Menopause vs Perimenopause: What to Expect

Menopause and perimenopause are natural stages in a woman’s life, but many women feel confused about the difference between the two. Understanding what is happening in your body, recognising early signs, and knowing when to see your GP can make this transition much easier to manage.

This guide breaks down the key differences, common symptoms, how menopause is diagnosed, available treatments, and important myths to avoid.

What Is Perimenopause?

Perimenopause is the transition period leading up to menopause. It is when hormone levels—particularly oestrogen—begin to fluctuate. This stage can last several months to 10 years, although most women experience symptoms for around 4–6 years.

Common Symptoms of Perimenopause

Many women notice:

• Irregular periods

• Hot flushes or night sweats

• Mood swings or irritability

• Breast tenderness

• Trouble sleeping

• Migraines or headaches

• Vaginal dryness

• Lower libido

• Difficulty concentrating or “brain fog”

These symptoms come and go because hormones change unevenly during this time.

What Is Menopause?

Menopause is reached when a woman has not had a menstrual period for 12 consecutive months. It marks the end of natural fertility.

Most women in Australia reach menopause between 45 and 55, with the average age being around 51.

Common Symptoms of Menopause

Some symptoms continue from perimenopause, while others may increase:

• Persistent hot flushes

• Mood changes

• Weight gain

• Vaginal dryness and discomfort

• Decrease in bone density

• Sleep issues

• Changes in skin, hair, and energy levels

These symptoms vary widely from woman to woman.

How Are Perimenopause and Menopause Diagnosed?

A diagnosis is usually based on:

• Your symptoms

• Your age

• Your menstrual pattern

Most of the time, no blood test is needed. However, your GP may order:

• Follicle-stimulating hormone (FSH) test

• Oestrogen levels

• Thyroid function test (to rule out other conditions)

It’s important to talk to a GP who is experienced in women’s health or menopause care—such as Dr Celine Gol at Alma Street Medical.

Treatment Options

Treatment depends on your symptoms and medical history. Options include:

1. Menopause Hormone Therapy (MHT)

Previously called HRT, this is one of the most effective treatments for:

• Hot flushes

• Night sweats

• Vaginal dryness

• Bone health

MHT is safe for many women but should be discussed with a GP to check suitability.

2. Non-Hormonal Medications

These may help reduce hot flushes, mood symptoms, or sleep issues.

3. Lifestyle Changes

These play a big role in symptom management:

• Regular exercise

• Balanced diet

• Reducing caffeine and alcohol

• Stress management

• Improving sleep habits
  

4. Vaginal Oestrogen

Safe for long-term use and effective for vaginal dryness and discomfort.

5. Counselling or Psychology Support

Useful for anxiety, mood swings, or emotional changes.

Who Is More Likely to Experience Early or Severe Symptoms?

Some women may experience earlier or stronger symptoms:

• Family history of early menopause

• Smokers

• Women who have had chemotherapy or radiation

• People with autoimmune conditions

• Those who have had their ovaries surgically removed (surgical menopause)
  

Common Myths About Menopause and Perimenopause

Myth: Menopause happens suddenly.

Truth: It is a gradual transition, usually starting with perimenopause.

Myth: You can’t get pregnant during perimenopause.

Truth: Pregnancy is still possible until 12 months after your last period.

Myth: All women get severe menopause symptoms.

Truth: Some women have mild or no symptoms at all.

Myth: Hormone therapy is unsafe for everyone.

Truth: MHT is considered safe and effective for most women when prescribed appropriately by a doctor.

Myth: Menopause only affects physical health.

Truth: It can affect emotional wellbeing, sleep, and cognitive function too.

What You Can Do

• Keep track of your menstrual cycle and symptoms

• Maintain a healthy lifestyle

• Speak to your GP early if symptoms affect your daily life

• Have regular health checks for bone density, heart health, and breast health

• Seek support—physical and emotional changes are normal

At Alma Street Medical, we provide perimenopause and menopause assessments, hormone therapy guidance, lifestyle support, and ongoing management tailored to each woman’s needs. Video Telehealth Menopause Clinic with Dr Celine Gol

Dr Celine Gol (MB BCh BAO, MRCGP, FRACGP, PgDip Weight Management, PgDip Allergy, FASLM, Australasian Menopause Society Member) provides expert, evidence-based support for women experiencing perimenopause and menopause. With over 20 years of experience in women’s health, she offers personalised guidance to help you manage symptoms, understand your options, and feel supported during this important life stage.

To book an appointment, please call (07) 4922 3300.