Feature Article

Perimenopause: a time of change

Fiona Jane, Susan R Davis



Fluctuating hormone levels during the perimenopause can lead to heavy and irregular menstrual bleeding along with menopausal symptoms. GPs can help women through this transition by providing information, relieving distressing symptoms and addressing modifiable health risks.

Key Points

  • The perimenopause begins with menstrual irregularity and continues until menopause, the complete cessation of menses.
  • Symptoms reflect intermittent phases of deficiency and excess of oestrogen and can be difficult to differentiate from the effects of chronological ageing.
  • Good preventive health care, close monitoring and early intervention in the perimenopause might help prevent progression to metabolic syndrome, cardiovascular disease, diabetes, obesity, osteoporosis and fractures.
  • Quality of life is an important determinant in management of vasomotor symptoms and disturbances of sleep, mood and sexual functioning.
  • The need for appropriate contraception should be remembered.