Understanding Perimenopause and Menopause

A Guide for Defence Families and Veterans Dr Lise Legault, MD, FRACGP

If you've been feeling unlike yourself lately, you're not alone. In Australia, around 1.5 million women are navigating perimenopause or menopause at any given time. For defence families and veterans, where the demands of service, frequent relocations, deployments, and the transition to civilian life already take a toll, understanding this change can make a real difference.

What is perimenopause and menopause?

Perimenopause is the transition phase leading up to menopause, usually beginning in a woman's mid-40s but sometimes earlier. During this time, hormone levels fluctuate, causing a wide range of symptoms.

What do I hear from my patients?

In their 40s, women often start noticing early changes they can't quite explain. They tell me they're feeling hot for no reason, their libido has dropped, and they're getting new muscle aches and pains. Hair and nails start changing. Many say they've become "snappy" or more emotional than usual.  

One of the most common complaints is brain fog: trouble with memory, difficulty concentrating, and feeling scattered. Some women even wonder whether they have ADHD. Weight creeping on around the stomach, despite no change in diet or exercise, is another frequent frustration.

As women move into their mid-50s and beyond, new issues tend to appear which are incredibly common but often go unmentioned because women feel embarrassed to bring them up - we are here to help throughout the menopausal journey.

What can help?

Menopausal Hormone Therapy (MHT) is the most effective treatment for bothersome symptoms. It is available as gels, patches or tablets, and usually involves oestrogen combined with progesterone if you still have your uterus. MHT can reduce hot flushes and night sweats, improve sleep, mood, and brain fog, and support bone and heart health long term.

Is it safe?

For most women who start MHT before age 60 or within 10 years of menopause, the benefits outweigh the risks. Modern preparations like patches and gels carry minimal blood clot risk. MHT does not cause weight gain. There is a small increased breast cancer risk with combined therapy, depending on the type and personal factors, and this risk decreases after stopping. There are other treatments that can help, such as Testosterone therapy (Androfeme).

Don't forget your screening

Midlife is also an important time for health checks: cervical screening every five years, breast screening from age 50, a cardiovascular risk check, and bone density screening from age 70.

The bottom line

Whether you are serving, have served, supporting a partner through service, or navigating life after the military, you do not need to just push through. There are safe and effective options to help you feel like yourself again. Talk to your GP about what is right for you.