Perimenopause: Symptoms, Signs, Treatment, Skin and Bone Health — How Skindepth Can Help
Perimenopause is a natural but often challenging transition that can affect a woman’s physical, emotional, and skin health. As hormone levels fluctuate, many women experience a combination of perimenopause symptoms including irregular periods, hot flushes, sleep disturbance, mood changes, and visible skin changes. Early recognition of perimenopause allows women to access evidence-based care and feel supported during this stage of life.
What is perimenopause?
Perimenopause is the stage of life leading up to your last period, where you may experience various perimenopausal symptoms. During this transition, your ovaries begin to run out of eggs, and your hormone levels, particularly oestrogen and progesterone, rise and fall unpredictably. You have reached menopause once you've gone 12 months without a menstrual period.
When does perimenopause start?
The perimenopause age varies, most commonly beginning in the early to mid-40s, though symptoms may appear earlier. Some women notice signs as early as their 30s, while others experience the transition as late as their 50s.
On average, perimenopause lasts 4 to 6 years, though it can range from 1 to 10 years depending on the individual. Early perimenopause may be identified by menstrual cycle changes of 7 days or more in length compared to your usual pattern. Late perimenopause is typically marked by 60 days or more between periods.
What causes perimenopause?
Perimenopause is caused by changes in two key female hormones: oestrogen and progesterone. As you transition toward menopause, oestrogen and progesterone levels fluctuate rather than decline steadily. Many of the physical and emotional changes you experience are directly caused by these hormonal fluctuations and declining oestrogen levels.
Common perimenopause symptoms
Most women will experience some physical or emotional symptoms during perimenopause. Typical perimenopause symptoms include irregular cycles, night sweats, hot flushes, poor sleep, brain fog, and perimenopause tiredness. Some women experience perimenopause dizziness anxiety, which can feel distressing and is often related to hormonal fluctuation rather than stress alone.
Physical symptoms of perimenopause
Irregular periods and menstrual changes
Changes in menstrual patterns are common. Your periods may become longer or shorter, come more or less frequently, or vary in flow from light to heavy. Some months you might skip a period entirely, and patterns can change month to month. These irregular periods are normal during perimenopause, though very heavy or unpredictable periods and spotting should be assessed by a women’s health GP.
Increased skin dehydration
Declining oestrogen levels significantly affect skin structure and function. Oestrogen supports collagen production, hydration, and skin barrier integrity. As levels fall, many women notice increased skin dehydration, dryness, sensitivity, thinning, fine lines, and accelerated ageing. Hormonal shifts can also trigger breakouts or flare conditions such as rosacea or eczema.
Vasomotor symptoms: Hot flushes and night sweats
Hot flushes are one of the most recognised vasomotor symptoms of perimenopause, affecting many women during this transition. These sudden sensations of heat can vary in intensity, duration, and frequency. Night sweats, hot flushes that occur during sleep, often disrupt sleep quality and contribute to fatigue and irritability. Repeated flushing can lead to facial redness and flushing, particularly across the cheeks, nose, and chin caused by dilated blood vessels triggered by hormonal fluctuation.
At Skindepth Dermatology, we offer advanced vascular laser treatments to target visible blood vessels and diffuse redness associated with vasomotor symptoms. Vascular laser therapy works by selectively treating dilated vessels, helping to reduce flushing, calm redness, and improve overall skin tone. These treatments are an effective adjunct to medical menopause care and tailored skincare.
Sleep disturbance and tiredness
Trouble sleeping is common during perimenopause, often due to night sweats or hot flushes, but changes in sleep patterns can occur even without these vasomotor symptoms. The resulting sleep disruption frequently leads to perimenopause tiredness, brain fog, and difficulty concentrating during the day.
Vaginal and bladder symptoms
As oestrogen levels drop, vaginal tissues become drier and less elastic, causing vaginal dryness that can lead to discomfort during sex. This dryness can also cause burning when urinating, increased urinary tract and vaginal infections, more frequent urination, or involuntary urine leakage.
Oestrogen decline, bone health, and skin ageing
Oestrogen plays a vital role in maintaining both bone density and skin collagen during the menopause transition. As oestrogen declines during perimenopause, bone loss begins to accelerate, increasing long-term osteoporosis risk. Skin and bone share common structural proteins, which is why bone health and skin ageing often change in parallel. Early recognition allows proactive management of both.
Emotional and mental symptoms during perimenopause
Mood swings, irritability, anxiety, depression, and brain fog are common emotional symptoms during perimenopause. These changes are related to hormonal fluctuation rather than stress alone. Women with a history of premenstrual syndrome (PMS), premenstrual dysmorphic disorder (PMDD), postpartum depression, or other mood disorders are at higher risk for mood changes during perimenopause.
Perimenopause dizziness and anxiety may occur and can feel distressing, but these are often linked to hormonal shifts rather than other medical conditions.
When to see a doctor
While irregular bleeding is normal in perimenopause, certain bleeding patterns warrant medical evaluation. See your healthcare provider if you experience:
- Very heavy bleeding or bleeding that lasts longer than seven days
- Bleeding between periods or more frequent periods (less than 21 days apart)
- Bleeding after 12 months without a period, which could indicate a health issue requiring attention
- Bleeding after sexual intercourse
At Skindepth, women can book a comprehensive women’s health consultation with Dr Maryam Dehkordi, who provides personalised, evidence based care for perimenopause and hormonal health. These consultations attract Medicare rebates and do not require a GP referral, making access to care simple and convenient.
Dr Dehkordi takes a holistic approach, looking beyond symptoms to assess hormonal balance, metabolic health, weight, mood and overall wellbeing. Based on this thorough assessment, she provides individualised management options that may include lifestyle guidance, nutritional strategies and prescription treatments where clinically appropriate.
Effective perimenopause care is never one size fits all. At Skindepth, our medical and dermal teams work together to support women through this transition, helping you feel informed, confident and supported in both your internal health and the skin you live in every day.
Book an appointment with Dr Maryam Dehkordi today.
Frequently asked questions
What is the difference between perimenopause and menopause?
Perimenopause is the transition stage leading up to menopause, when your hormone levels fluctuate and symptoms may occur. This phase can last 1 to 10 years. Menopause is officially defined as 12 months without a menstrual period. Once you've reached that milestone, you are in menopause and the perimenopause transition is complete.
At what age does perimenopause typically start?
Perimenopause most commonly begins in the early to mid-40s, though some women may experience signs of perimenopause as early as their 30s, while others don't experience symptoms until their 50s. Age of onset can vary significantly based on family history, lifestyle factors, and individual health.
How long does perimenopause usually last?
On average, perimenopause lasts 4 to 6 years, though the range can be anywhere from 1 to 10 years. There is significant individual variation, some women transition quickly while others experience a longer perimenopause phase.