Ask a female GP: 'How do I know if I've hit perimenopause?'

Is it stress, or raging hormones? 

General practitioner Dr Deb Cohen-Jones breaks down everything you need to  know about the perimenopausal period, and how you can be sure you're even in it at all. 

There is much information around menopause for women however its predecessor, perimenopause is often missed or forgotten.

This period, usually age 40-44, can often coincide with raising children, our careers peaking and supposedly our sexual well-being reaching its pinnacle.

Unfortunately, for many women, this period can be quite the opposite. Being able to recognise the symptoms of perimenopause and treat them if needed can be the difference between 40 and thriving and 40 and flailing.

The tell-tale symptoms of perimenopause

One of the tell-tale signs of perimenopause is a change in a woman’s menstrual cycle. This could be anything from longer or heavier periods, shorter gaps between cycles or longer periods between bleeds.

Women may also notice hot flushes and night sweats as well as insomnia or fatigue.

Vaginal dryness, loss of libido and urinary symptoms like urgency or frequency may also occur and be early signs that you are entering the perimenopausal period.

The brain can also be affected reasonably early on with altered memory, concentration, and brain fog. Finally, mood changes including anxiety, low mood or frequent mood changes are very common. The difficulty is that many of these symptoms could also be attributed to the stage of life you are on in terms of work pressures, stress, and external factors, hence, women often dismiss these early symptoms as being circumstantial.

One of the tell-tale signs of perimenopause is a change in a woman’s menstrual cycle. Image: Pexels

What to do if you think you are in perimenopause

There are several ways to ascertain whether it’s “you or your hormones" wreaking havoc, and these involve simple GP-led tests. 

Firstly, blood can be very informative and should also be used to exclude other causes. During perimenopause our two main female hormone markers, FSH (follicle-stimulating hormone) and oestradiol will change, in particular, a rising FSH suggests menopausal transition.

Sometimes several samples over a few months may be needed to ascertain where you are in the transition phase. This can be further investigated with pelvic ultrasound, ideally at a tertiary women's imaging centre specialising in gynaecology scans.

Unfortunately, the duration of perimenopause is uncertain, but confirming perimenopause may give women the ability to either simply observe or manage symptoms through lifestyle, diet and natural options. Alternatively, the use of prescription hormone replacement specifically for this perimenopausal period may be required.

onfirming perimenopause may give women the ability to either simply observe or manage symptoms through lifestyle, diet and natural options.

What to expect at a glance

Ultimately, perimenopause is a period in a woman’s hormonal life that is very similar to that when she first starts puberty and begins to menstruate.

Both stages involve dramatic hormone fluctuations with resulting irregular ovulation and the multiple resulting conditions of these ups and downs.

Women experiencing these changes have every reason to feel as if their teenage years have come back to haunt them, but having a diagnosis and medical practitioner to see them through this time can be a huge help. 

Dr Deb Cohen-Jones is a general practitioner at Cottesloe Medical Centre in Western Australia and co-owner of The Secret Skincare. She has a special interest in cosmetic medicine, mental health, women's health, and dermatology. You can find her on Instagram here. 

Originally published as Ask a female GP: 'How do I know if I've hit perimenopause?'