Perimenopause, or something else?

Why it is easy to miss

Perimenopause is a transition, not an event. Hormone levels fluctuate rather than fall in a straight line, which means symptoms come and go and a single blood test on a single day often does not settle the question.

The symptoms are also not specific. Sleep disruption, mood changes, brain fog, joint aches, changes in cycle length and heaviness, and changes in libido all have several possible explanations. Thyroid conditions, iron deficiency, sleep disorders, depression and anxiety can all produce a similar picture.

That is not a reason to shrug. It is the reason a proper history matters more here than a quick test.

What a consultation actually looks at

A women's health consultation is designed to understand how perimenopausal or menopausal symptoms are affecting your day-to-day life, and to explore evidence-based management options.

At Aevum, we believe a meaningful perimenopause consultation starts with listening. Understanding your symptoms, their progression and your individual health history helps us determine which investigations may be useful and which management options are appropriate.

Our 45-minute perimenopause and menopause consultation includes:

Understanding your symptoms. Exploring when your symptoms began, how they have changed over time, whether they relate to your menstrual cycle, and what makes them better or worse.

Reviewing your menstrual cycle. Discussing changes in cycle length, bleeding patterns and heaviness, including how these may have evolved over the past one to two years.

Considering other possible causes. Assessing whether other health conditions or factors could be contributing to your symptoms, rather than automatically attributing them to perimenopause.

Investigations when appropriate. Considering blood tests or other investigations when the results are likely to inform clinical decisions or change your management plan. Basic pathology is covered by Medicare at no additional cost to you.

Exploring your options. Discussing available treatment and management approaches in clear, straightforward language, including their potential benefits, risks and limitations, what the evidence tells us, and where uncertainty remains.

Any investigations, prescriptions or treatment recommendations will depend on your individual symptoms, medical history and clinical assessment.

What to bring

Before your appointment you will be asked to complete some paperwork and a health questionnaire. It helps your practitioner prepare, but it does not replace the full health assessment on the day.

Beyond that, three things make the appointment substantially better:

A rough cycle log for the last few months, even if it is only dates and a note on heaviness. An app is fine, so is a calendar.

Any blood tests from the last year or two, including ones you were told were normal.

A short written list of what is bothering you most, in your order of priority. Thirty minutes goes quickly, and it is easy to spend it all on the symptom you happened to mention first rather than the one that matters most.

"You are too young" is not a diagnosis

Perimenopause commonly begins in the forties and can begin earlier. Age alone does not rule it out, and being told it does is a reason to ask for the reasoning rather than to accept the conclusion.

Equally, it is not the answer to everything. A consultation worth having is one that is genuinely willing to land somewhere other than perimenopause if that is where the history points.