Does hormone replacement therapy treat perimenopause?

Perimenopause is the transition before menopause, when ovarian hormone levels can change unevenly. Periods may become irregular, and hot flushes, night sweats, mood changes, sleep disruption or vaginal symptoms can appear and vary over time. Hormone replacement therapy can reduce some symptoms for people who are suitable candidates, but it does not switch off the ovaries or make cycles predictable. Hormonal contraception may be considered separately when pregnancy prevention or cycle control is needed.

Record bleeding patterns, symptoms, medicines and any chance of pregnancy before an appointment. Discuss whether hormone therapy, contraception, non-hormonal treatment or a combination fits your goals. Tell the clinician about migraines, high blood pressure, blood clots, liver problems, unexplained bleeding and personal cancer history. If hormones are prescribed, ask how to take them, what changes are expected and when the plan should be reviewed.

Arrange assessment for bleeding that is very heavy, lasts unusually long, happens between periods or follows sex, particularly when it is a new pattern. Seek urgent help for sudden breathlessness, chest pain, severe headache, weakness, speech difficulty or a painful swollen leg. A positive pregnancy test with pain or bleeding also needs prompt medical advice.

Are my symptoms consistent with perimenopause, and what else should be checked? Do I need contraception as well as symptom treatment? Which option best fits my bleeding pattern and medical history?