Low estrogen during perimenopause

Perimenopause is a changing phase before menopause. Ovarian hormone production becomes less predictable, so symptoms can vary from one week or cycle to another. Irregular or heavier periods, hot flushes, night sweats, mood changes, lower sex drive and vaginal dryness may occur. Symptoms can also come from pregnancy, thyroid disease, anaemia, medicines or stress, so the label should not replace an assessment.

A symptom diary can show links between energy, sleep, bleeding and temperature symptoms. Hormone levels can change quickly, which means one blood test may not explain the whole pattern; a clinician interprets results in context.

Record cycle dates, bleeding amount, flushing, sleep, mood, pain and medicines. Use breathable layers, keep the bedroom cool, and protect sleep with a steady routine. Gentle activity and regular meals may support day-to-day energy. Lubricant or a vaginal moisturiser may ease dryness.

Make an appointment if symptoms interfere with work, relationships, sleep or daily life. Treatment choices depend on your age, pregnancy possibility, bleeding pattern, migraine history, clot risk and other health conditions. You can read about [Perimenopause](/conditions/perimenopause/) and [Irregular Periods](/symptoms/irregular-periods/).

Get urgent help for fainting, severe breathlessness, chest pain, confusion, or bleeding that makes you feel weak. Arrange prompt review for bleeding between periods, bleeding after sex, very heavy bleeding, new severe pelvic pain, or a sudden change in symptoms. Pregnancy remains possible while periods are occurring, even when they are irregular.

Could my symptoms be perimenopause, or should we check for anaemia, thyroid disease or pregnancy? Which treatment options fit my history? How should I monitor heavy or missed periods, and when should I return for review?