Perimenopause hormone balance: what to know

Ovulation becomes less predictable during the menopause transition. Oestrogen and progesterone can rise and fall unevenly, which may alter bleeding, sleep, body temperature, mood, and vaginal comfort. A single hormone result may not reflect these fluctuations. Thyroid disease, pregnancy, anaemia, medication effects, and other conditions can cause similar symptoms, so the pattern and examination matter.

List your main symptoms and how they affect daily life before an appointment. Regular meals, movement, a stable sleep routine, breathable clothing, and identifying heat or alcohol triggers may be useful for some people. Depending on your symptoms and medical history, a clinician may discuss hormonal treatment, non-hormonal medicines, contraception, or local treatment for vaginal symptoms. Avoid unlabelled hormone products and supplements promoted as hormone balancers.

Seek assessment for heavy bleeding, bleeding between periods, bleeding after sex, or bleeding after a long gap without periods. Get urgent help for faintness, severe pain, chest pain, breathing difficulty, or sudden neurological symptoms. Arrange routine care when sleep, mood, temperature symptoms, or sexual comfort remain disruptive.

Ask whether your symptom pattern suggests perimenopause, whether tests are needed, what benefits and risks apply to each option, and how treatment will be reviewed.