Perimenopause & Menopause – Dr David Krones

Gynaecology

Perimenopause & Menopause

The menopause transition is a significant phase of life, not a problem to be tolerated. With clear information and modern, individualised treatment, most women feel substantially better.

40s Perimenopause often begins in the early-to-mid 40s
51 Average age of menopause in Australia
12 mo Without a period confirms menopause has occurred

Perimenopause is the transitional phase before periods stop, often beginning in the early-to-mid 40s. Menopause itself is confirmed once 12 consecutive months have passed without a period — on average, around the age of 51 in Australia. The years that follow are called postmenopause.

Understanding the transition


The menopause transition unfolds across three distinct phases, each with its own characteristics.

Perimenopause

Often early-to-mid 40s

The transitional years before periods stop. Hormone levels fluctuate, periods become irregular, and symptoms such as hot flushes and sleep disturbance often begin.

Menopause

Average age 51

Confirmed once 12 consecutive months have passed without a period. This marks the natural end of the reproductive years.

Postmenopause

The years that follow

Life after menopause. Some symptoms ease, while attention to bone, cardiovascular and genitourinary health becomes increasingly important.

Common symptoms


Symptoms vary widely between women and can affect physical health, mood, sleep and quality of life.

Hot flushes & night sweats The most recognised symptoms, varying in frequency and intensity
Disturbed sleep Difficulty falling or staying asleep, often worsened by night sweats
Mood & anxiety changes Mood changes, anxiety and lower tolerance for stress
Brain fog Concentration and memory difficulties that can be unsettling
Menstrual changes Irregular, heavier or lighter periods during perimenopause
Vaginal dryness Dryness and discomfort, including during intercourse
Reduced libido A decline in sexual desire, often multifactorial
Joint & muscle aches Generalised aches and stiffness that are easily overlooked
Urinary symptoms Urgency, frequency or recurrent urinary tract infections

How perimenopause and menopause are diagnosed


Diagnosis is primarily based on age, symptoms and menstrual pattern. For most women, blood tests have a limited role — although they can be helpful for younger women with menopausal symptoms, or where the diagnosis is unclear.

A general health review forms an important part of the consultation, including blood pressure, cholesterol, bone health, and breast and cervical screening. This phase of life is an ideal opportunity to take stock of long-term health, not just to manage symptoms.

Treatment approach


Treatment is individualised to your symptoms, risk profile and preferences — there is no single right answer.

Lifestyle & nutrition

Practical advice on weight, alcohol, exercise and sleep — foundations that improve symptoms and long-term health.

Menopausal hormone therapy

MHT tailored to your symptoms, risk profile and preferences, with a clear discussion of the modern evidence.

Non-hormonal options

Effective alternatives for women who prefer or medically require a non-hormonal approach.

Vaginal therapy

Localised treatment for genitourinary symptoms such as dryness, discomfort and urinary changes.

Bone & heart health

Screening and advice on bone density and cardiovascular health, which become increasingly important after menopause.

Mental health & sleep

Support for mood, anxiety and sleep disturbance, recognising how closely these are tied to the transition.

Dr Krones' Approach

Modern, evidence-based menopause care


Modern menopause care is far more nuanced than the headlines of two decades ago suggested. Dr Krones takes a contemporary, evidence-based approach to menopausal hormone therapy, with a careful individual discussion of the risks, benefits and alternatives.

The goal is to help you make an informed choice that fits your symptoms, your health history and your priorities — so that this phase of life feels managed rather than merely endured.

When to see a specialist


Specialist review is particularly helpful if:

  • Symptoms are significantly affecting your daily life
  • You have early menopause (before age 45)
  • You have a complicated medical history
  • You have tried first-line treatments without success

Book a consultation


Dr Krones consults at Suite 3A, North Shore Private Hospital, St Leonards, with operating privileges at North Shore Private Hospital and The Mater Hospital, Crows Nest.

A valid GP or specialist referral is required for all new appointments.

02 9053 1245