Women’s Health


Menopause means the last menstrual period. Periods stop because the low levels of estrogen and progesterone do not stimulate the lining of the womb (endometrium) in the normal cycle.


Perimenopause is the stage from the beginning of menopausal symptoms to the postmenopause.

The fluctuating and gradually falling level of estrogen taking place during the perimenopause, can lead to early signs of the symptoms more often associated with the menopause such as hot flushes, night sweats, mood changes, disturbed sleep, joint aches and change in weight and distribution of fat; more fat tends to be deposited around the waist rather than the hips leading to a change to the “apple” shape rather than “pear” shape. Symptoms affecting the vagina and bladder such as vaginal dryness, irritation and itch, discomfort during sex, passing urine often and at night and discomfort when passing urine, are thought to be later symptoms of the menopause, but some women may notice them in the perimenopause. Symptoms may be initially mild and, because periods are still present, are often not recognised as being hormone related. Further confusion may arise because, as with period problems changing from month to month due to fluctuating ovarian function and hence fluctuating progesterone production, estrogen production may also fluctuate and so these estrogen deficiency symptoms may also vary.

It is important that women are able to recognise these early changes and that discussions take place so that women understand what is happening. Dr. Pep is available for a consultation to explore these changes with you.


Postmenopause is the time following the last period, and is usually defined as more than 12 months with no periods in someone with intact ovaries, or immediately following surgery if the ovaries have been removed.

Menopause – when does menopause happen?

The average age of the natural menopause is 51 years, but can occur much earlier or later. Menopause occurring before the age of 45 is called Early Menopause and before the age of 40 is premature menopause.

Generally, women having an early or premature menopause are advised to take HRT until approximately the average age of the menopause, for both symptom control and bone protective effect.

Late menopause may also occur but by the age of 54, 80% of women will have stopped having periods.

Period Problems

Often the changing and falling progesterone level, which regulates the lining of the womb (the endometrium), causes erratic, heavy or prolonged periods before any other menopausal symptoms are noticed. Many women experience periods which can be unpredictable and so heavy that the flow can be difficult to control, often flooding through sanitary wear and clothing. Women often put up with this inconvenience for some time before seeking help.

At Perpetual Beauty and Wellness, we want to make sure you’re not alone in this journey. Dr. Pep will discuss with you the very effective treatments that are are available to manage your symptoms. Dr. Pep recommends that help should be sought sooner rather than later by women who are going through the change.

Dr. Pep will arrange investigations such as an examination and possibly referral for a sample to be taken from the lining of the womb or a pelvic scan based on individual patients needs and time of presentation. These investigations are to exclude causes other than the hormonal changes of the perimenopause. Once it is established that the cause is hormonal imbalance, treatments can be considered and discussed with you.


If the main problem is heavy periods which are not too frequent, you can be given treatment based on your preference. These treatments can be lifestyle changes, hormonal, non-hormonal or surgical treatment options. Dr. Pep understands that women tend to have thoughts and ideas on how they want to manage their life during this time. Some are worried about medications and their side effects. Dr. Pep feels that information around menopause should be available for everyone women enough for each woman to make an information treatment decision. Dr. Pep will provide you with adequate information to make the right and safe decisions for you.

If any of the above applies to you or you are wondering about the next phase of your life -the menopause phase or you are already experiences above mentioned symptoms, click on the link for consultation with Dr. Pep