What are the treatment options for perimenopause?

Perimenopause is the transition before periods stop. Hormone levels can fluctuate, so cycles may become irregular and symptoms can include hot flushes, night sweats, vaginal dryness, sleep disruption, headaches or mood changes. Treatment is based on symptoms, medical history, bleeding pattern, pregnancy possibility and personal preferences.

Hormone Replacement Therapy may help several menopause-related symptoms when it is suitable. If the womb is present, the treatment plan usually needs protection for the womb lining. Non-Hormonal Menopause Treatment may be useful when hormones are unsuitable or when a person prefers another approach; options depend on the symptom being treated.

A Hormonal Coil can provide contraception and may reduce heavy menstrual bleeding for some people; it may also be combined with prescribed oestrogen when clinically appropriate. It does not treat every perimenopause symptom. Use cooling layers, regular sleep routines, movement and a symptom diary to identify triggers and guide review.

Contraception is still needed during perimenopause if pregnancy is possible. Do not assume an irregular period means fertility has ended. A clinician should assess new, very heavy, prolonged or post-sex bleeding rather than attributing it automatically to hormonal change.

Arrange medical review for bleeding that is unusually heavy, lasts longer than expected, happens between periods or follows sex. Seek urgent care for bleeding that makes you faint or weak, severe pelvic pain, chest pain, sudden breathlessness or a new neurological symptom. Prompt help is also needed for severe depression or thoughts of self-harm.

Ask which symptoms are most suitable for hormone or non-hormonal treatment, whether you need contraception, how bleeding will be monitored, and what risks your health history creates. Ask when to review treatment and which symptoms require an examination.