Perimenopause can present with a wide range of symptoms, making it easy for the consultation to become an unprioritised list of concerns. For women over 45 with typical symptoms and changing menstrual patterns, however, diagnosis is usually clinical, rather than dependent on hormone testing.

In this HealthCert podcast, Dr Simone Gonzo explores a structured approach to assessment and management, including how to recognise perimenopause while avoiding diagnostic overshadowing.

A key consideration is abnormal bleeding. While cycle changes are common during perimenopause, heavy, intermenstrual, postcoital, or postmenopausal bleeding should not simply be attributed to hormonal changes. Dr Gonzo discusses how to assess bleeding, identify relevant risk factors, and determine when further investigation or specialist assessment is warranted.

The episode also covers symptom-focused management, including menopausal hormone therapy, non-hormonal options, genitourinary symptoms, contraception, and the role of the 52 mg LNG-IUD.

Watch the full video podcast here.

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