My role in this is smaller than people expect and I would rather say so. Perimenopause and menopause are managed by a GP, and the single most valuable thing is a proper conversation about menopausal hormone therapy, because the Australian guidance has changed and a lot of women were told something a decade ago that is no longer current.
What I check is what gets missed. Thyroid function, because an underactive thyroid looks almost identical to perimenopause and is treatable. Iron and ferritin, because heavy erratic bleeding in this decade causes anaemia quietly and that explains the fatigue and the fog. Vitamin D and bone risk. Blood pressure and lipids, which shift in this period and nobody mentions. And whether cervical screening is current, which gets forgotten precisely when cycles become irregular.
I also check what is being attributed to menopause that is not. New heavy bleeding, bleeding between periods, bleeding after sex and any bleeding after twelve months without one all need investigation and are not perimenopause until a doctor says so. That is the referral I make without hesitation.
What is left for me is sleep, held tension, joint pain that is limiting exercise, and the digestive changes that come with this decade. I work with modest claims and a review point. The clinic is in Lane Cove, opposite the library, and I write to your GP with what I have found rather than leaving you to relay it.
