men & women
Menopause & Perimenopause
Menopause is the point when periods stop permanently, and perimenopause is the hormonal transition before it; symptoms of both are real and very treatable.
Symptoms
1
Hot flushes and night sweats
2
Broken, unrefreshing sleep
3
Mood changes, anxiety or irritability
4
Brain fog and poor concentration
5
Irregular, heavier or skipped periods in perimenopause
6
Vaginal dryness and discomfort with sex
7
Low libido, joint aches, thinning hair or skin changes
Causes and how it spreads
Perimenopause begins when the ovaries' hormone output becomes erratic, usually from the mid-40s but sometimes earlier, and can last several years. Menopause, defined as twelve months without a period, arrives on average around 51. Fluctuating and then falling oestrogen drives most symptoms, which is why treatment that restores oestrogen works.
How PVT tests for it
In women over 45 with typical symptoms, diagnosis is clinical; hormone levels swing so much in perimenopause that a single blood test can mislead. Bloods via an accredited pathology laboratory are used where the picture is unclear, in younger women, or to exclude look-alikes such as thyroid disease.
Treatment
HRT is the most effective treatment for hot flushes, night sweats and many mood and sleep symptoms, and PVT prefers transdermal oestrogen where suitable because of its safety profile. Local vaginal oestrogen treats dryness and discomfort with very little absorption into the body. Non-hormonal medication, lifestyle measures and CBT-based approaches help women who cannot or prefer not to use HRT. Every plan comes with a scheduled review.
When to see a doctor
Come in when symptoms interfere with your sleep, work, mood or relationships. You do not need to wait for periods to stop, for a particular age, or for symptoms to become unbearable. Perimenopause is the ideal time to build a plan.
Related service
Sexual Health Screening
Sexual health screening at PVT is confidential doctor-led testing for sexually transmitted infections, for men and women, with results and treatment handled privately.
Questions about
Menopause & Perimenopause
How do I know if this is perimenopause?
The combination tells the story: cycle changes plus new symptoms such as flushes, night sweats, disturbed sleep or mood shifts, typically from the mid-40s. In this age group a doctor diagnoses perimenopause from the pattern, not a single blood test, because hormone levels fluctuate daily.
Is HRT safe for me?
For most healthy women within ten years of menopause, current evidence supports HRT as safe and effective, with benefits that often outweigh risks. Individual factors matter, which is why your history is reviewed first and transdermal options are preferred where suitable.
What if I cannot take HRT?
There are real alternatives. Certain non-hormonal prescription medicines reduce flushes, vaginal moisturisers and local treatments manage dryness, and CBT-based approaches improve sleep and mood symptoms. Not wanting HRT does not mean putting up with symptoms.
How long can I stay on HRT?
There is no fixed cut-off. Current guidance supports continuing HRT for as long as the benefits outweigh the risks for you, reviewed with your doctor each year. Many women use it for years; the decision is individual, not a countdown.