrogen
• Tracking your cycle
• Practising a calming routine before bed
• Using a vaginal moisturiser daily
Your job isn't to "fix" yourself — it's to find what actually shifts the needle.
5. Develop: Continue to refine
Bodies change. Hormones shift. Stressors evolve.
Your system should do the same.
Normalise updating the plan.
Normalise asking for help.
Normalise advocating for yourself when someone tries to minimise your symptoms.
Practical Tools You Can Use Today
Symptom Tracker
Track weekly:
• Period dates
• Sleep quality
• Mood shifts
• Libido
• Skin changes
• Energy levels
• Joint aches
• Any sexual health symptoms - vaginal dryness / itching
• Forgetfulness / brain fog
• Hot flush triggers
Patterns reveal stories!
Healthcare Conversation Script
Frame:
“I’m noticing consistent changes in sleep/mood/cycle/etc. I’d like to explore whether this is perimenopause.”
Share specifics:
“These symptoms have been occurring for X months, and they’re affecting my daily life.”
Ask:
“What are my options? Can we discuss MHT, local oestrogen, and supportive care?”
Close:
“I’d like a plan that supports my quality of life — can we review this again in 4–6 weeks?”
Clear, direct, confident.
The Australian Menopause Society also has lots of fact sheets that you can download and a list of General Practitioners who have an interest in supporting women who are experiencing perimenopause or menopause.
Common Mistakes & How to Avoid Them
Thinking symptoms must be extreme to “count”. Perimenopause starts subtly for many.
Relying on memory or guesswork instead of tracking. Patterns help identify when to seek support.
Assuming libido drops mean you’re “not sexual anymore”. Hormones, sleep, stress, and comfort all play a role.
Pushing through exhaustion.Your nervous system is working overtime.
Seeing perimenopause as decline rather than transition. This can be a powerful identity shift — with the right support.