Well-woman care during perimenopause

A well-woman review during perimenopause can assess changing periods, symptoms, contraception, pregnancy plans, health risks and treatment choices in a personalised way. Perimenopause is a transition, so symptoms can vary and may not arrive together. A review is a chance to check concerns, update preventive care and make a plan that fits your health and priorities.

Hormone fluctuations can make periods irregular, heavier, lighter, closer together or further apart. Some people notice hot flushes, night sweats, sleep disruption, mood changes, lower sexual desire or vaginal symptoms. Pregnancy remains possible while periods continue, so contraception and pregnancy intentions belong in the conversation. Symptoms can overlap with thyroid disease, anaemia, medication effects, stress or pregnancy, and a clinician may need to separate these explanations.

Bring a record of period dates, bleeding amount, hot flushes, night sweats, sleep, mood, headaches, pain, medicines and contraception. Mention smoking, alcohol, blood pressure, migraines, clotting history, bone health, family history and pregnancy plans. Ask about symptom treatments, cervical screening, breast awareness, pelvic health and exercise. If periods are heavy, note flooding, clots, fatigue or breathlessness because these details help guide assessment.

Arrange prompt care for very heavy bleeding, bleeding between periods, bleeding after sex, new pelvic pain, faintness, breathlessness or symptoms of anaemia. Seek urgent help for severe pain, collapse, or bleeding with a possible pregnancy. New or troubling mood symptoms, including thoughts of self-harm, need immediate support. The urgency depends on the symptom and its severity, not simply on being in perimenopause.

Ask whether your pattern is consistent with perimenopause; whether tests are needed; how to manage heavy or irregular periods; what contraception remains suitable; whether treatment is safe with your medical history; and which symptoms should lead to an earlier review.