Could I Be in Perimenopause?
Are you aged over 45 and wondering whether you could be in perimenopause? You might have a combination of symptoms—but because your period is still regular, you're unsure. If this sounds like you, read on (and if it’s not you yet, it will be one day—so read on anyway).
What Is Perimenopause?
Perimenopause precedes menopause and can last anywhere from 5 to 10 years, often starting in the mid to late 40s. During this time:
We begin to run out of eggs
Oestrogen levels shift dramatically
Our periods eventually stop
Menopause is officially defined as 12 months without a period.
However, perimenopause is not linear. Our oestrogen and progesterone levels fluctuate wildly, often rising up to three times their normal level before finally dropping off as we enter menopause. These fluctuations are what lead to the rollercoaster of symptoms many women experience.
Some breeze through with barely a symptom. But if you’re reading this, chances are you fall into the group that doesn’t.
Common Signs and Symptoms
There are many signs and symptoms associated with perimenopause, and they vary in intensity and frequency from person to person. Some of the most common include:
Hot flushes
Irregular periods
Lightheadedness
Headaches
Irritability
Panic attacks
Depression and anxiety
Mood changes and rage
Brain fog
Sleeplessness
Joint or muscle pain/loss
Weight gain, especially around the belly
Dry, itchy skin and dry eyes
Thinning hair on the head or facial hair
Urinary frequency
Low libido and vaginal dryness
Breast tenderness
Insulin resistance
Increased blood pressure or cholesterol
As Dr Mary Claire Haver puts it:
“The ovaries don’t simply ease into retirement—they go out fighting.”
Why Blood Tests Aren’t Helpful
You’ve probably seen Facebook group posts recommending blood tests to diagnose perimenopause. But this is no longer the recommended approach.
If you are over 45 and experiencing these symptoms, then blood tests won’t provide a reliable diagnosis. Hormones like FSH, LH, AMH, oestradiol, and testosterone fluctuate daily during perimenopause. This means:
You could test “normal” even though symptoms are intense
Doctors might delay treatment based on lab results instead of listening to your lived experience
The Australasian Menopause Society advises that for women aged over 45, clinical signs and symptoms should guide treatment, not blood tests.
So what should you do? Keep a journal of your symptoms and bring that to your health provider. Make sure they know the current recommendation is to treat based on symptoms, not labs.
How TCM Can Help
So, where does Traditional Chinese Medicine (TCM) fit in?
A recent randomised control trial published in The BMJ found that six weekly acupuncture sessions led to significant improvements in:
Hot flushes and night sweats
Sleep quality
Mood and emotional wellbeing
Physical symptoms like joint pain
Skin and hair symptoms
From a TCM perspective, treatment focuses on strengthening the kidney and increasing yin, restoring the yin-yang balance. This may include:
Acupuncture
Chinese herbal medicine
Stress reduction
A Mediterranean-style diet (whole foods, healthy fats, minimal caffeine and alcohol)
Movement and exercise
TCM works on its own or alongside Western medicine, depending on your needs. At Sydney Natural Fertility, we’ll never dismiss your symptoms or require unnecessary blood tests. We'll listen, support, and create a treatment plan to help you feel more like yourself again.
Final Thoughts
Perimenopause can feel confusing and isolating—but you’re not imagining it. You’re not overreacting. And you don’t have to suffer through it in silence.
If you’d like help managing your symptoms naturally, please get in touch with us at Sydney Natural Fertility. We're here to support you through this transition—step by step.
