Opinion article
Perimenopause and menopause: what changes and how to recognise the transition
Menopause is defined, retrospectively, as twelve consecutive months without a period, usually between ages 45 and 55. Before that comes perimenopause, the transition during which the ovaries gradually and irregularly reduce hormone production, which can last four to eight years.
Signs of perimenopause
- Menstrual cycles that are shorter, longer, or more irregular than usual.
- Hot flushes and night sweats, even before cycles stop altogether.
- Sleep and mood changes, and increased irritability.
- Vaginal dryness and lower libido.
- Difficulty concentrating, often described as “brain fog”.
Do you still need contraception?
Yes. As long as cycles continue, even irregularly, pregnancy is still possible. Contraception is generally recommended until one year after the last period if it occurred after age 50, or two years if it occurred before 50.
Not every symptom of this stage needs hormonal treatment. But all of them are worth discussing in a consultation, because there are effective options, hormonal and non-hormonal, for most of them.
For anyone who wants to understand the hormonal treatment options available at this stage in more depth, I’ve written a dedicated article on that topic.
This article is for information only and does not replace a medical consultation.