Perimenopause
Perimenopause is the transitional phase leading up to menopause when hormone levels begin to fluctuate, often starting in the mid-to-late 40s. Because hormone levels fluctuate rather than steadily decline, it is often a clinical diagnosis based on symptoms and age. Dr Kasi Subbiah provides a thorough assessment and personalised treatment plan.
Common symptoms
- Irregular periods, heavier, lighter, more or less frequent than before
- Hot flushes and night sweats
- Mood swings, irritability, or anxiety
- Sleep problems
- Brain fog
Diagnosis and symptom assessment
Perimenopause is usually identified from age, changing menstrual patterns and symptoms rather than a single hormone test. Review considers hot flushes, sleep, mood, headaches, bleeding pattern, sexual symptoms, contraception needs, bone health and alternative causes such as thyroid disease or anaemia.
What we offer
- Thorough discussion of symptom pattern and cycle changes
- Blood tests where they add useful information
- Personalised treatment plan, including hormonal and non-hormonal options
Treatment choices
Options can include lifestyle measures, non-hormonal treatments and hormone replacement therapy when suitable. The choice depends on symptoms, personal and family history, cardiovascular and breast-health factors, migraine, bleeding, contraception and individual preferences. Unexpected heavy bleeding, bleeding after sex or persistent bleeding requires appropriate assessment.
UK-wide video consultations
Assessment and follow-up can often take place securely by video across the UK. Examination, breast or pelvic assessment, imaging and urgent care are arranged locally when needed.