Perimenopause and menopause:
What’s happening in your body and how to manage the changes

Is this normal?

Hot flushes. Mood swings. Brain fog. Sleep that just doesn’t feel restful. Periods that are late, missing, or suddenly heavier. Or maybe they’ve stopped completely, and now you’re dealing with a new wave of symptoms.
If your body feels unfamiliar lately, it could be perimenopause or menopause—and yes, what you’re feeling can be completely normal.

This life stage can be natural, gradual, or brought on suddenly through surgery or cancer treatment. However it arrives, it helps to understand what’s going on—and what support is available.

Understanding

What is menopause?

Menopause is when your periods stop for good. It’s diagnosed once you’ve gone 12 months without a period (not due to pregnancy, contraception or other causes). The average age is around 51, but it can happen earlier or later.
Before this, there’s perimenopause—a phase of hormonal changes that can start in your 40s or even late 30s. This is often when symptoms begin, even if your periods haven’t stopped yet.

What causes menopause?

Menopause occurs when the ovaries stop releasing eggs and hormone levels (especially oestrogen and progesterone) fall. This can happen:

Menopause after surgery

Menopause after cancer treatment

Menopause Symptoms

What are the symptoms of perimenopause and menopause?

Not everyone has symptoms, but for many, these changes can affect day-to-day life—sometimes in unexpected ways.

Common symptoms include:

Hot flushes and night sweats
Trouble sleeping
Mood swings, anxiety, or low mood
Brain fog or difficulty concentrating
Vaginal dryness or discomfort during sex
Irregular or heavier periods (in perimenopause)
Lower libido
Fatigue
Joint or muscle aches
Weight changes or fluid retention
Thinning hair or dry skin

Less common symptoms (but still normal)

Some symptoms are less talked about, but still part of the hormonal changes happening during this phase.

Click to view less common symptoms

How is menopause diagnosed?

For people over 45, menopause is usually diagnosed based on your symptoms and menstrual history. Blood tests aren’t always needed, but they may be useful in certain situations—especially if:

You’re under 45 and showing signs of menopause
You’ve had a hysterectomy but still have your ovaries (so you no longer get periods)
You’ve had chemotherapy, radiation, or hormone therapy
You have a progestin-containing IUD in situ and don’t experience periods
Your symptoms are unclear and further investigation is needed

In people under 40, menopause is called premature ovarian insufficiency (POI). In this case, blood tests are essential, including checks for:

A diagnosis of POI or early menopause can feel overwhelming—but understanding what’s happening allows you to access the right support, treatment, and monitoring.

How is menopause managed?

Management is based on your symptoms, preferences, medical history, and personal goals. You don’t need to “tough it out” if it’s affecting your quality of life.

Treatment options may include:

Menopausal hormone therapy (MHT)

Formerly called HRT, this can ease hot flushes, sleep issues, and vaginal dryness, and protect bone health. Not recommended for everyone (e.g. some cancer survivors).

Non-hormonal medications

May help with hot flushes, mood swings, and sleep disturbances

Vaginal moisturisers and lubricants

For dryness or discomfort

Lifestyle changes

Regular movement, gentle exercise, balanced nutrition, and quality sleep all support hormone health

Mental health support

Counselling or therapy can help with mood, anxiety or adjusting to life changes

Complementary therapies

Acupuncture, yoga or herbal options may offer relief, but always discuss these with your doctor first

What people are saying

Here are some anonymous reflections from people who’ve experienced this stage of life:

“My period hadn’t come in months, but it was the brain fog and mood swings that really caught me off guard.”
“After my surgery, it felt like someone flipped a switch. The hot flushes started almost straight away.”
“I had to find ways to manage my symptoms without hormones due to breast cancer. It took time, but I got there.”
“I thought I was just overwhelmed—until I realised I was in perimenopause. Suddenly everything made sense.”

When should you seek support?

You don’t have to wait until your periods stop. You don’t have to be under 45. And you definitely don’t have to reach breaking point.

If any of this sounds familiar, it might help to chat with your GP or a specialist who understands menopause.

You’re noticing physical or emotional changes that don’t feel right
You feel flat, anxious, or just not like yourself
Your cycle has changed in a way that doesn’t feel normal for you
You’ve had your ovaries removed or cancer treatment
You’re curious about your options and want to plan ahead

You don’t have to wait until your periods stop. You don’t have to be under 45. And you definitely don’t have to reach breaking point.

If any of this sounds familiar, it might help to chat with your GP or a specialist who understands menopause.

Take action now. Get checked today

Mnopause treatment

What now?

If you think you’re in perimenopause, menopause, or experiencing symptoms after surgery or cancer treatment, here are a few steps to take:

Track your symptoms

Write down what you’re noticing—changes in mood, sleep, your period, or anything else that feels different.

Talk to your GP

They can help with testing, support, or refer you to a specialist if needed.

Explore your options

There’s no one-size-fits-all approach. The right solution is the one that fits your body, your values, and your stage of life.

Be kind to yourself

This is a big transition. And you don’t need to go through it silently or alone.

Menopause specialist Perth

Let’s talk about menopause

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Book a consultation if you’d like to talk things through
Download a symptom tracker to bring along to your GP or specialist appointment. As a founder of Charli.health, I’ve worked on a symptom tracker designed to help you log your cycle and symptoms. It’s a simple tool you can use to support conversations with your healthcare team.

Perimenopause and menopause: What’s happening in your body and how to manage the changes