A plain-language guide to understanding the perimenopause transition — what it is, when it starts, what to expect, and how to get support in Australia.
Perimenopause is the transitional phase leading up to menopause — the time when your ovaries gradually produce less oestrogen and progesterone. "Peri" means "around" or "near," so perimenopause literally means "around menopause."
Menopause itself is a single point in time: the day that marks 12 consecutive months without a menstrual period. Everything before that point (while you are still having periods, however irregular) is perimenopause. Everything after is post-menopause.
"Perimenopause is not a disease. It is a natural biological transition — as normal as puberty — that every woman with ovaries will experience."
Typically 40–47
Cycles begin to change in length or regularity. Oestrogen starts to fluctuate. Symptoms may be subtle — occasional missed periods, mild sleep changes, or mood shifts.
Typically 47–51
Periods become increasingly irregular or absent for months at a time. Hot flushes, night sweats, and other symptoms often intensify. Oestrogen levels declining significantly.
After 12 months no period
Menopause has been reached. Many symptoms gradually ease, though some women experience ongoing symptoms for years. Bone and cardiovascular health become important focus areas.
Most Australian women enter perimenopause between the ages of 45 and 55, with the average age of menopause being 51–52. However, perimenopause can begin as early as the late 30s for some women.
Premature menopause (before age 40) affects approximately 1 in 100 Australian women and requires prompt medical attention. Early menopause (ages 40–45) affects about 5% of women.
The perimenopause transition typically lasts 4–10 years, though this varies greatly between individuals.
Perimenopause is caused by the natural decline in the number of follicles (egg-containing structures) in the ovaries. As follicle numbers decrease, the ovaries produce less oestrogen and progesterone. This hormonal fluctuation — not a steady decline, but an erratic rise and fall — is what causes the wide range of symptoms women experience.
Oestrogen receptors exist throughout the body — in the brain, bones, heart, skin, bladder, and vaginal tissue — which is why perimenopause can affect so many different systems simultaneously.
From July 2025, Australian women are eligible for a new Medicare rebate for a dedicated menopause health assessment with their GP. This is a significant development that makes professional support more accessible and affordable.
Your GP is your first point of contact. They can assess your symptoms, order relevant blood tests (such as FSH and oestradiol levels), and discuss all treatment options — including Menopausal Hormone Therapy (MHT), which is safe and effective for most women.
Use our free GP Report Generator to create a professional symptom summary before your appointment — ensuring nothing is missed and making the most of your consultation time.