Supporting women through every stage of menopause
WellFemme is a proud TerryWhite Chemmart partner, and their preferred provider of quality Perimenopause and Menopause Telehealth services.
WellFemme + TerryWhite Chemmart = Complete Menopause Care
Midlife is a critical turning point for women's health
If you experience symptoms or issues related to the menopausal transition, timing is everything! Evidence-based treatments that relieve your symptoms can also provide long term health benefits for your heart, bones and brain.
See a menopause informed health professional about your specific symptoms and circumstances
Responsive Support, online AND in-store
TerryWhite Chemmart's partnership with WellFemme provides seamless end-to-end care: from your initial assessment through to prescribing, filling scripts and follow up.
With WellFemme's detailed GP reports and on-demand clinical support, plus in-store support from your local TerryWhite Chemmart, you can count on responsive support when you need it most- especially in the early months of a new treatment.
Accessible & Personal
We meet every woman where she’s at: no topic is off limits. Whether you’re just beginning perimenopause or navigating hormonal treatments, You can expect warm, respectful, and judgement-free support.
WellFemme's Telehealth model makes it easier for women across Australia- especially in regional and rural areas- to access tailored menopause care from trusted professionals, without long waitlists or rushed appointments.
VIP Benefits for TerryWhite Chemmart customers
We strongly believe that integrated healthcare from trusted, collaborative providers is the key to optimal health for our patients. We want you to have the best possible care, so we welcome TerryWhite Chemmart customers with these extra VIP benefits:
*FREE access to our Menopause Uncensored Summit on demand, and
*50% discount on lifetime access to our Next Phase Women’s Wellness Program
Signs and Symptoms of Menopause
Click on the relevant tab below for information about these symptoms. For more detailed information you can also explore our pages about Vaginal and Urinary Symptoms, Peri & Menopausal Symptoms, and Hormonal Therapy.
What it feels like:
A sudden wave of heat, often across the face, neck, and chest, sometimes with flushing, sweating, palpitations, dizziness, anxiety, or a feeling of needing to cool down quickly. Episodes may last from seconds to several minutes and can occur day or night.
Waking during the night feeling hot, sweaty, and uncomfortable, often needing to change clothes or bedding. Episodes may be followed by chills and difficulty returning to sleep.
What it can be caused by:
Fluctuating and declining estrogen levels affect the brain’s temperature control centre, making it more sensitive to small changes. Hot flushes (vasomotor symptoms) are a common result of this process. As oestrogen declines, the brain becomes more reactive to temperature changes, triggering sudden cooling responses such as sweating and flushing. These symptoms can vary in frequency and intensity and may be influenced by stress, poor health, alcohol, and lifestyle factors.
Night sweats often occur alongside hot flushes and can be worsened by stress, alcohol, or sleep environment factors. They also fragment sleep and reduce restorative deep sleep.
Whilst sweats are a common feature of perimenopause and menopause, they can also be a sign of other medical conditions, including some serious ones. If sweats don’t improve with appropriate menopause treatments you should see a doctor for investigation of other possible causes.
Practical steps:
- Dress in layers that can be removed quickly
- Carry a portable fan or cooling spray
- Sip ice-cold water or suck ice chips during episodes
- Keep bedroom temperature cool with airflow or air conditioning
- Wear hair up to reduce neck heat
- Avoid triggers such as alcohol, spicy food, caffeine, and smoking
- Keep a symptom diary to identify patterns
- Practice paced breathing during episodes
- Use breathable bedding (cotton, bamboo, linen)
- Layer bedding for easy adjustment
- Wear lightweight sleepwear
- Keep spare clothing and towel nearby
- Take a lukewarm shower before bed
- Use relaxation techniques before sleep
Local / non-pharmacological treatments:
- Cognitive Behavioural Therapy (CBT)
- Clinical hypnosis
- Exercise Physiology support
- Weight management
- Stress reduction technique
Over-the-counter options:
Whilst there are some herbal options that are supported by evidence, most are not. Overall they are not the most effective treatment for flushes, and users should be aware that these products are unregulated: there is no guarantee of consistency, purity or effectiveness.
If your symptoms are mild and you would like to try something, check out the evidence in this factsheet from the Australasian Menopause Society.
Medical treatments:
For those who can’t, or prefer not to, take hormonal therapies there are a range of non-hormonal medications that can result in good reduction of hot flushes. For example, if you have had breast cancer you will usually be advised to avoid hormonal treatment, but you still may have dreadful symptoms that need managing.
The options include medications that were originally designed for other purposes, and therefore have additional effects which some people might find beneficial, eg. sedation, anti-depressant effects or reduction of urinary frequency. There is also a new class of drug specifically targeting flushes (NK3 inhibitors).
You can read about various options here, but you will need an appointment with a menopause-informed doctor for an assessment and prescribing.
Hormonal treatments:
Nothing else is as effective for management of menopause-related hot flushes and sweats (vasomotor symptoms) as hormonal therapy. It is over 95% effective for this purpose and is also indicated for the treatment of osteoporosis because of its benefits in preventing bone loss.
It is also known to have preventive benefits against cardiovascular disease for many women, but it is important to commence treatment at around the age of menopause, or within 10 years of menopause.
The safety concerns about Menopausal Hormone Therapy (MHT) have been reassessed in the last 20 years, and international menopause societies now agree that it is a safe and effective option for most women if commenced within 10 years of menopause.
You can read about various options here, but you will need an appointment with a menopause-informed doctor for an assessment and prescribing.
When to See a Doctor
Persistent, severe, or disruptive hot flushes and night sweats should be medically assessed, particularly if they affect sleep, daily functioning, or occur alongside other concerning symptoms.
If you can’t find the professional help you need for your menopausal symptoms then book a Telehealth consultation today with an expert WellFemme menopause doctor.
Disclaimer: This content is for informational purposes only and does not constitute medical advice or a clinical consultation. Always discuss your symptoms and treatment options with a qualified health professional for an individualised assessment and recommendations.
Mood changes during perimenopause and menopause are a common and sometimes devastating issue. Beyond Blue reports that around 1/3 of Australian women in the menopausal transition report clinically meaningful mood problems (depression and/or anxiety). It is also the age group of women with the highest suicide rates.
What it feels like:
Increased emotional sensitivity, irritability, or feeling “on edge” without a clear trigger. Some women experience low mood, irrational rages, tearfulness, anxiety, or reduced stress tolerance. It may feel harder to cope with everyday challenges, with emotions feeling more intense or unpredictable than before. For some, there may be episodes of overwhelm, mental fatigue, or loss of confidence in emotional stability.
What it can be caused by:
Mood is strongly influenced by fluctuating and declining oestrogen levels, which affect key neurotransmitters in the brain including serotonin, dopamine, and GABA. These hormonal shifts can alter emotional regulation, stress tolerance, and resilience. Sleep disruption, hot flushes, fatigue, and physical symptoms can further intensify emotional vulnerability.
Life stage factors such as increased responsibilities, caregiving roles, and psychological stressors may also contribute. These changes are widely recognised as part of the neuroendocrine transition of menopause, as reflected in clinical menopause education resources such as wellfemme.com.au.
Practical steps:
- Prioritise consistent sleep and rest to stabilise mood regulation systems
- Regular physical activity (especially walking or resistance training) to support neurotransmitter balance
- Reduce caffeine and alcohol, which can worsen anxiety and sleep disruption
- Establish simple daily routines to reduce cognitive overload
- Practice grounding techniques such as paced breathing or mindfulness
- Maintain regular social connection and supportive conversations
- Track mood patterns alongside menstrual cycle and /hormonal changes if relevant
- Break tasks into smaller, manageable steps during low mood periods
Local / non-pharmacological treatments
There are a range of very effective psychological therapies that can be delivered in person by a health professional, or even though an App. Check this guide for ideas, including:
• Cognitive Behavioural Therapy (CBT) for mood regulation and thought patterns
• Mindfulness-based stress reduction (MBSR)
• Exercise physiology programs for structured movement support
• Counselling or psychotherapy for emotional processing and life-stage stressors
• Breathwork, yoga, and nervous system regulation practices
• Menopause education and support programs
Over-the-counter options:
- Magnesium: supports nervous system regulation and sleep quality
- Omega-3 fatty acids: may support mood stability and brain health
- Vitamin D: associated with mood regulation in deficiency states
- B-complex vitamins: support energy metabolism and nervous system function
- Herbal options (variable evidence):
– St John’s Wort (mild depressive symptoms; interactions possible)
– Saffron extract (emerging evidence for mood support)
Medical treatments:
You will need a thorough assessment by a doctor who is knowledgeable about midlife hormonal issues and mental health for a discussion of options and prescribing, such as a GP or Psychiatrist.
- Menopausal Hormone Therapy (MHT/HRT): may improve mood stability in perimenopause and early menopause
- Antidepressants: may support anxiety, irritability, sleep and depressive symptoms
- Short-term sleep support medications (if sleep disruption is driving mood changes)
- Thyroid assessment and treatment if clinically indicated
- Mental health review if symptoms are persistent or significantly impacting function
- Your GP can write a Mental Health Care Plan for reduced-cost psychology support
When to See a Doctor
Ongoing mood or cognitive changes such as anxiety, low mood, irritability, brain fog, poor concentration, memory difficulties, or mental fatigue should be medically assessed, particularly if they are worsening or affecting daily functioning, relationships, sleep, or work performance.
If you can’t find the professional help you need for your menopausal symptoms then book a Telehealth consultation today with an expert WellFemme menopause doctor.
Disclaimer: This content is for informational purposes only and does not constitute medical advice or a clinical consultation. Always discuss your symptoms and treatment options with a qualified health professional for an individualised assessment and recommendations.
Sleep disturbance affects up to 60% of women during the menopausal transition, roughly double the rate seen before perimenopause. Around one in four experience symptoms severe enough to qualify as clinical insomnia, with significant impacts on mood, energy, work performance, and overall health.
What it feels like:
Difficulty falling asleep, frequent waking, early morning waking, waking at 2–3am with racing thoughts, or non-restorative sleep with persistent fatigue.
The most common sleep disorder of midlife women in Australia is Obstructive Sleep Apnoea (OSA)- 24% of women. Restless legs syndrome affects around 3-4% of women, and there are other sleep movement disorders too.
What it can be caused by:
Sleep disturbance is often multifactorial during perimenopause and menopause. Contributing factors specific to this life stage include:
- Hormonal changes — declining oestrogen and progesterone disrupt circadian rhythm regulation; rapid hormonal shifts (as in surgical menopause) are associated with more severe symptoms
- Vasomotor symptoms — hot flushes and night sweats strongly correlate with waking, though not every flush causes waking and not every waking is flush-related
- Sleep-disordered breathing — snoring and obstructive sleep apnoea (OSA) become more common post-menopause; women often present differently than men, with fatigue and insomnia rather than witnessed apnoeas
- Restless legs syndrome — increases around menopause
- Mood changes — anxiety and depression both cause and are worsened by poor sleep
- Life stressors — caring for ageing parents, relationship changes, career pressures
Practical steps:
- Maintain consistent sleep and wake times
- Create a cool, dark, quiet bedroom environment
- Avoid screens 1 hour before bed
- Use wind-down routines such as reading or breathing exercises
- Get morning light exposure
- Limit naps
- Reduce caffeine and alcohol
- Use cooling strategies if needed
Over-the-counter options:
- Melatonin
- Magnesium glycinate – Magnesium glycinate is a well-tolerated form of magnesium often used to support relaxation and sleep. Australian sleep health guidance does not position magnesium as a primary treatment for insomnia; however, magnesium plays a role in neuromuscular relaxation and may be used as an adjunct in some individuals. Evidence for direct improvement in sleep quality remains limited.
Medical Treatments:
Medication is typically considered when behavioural and lifestyle strategies alone are insufficient, or when there is a clear underlying medical contributor such as significant insomnia, anxiety, pain, or vasomotor symptoms. All pharmacological options should be used under medical supervision, with careful consideration of risks, benefits, interactions, and suitability for long-term versus short-term use.
Specialist Assessment:
Your GP should conduct screening and possibly refer you for a sleep study and/or specialist advice for:
- Suspected sleep apnoea (especially if snoring, witnessed pauses, or excessive daytime sleepiness)
- Restless legs syndrome not responding to simple measures
- Insomnia persisting despite CBT-I and treatment of vasomotor symptoms
- Complex presentations or multiple sleep disorders
Important note:
Persistent sleep disturbance should be medically assessed to rule out conditions such as sleep apnoea, thyroid dysfunction, anxiety disorders, or other underlying causes.
When to See a Doctor
Persistent sleep disturbance should be medically assessed to rule out conditions such as sleep apnoea, thyroid dysfunction, anxiety disorders, or other underlying causes
If you can’t find the professional help you need for your menopausal symptoms then book a Telehealth consultation today with an expert WellFemme menopause doctor.
Disclaimer: This content is for informational purposes only and does not constitute medical advice or a clinical consultation. Always discuss your symptoms and treatment options with a qualified health professional for an individualised assessment and recommendations.
What it feels like:
Symptoms may include vaginal dryness, irritation, burning, itching, or a feeling of tightness. Pain may occur at the vaginal entrance, during penetration, or as a deeper aching pain with thrusting. Some women also experience soreness or sensitivity that persists after intercourse, which can lead to anxiety, muscle guarding, or avoidance of intimacy.
What it can be caused by:
Vaginal dryness and sexual pain (dyspareunia) are commonly caused by declining estrogen levels during perimenopause and menopause, which lead to reduced vaginal lubrication, decreased blood flow, and thinning and loss of elasticity of the vaginal and vulval tissues. This is part of a broader condition known as Genitourinary Syndrome of Menopause (GSM).
Other contributing factors may include insufficient arousal, pelvic floor muscle tension, infections (such as thrush or bacterial vaginosis), skin sensitivity or allergic reactions to products (including condoms or lubricants), endometriosis, vaginismus (involuntary pelvic floor tightening), and psychological or relational factors. Sexual pain is often multifactorial and may require a comprehensive assessment to identify contributing causes.
Practical steps:
- Avoid irritants such as fragranced soaps, washes, douches, wipes, and perfumed products around the vulva or vagina
- Avoid products containing glycerin, propylene glycol, petroleum-based products, and nonoxynol-9 (spermicides) where possible
- Minimise constant use of panty liners or pads, particularly if contributing to irritation
- Avoid very hot water on the genital area
- Wear loose clothing and 100% cotton underwear where possible
- Allow extended foreplay (20+ minutes) to support natural lubrication
- Use lubricants generously before and during intercourse
- Try positions that allow control of depth and pace (e.g. woman on top) or consider spacer devices such as Ohnut
- Practice pelvic floor relaxation techniques (deep breathing, reverse Kegels)
- Communicate openly with your partner about comfort and pain
- Empty bladder before sex to reduce discomfort or pressure
- Avoid intercourse during active irritation, infection, or significant dryness until symptoms settle
Over-the-counter options:
- Vaginal moisturisers: used regularly (2–3 times per week) to hydrate tissues, improve elasticity, and support baseline comfort. Choose pH-balanced, fragrance-free products, ideally with hyaluronic acid. Water-based options are generally preferred for internal use
- Vaginal lubricants: used before or during sex to reduce friction and pain. Water-based lubricants are generally low-irritant and condom-safe; silicone-based lubricants may last longer but should be avoided with silicone toys; oil-based products are not compatible with latex condoms
- Barrier creams (external use only): may help protect vulval skin from irritation or friction (e.g. zinc-based or bland emollients)
- Simple analgesia (e.g. paracetamol or ibuprofen): may be used before sex if pain or muscle tension contributes
- Lidocaine 2–5% gel: short-term use for entry pain under guidance where appropriate
Medications & hormonal options:
Prescription treatments should be discussed with a doctor or nurse practitioner following assessment. These may include treatment of underlying infection or inflammation, as well as symptom-directed therapies:
- Antifungal or antibiotic treatment if infection is present
- Low-dose topical steroid creams for vulval skin inflammation or dermatitis
- STI testing and treatment where appropriate
Hormonal treatments:
- Vaginal oestrogen cream: applied locally to improve tissue thickness, elasticity, and moisture
- Vaginal oestrogen pessary/tablet: low-dose local oestrogen delivered intravaginally
- Vaginal DHEA pessary: converted locally into oestrogen and androgens within vaginal tissues
- Systemic menopausal hormone therapy (MHT/HRT): may be considered if vaginal symptoms occur alongside other menopausal symptoms
- Note: Vaginal oestrogen therapies are highly effective and generally considered very safe for local treatment of GSM. They act primarily on local tissues with minimal systemic absorption and may be suitable in many women after individual clinical assessment.
For muscle tension and pain-related contributors:
• Pelvic floor physiotherapy for muscle relaxation and coordination
• Psychological therapy or sexual counselling for pain-related anxiety, trauma, or relationship factors
• Muscle relaxant treatments or specialist interventions (e.g. Botox) in selected cases under specialist care
When to See a Doctor
Persistent vaginal dryness or sexual pain should be medically assessed, particularly if symptoms are ongoing or worsening, or to exclude underlying causes such as infection, dermatological conditions, pelvic floor dysfunction, endometriosis, or other gynaecological conditions.
If you can’t find the professional help you need for your menopausal symptoms then book a Telehealth consultation today with an expert WellFemme menopause doctor.
Disclaimer: This content is for informational purposes only and does not constitute medical advice or a clinical consultation. Always discuss your symptoms and treatment options with a qualified health professional for an individualised assessment and recommendations.
Low libido in perimenopause and menopause is influenced by fluctuating and declining estrogen and testosterone levels, which affect sexual desire, arousal, and sensitivity. These hormonal changes also impact vaginal tissue health, blood flow, and lubrication, which can make intimacy feel less comfortable or less rewarding.
Beyond hormones, libido is closely linked to sleep quality, stress, fatigue, mood changes, relationships (or the lack of) and the overall nervous system state. Many women also experience a shift in identity, body confidence, and emotional connection during midlife, which can further influence desire.
What it feels like:
A reduction or absence of sexual desire, less spontaneous interest in intimacy, or feeling emotionally or physically “disconnected” from sexual response. Some women notice reduced arousal, less sensitivity during intimacy, or needing more time and stimulation than previously. It may also feel like sex becomes something avoided rather than desired, particularly if there is vaginal dryness, discomfort, fatigue, or mental overload.
Practical steps:
- Prioritise sleep and rest to support energy and hormonal balance
- Use regular vaginal moisturisers to support tissue comfort
- Use lubricants during intimacy to reduce discomfort
- Reduce stress load where possible, including mental and emotional fatigue
- Rebuild intimacy without pressure or expectation of performance
- Incorporate pelvic floor relaxation and gentle movement
- Support circulation through regular exercise and walking
- Discuss with a trusted friend or health professional
Over-the-counter options:
- Vaginal moisturisers are designed for ongoing dryness, not just sex-related lubrication. Used regularly, often a few times per week, they help hydrate the vaginal tissues, provide a protective barrier, improve elasticity and help reduce discomfort. It is important to read the label carefully and choose products that are pH balanced, fragrance free and ideally contain hyaluronic acid. Water based options are generally more soothing and safer for internal use. They can also be used with condoms and toys. Oil and silicone based moisturisers may last longer but may be more irritating and are unsafe with condoms
- Vaginal lubricants are used before or during intercourse to help reduce friction and/or pain. Water-based lubricants are low irritant and can be used safely with condoms and toys. They can soak quickly into dry tissues during sex however, whereas oil and silicone lubricants stay slick and slippery for longer. Silicone lubes should be avoided with silicone-coated toys, and oil-based lubricants should be avoided with condoms. Once again, choose products that are fragrance and flavour free, pH balanced and avoid the same ingredients as moisturisers
- Barrier creams. For those times when your vulval area might be exposed to chemicals or soaps (like swimming or baths), or friction from bike/ horse riding or chafing clothes, a barrier layer will help to coat and protect the delicate tissues. Ask your pharmacist about bland baby-safe zinc or barrier creams (external use only), or even an oil-based lubricant (we love Olive and Bee for this job, as well as intimate lubrication
- Omega-3 fatty acids: may support mood and hormonal balance
- Magnesium: supports sleep, stress regulation, and nervous system balance
- There are also a range of comfort, support and arousal devices to help with pleasure (and avoid pain); your pelvic floor physio can help with recommendations.
Medical treatments:
You will need a thorough assessment by a doctor who is knowledgeable about intimacy issues and hormones for a discussion of options and prescribing. Seek out a trusted health professional who you feel comfortable with and trust… these things shouldn’t be rushed.
- Menopausal Hormone Therapy (MHT/HRT): may improve libido indirectly via sleep, mood, and vaginal symptom improvement
- Vaginal oestrogen therapy: improves tissue health, comfort, and sexual function
- Testosterone therapy (selected postmenopausal cases): may improve sexual desire
- Medication review (e.g. antidepressants): SSRIs: some medications, such as antidepressants may reduce libido in some cases and orgasms
Local / non-pharmacological treatments:
- Sex therapy or relationship counselling
- Pelvic floor physiotherapy
- Cognitive Behavioural Therapy (CBT) for desire, stress, and body image
- Mindfulness-based stress reduction approaches
- Menopause education and coaching support
When to See a Doctor
Persistent low libido or reduced sexual desire should be medically assessed, particularly if it is distressing, affecting relationships or quality of life, or to exclude underlying causes such as hormonal changes, mood disorders, medication effects, thyroid dysfunction, or chronic medical conditions.
If you can’t find the professional help you need for your menopausal symptoms then book a Telehealth consultation today with an expert WellFemme menopause doctor.
Disclaimer: This content is for informational purposes only and does not constitute medical advice or a clinical consultation. Always discuss your symptoms and treatment options with a qualified health professional for an individualised assessment and recommendations.
What it feels like:
Changes in menstrual patterns can present in different ways, including missed periods, very frequent cycles, irregular timing, heavier or lighter bleeding than usual, prolonged bleeding, or significant menstrual pain. Some women experience fatigue, dizziness, or breathlessness related to heavy blood loss, while others may notice disruptive cramping, pelvic pain, or pain that interferes with daily activities. Emotional symptoms such as frustration or anxiety around unpredictable bleeding are also common.
What it can be caused by:
Irregularity is common during early adolescence and the perimenopausal transition due to fluctuating and declining ovarian hormone production. Outside these life stages, changes in menstrual frequency, flow, or pain may reflect hormonal imbalance, structural conditions (such as fibroids or adenomyosis), ovulatory dysfunction, thyroid disorders, polycystic ovarian syndrome (PCOS), endometriosis, stress, nutritional factors, or (less commonly) more serious underlying conditions. Family history of menstrual disorders, early menopause, infertility, or endometriosis may increase individual risk.
Practical steps:
- Track cycle length, bleeding days, and symptoms using a diary or app
- Record severity of pain using a 1–10 scale
- Track bleeding volume (e.g. number of pads/tampons used per day)
- Note associated symptoms such as fatigue, clots, or intermenstrual bleeding
- Seek medical review if cycles fall consistently outside 21–35 days outside perimenopause/adolescence
- Pay attention to family history of menstrual or gynaecological conditions
- Seek early assessment for heavy bleeding, severe pain, or significant cycle change
- Consider iron levels if experiencing fatigue, heavy bleeding, or breathlessness
Over-the-counter options:
- Non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen or naproxen (when used at period onset, can reduce pain and bleeding)
- Heat therapy (heat packs) for cramp relief
- Magnesium: may support muscle relaxation and reduce cramping in some individuals
- Iron supplementation if iron deficiency is present or suspected
Medical treatments:
- Combined oral contraceptive pill: regulates cycles, reduces bleeding, and may reduce pain
- Progestin therapies: regulate endometrial growth and bleeding patterns
- Tranexamic acid (where appropriate and prescribed in some settings) for heavy menstrual bleeding
- Levonorgestrel intrauterine device (Mirena): highly effective for reducing heavy bleeding
- Hormonal contraceptive implants or injections (may alter bleeding patterns variably)
- Menopausal Hormone Therapy (in perimenopause, where appropriate)
- Treatment of underlying conditions such as PCOS, thyroid disorders, fibroids, or endometriosis
- Specialist gynaecological procedures (e.g. fibroid management, endometrial ablation)
- Surgery (e.g. hysterectomy) in severe or treatment-resistant cases
Local / non-pharmacological treatments:
- Gynaecology or GP assessment for diagnosis and management planning
- Pelvic ultrasound or further investigation where indicated
- Pelvic physiotherapy for chronic pelvic pain
- Dietary and lifestyle support (iron intake, nutrition, stress management)
- Cognitive Behavioural Therapy (CBT) for chronic pain coping strategies
- Endometriosis education and support services
- Fertility and hormonal counselling where relevant
When to See a Doctor
Abnormal menstrual changes such as very heavy, prolonged, frequent, infrequent, irregular, or painful periods should be medically assessed, particularly if they are new, worsening, or to exclude underlying causes such as hormonal imbalance, fibroids, endometriosis, thyroid disorders, PCOS, or other gynaecological conditions.
If you can’t find the professional help you need for your menopausal symptoms then book a Telehealth consultation today with an expert WellFemme menopause doctor.
Disclaimer: This content is for informational purposes only and does not constitute medical advice or a clinical consultation. Always discuss your symptoms and treatment options with a qualified health professional for an individualised assessment and recommendations.
What it feels like:
Gradual weight gain, often centred around the abdomen, with clothes feeling tighter at the waist despite little or no change in lifestyle. Many women notice a change in body shape rather than just overall weight, along with increased bloating, fluid retention, and a sense that their body is “resisting” previous diet and exercise approaches. Everyday activities such as walking upstairs or carrying groceries may feel more effortful. Fatigue, low mood, and sleep disruption are often present and can make lifestyle changes feel harder to maintain, contributing to frustration and a loss of control over energy and body composition.
What it can be caused by:
Weight gain during perimenopause and menopause is driven by the interaction of declining oestrogen levels, ageing, and lifestyle changes, which together alter how the body stores and uses energy. Falling oestrogen influences fat distribution, leading to increased abdominal (visceral) fat rather than hip and thigh storage. This shift is associated with increased insulin resistance, inflammation, and higher cardiovascular risk.
At the same time, loss of muscle mass (sarcopenia) reduces resting metabolic rate, meaning the same dietary intake may now result in gradual weight gain. Hormonal changes affecting appetite regulation (including leptin and ghrelin), along with sleep disruption, chronic stress, and elevated cortisol, further contribute to increased cravings, reduced energy expenditure, and difficulty maintaining previous habits. These factors combine to create a metabolic environment that is less forgiving than in earlier life stages.
Practical steps:
- Aim for at least 150 minutes per week of moderate-intensity aerobic activity (e.g. brisk walking, cycling)
- Include 2–3 sessions per week of resistance or strength training to preserve and rebuild muscle mass
- Prioritise protein intake (approximately 1–1.2g per kg body weight) to support muscle maintenance and satiety
- Increase fibre intake (at least ~25g per day) from vegetables, fruit, legumes, whole grains, nuts, and seeds
- Focus on whole, minimally processed foods and reduce refined carbohydrates where possible
- Use mindful energy balance strategies (e.g. smaller portions, reducing energy-dense snacks)
- Prioritise 7–8 hours of sleep to support appetite regulation and metabolic hormones
- Manage stress through movement, breathwork, mindfulness, or relaxation practices
- Track progress using strength, energy, and measurements rather than weight alone
Over-the-counter options:
- Protein supplements (powders or bars): may support muscle maintenance and satiety when dietary intake is insufficient
- Creatine monohydrate: evidence supports improved strength and lean muscle mass in midlife women when combined with resistance training
- Fibre supplements (e.g. psyllium): may support satiety and blood sugar regulation
- Vitamin D: supports muscle function and metabolic health where deficiency is present
- Omega-3 fatty acids: support inflammation and cardiometabolic health
- Prebiotic and probiotic supplements: may support gut microbiome balance
These should be discussed with a pharmacist or healthcare provider, particularly in the presence of kidney, liver, or metabolic conditions.
Medical treatments:
Medical assessment is important to identify contributing factors such as thyroid dysfunction, insulin resistance, medication effects, or other metabolic conditions.
Treatment options may include:
- Menopausal Hormone Therapy (MHT/HRT): may support fat distribution, energy, mood, and metabolic changes in suitable candidates
- Metformin (where insulin resistance or pre-diabetes is present): may improve insulin sensitivity and reduce visceral fat
- GLP-1 receptor agonists (e.g. semaglutide, liraglutide): may be considered for weight management in eligible patients under medical supervision
- Thyroid assessment and treatment where clinically indicated
- Comprehensive metabolic and cardiovascular risk assessment
When to See a Doctor
Weight gain, particularly if rapid, progressive, or associated with other symptoms, should be medically assessed to exclude underlying causes such as hormonal changes, thyroid dysfunction, metabolic conditions, medication effects, or other medical issues.
If you can’t find the professional help you need for your menopausal symptoms then book a Telehealth consultation today with an expert WellFemme menopause doctor.
Disclaimer: This content is for informational purposes only and does not constitute medical advice or a clinical consultation. Always discuss your symptoms and treatment options with a qualified health professional for an individualised assessment and recommendations.
Mediterranean Diet/Diet Resources
For looking at ways increase protein/fibre/nutritional content of meals.
NutritionTracking Apps
Great for getting an understanding of the nutritional content of food, particularly protein and fibre. To be used with caution if you have had a previous eating disorder or unhealthy relationship with food.
Mindfulness/Meditation Apps:
Yoga Nidra (free)
iBreathe (free)
Calm (paid)
Headspace (paid)
Movement
Signs and Symptoms of Menopause
Click on the relevant tab below for information about these symptoms. For more detailed information you can also explore our pages about Vaginal and Urinary Symptoms, Peri & Menopausal Symptoms, and Hormonal Therapy.
What it feels like:
A sudden wave of heat, often across the face, neck, and chest, sometimes with flushing, sweating, palpitations, dizziness, anxiety, or a feeling of needing to cool down quickly. Episodes may last from seconds to several minutes and can occur day or night.
Waking during the night feeling hot, sweaty, and uncomfortable, often needing to change clothes or bedding. Episodes may be followed by chills and difficulty returning to sleep.
What it can be caused by:
Fluctuating and declining estrogen levels affect the brain’s temperature control centre, making it more sensitive to small changes. Hot flushes (vasomotor symptoms) are a common result of this process. As oestrogen declines, the brain becomes more reactive to temperature changes, triggering sudden cooling responses such as sweating and flushing. These symptoms can vary in frequency and intensity and may be influenced by stress, poor health, alcohol, and lifestyle factors.
Night sweats often occur alongside hot flushes and can be worsened by stress, alcohol, or sleep environment factors. They also fragment sleep and reduce restorative deep sleep.
Whilst sweats are a common feature of perimenopause and menopause, they can also be a sign of other medical conditions, including some serious ones. If sweats don’t improve with appropriate menopause treatments you should see a doctor for investigation of other possible causes.
Practical steps:
- Dress in layers that can be removed quickly
- Carry a portable fan or cooling spray
- Sip ice-cold water or suck ice chips during episodes
- Keep bedroom temperature cool with airflow or air conditioning
- Wear hair up to reduce neck heat
- Avoid triggers such as alcohol, spicy food, caffeine, and smoking
- Keep a symptom diary to identify patterns
- Practice paced breathing during episodes
- Use breathable bedding (cotton, bamboo, linen)
- Layer bedding for easy adjustment
- Wear lightweight sleepwear
- Keep spare clothing and towel nearby
- Take a lukewarm shower before bed
- Use relaxation techniques before sleep
Local / non-pharmacological treatments:
- Cognitive Behavioural Therapy (CBT)
- Clinical hypnosis
- Exercise Physiology support
- Weight management
- Stress reduction technique
Over-the-counter options:
Whilst there are some herbal options that are supported by evidence, most are not. Overall they are not the most effective treatment for flushes, and users should be aware that these products are unregulated: there is no guarantee of consistency, purity or effectiveness.
If your symptoms are mild and you would like to try something, check out the evidence in this factsheet from the Australasian Menopause Society.
Medical treatments:
For those who can’t, or prefer not to, take hormonal therapies there are a range of non-hormonal medications that can result in good reduction of hot flushes. For example, if you have had breast cancer you will usually be advised to avoid hormonal treatment, but you still may have dreadful symptoms that need managing.
The options include medications that were originally designed for other purposes, and therefore have additional effects which some people might find beneficial, eg. sedation, anti-depressant effects or reduction of urinary frequency. There is also a new class of drug specifically targeting flushes (NK3 inhibitors).
You can read about various options here, but you will need an appointment with a menopause-informed doctor for an assessment and prescribing.
Hormonal treatments:
Nothing else is as effective for management of menopause-related hot flushes and sweats (vasomotor symptoms) as hormonal therapy. It is over 95% effective for this purpose and is also indicated for the treatment of osteoporosis because of its benefits in preventing bone loss.
It is also known to have preventive benefits against cardiovascular disease for many women, but it is important to commence treatment at around the age of menopause, or within 10 years of menopause.
The safety concerns about Menopausal Hormone Therapy (MHT) have been reassessed in the last 20 years, and international menopause societies now agree that it is a safe and effective option for most women if commenced within 10 years of menopause.
You can read about various options here, but you will need an appointment with a menopause-informed doctor for an assessment and prescribing.
When to See a Doctor
Persistent, severe, or disruptive hot flushes and night sweats should be medically assessed, particularly if they affect sleep, daily functioning, or occur alongside other concerning symptoms.
If you can’t find the professional help you need for your menopausal symptoms then book a Telehealth consultation today with an expert WellFemme menopause doctor.
Disclaimer: This content is for informational purposes only and does not constitute medical advice or a clinical consultation. Always discuss your symptoms and treatment options with a qualified health professional for an individualised assessment and recommendations.
Mood changes during perimenopause and menopause are a common and sometimes devastating issue. Beyond Blue reports that around 1/3 of Australian women in the menopausal transition report clinically meaningful mood problems (depression and/or anxiety). It is also the age group of women with the highest suicide rates.
What it feels like:
Increased emotional sensitivity, irritability, or feeling “on edge” without a clear trigger. Some women experience low mood, irrational rages, tearfulness, anxiety, or reduced stress tolerance. It may feel harder to cope with everyday challenges, with emotions feeling more intense or unpredictable than before. For some, there may be episodes of overwhelm, mental fatigue, or loss of confidence in emotional stability.
What it can be caused by:
Mood is strongly influenced by fluctuating and declining oestrogen levels, which affect key neurotransmitters in the brain including serotonin, dopamine, and GABA. These hormonal shifts can alter emotional regulation, stress tolerance, and resilience. Sleep disruption, hot flushes, fatigue, and physical symptoms can further intensify emotional vulnerability.
Life stage factors such as increased responsibilities, caregiving roles, and psychological stressors may also contribute. These changes are widely recognised as part of the neuroendocrine transition of menopause, as reflected in clinical menopause education resources such as wellfemme.com.au.
Practical steps:
- Prioritise consistent sleep and rest to stabilise mood regulation systems
- Regular physical activity (especially walking or resistance training) to support neurotransmitter balance
- Reduce caffeine and alcohol, which can worsen anxiety and sleep disruption
- Establish simple daily routines to reduce cognitive overload
- Practice grounding techniques such as paced breathing or mindfulness
- Maintain regular social connection and supportive conversations
- Track mood patterns alongside menstrual cycle and /hormonal changes if relevant
- Break tasks into smaller, manageable steps during low mood periods
Local / non-pharmacological treatments
There are a range of very effective psychological therapies that can be delivered in person by a health professional, or even though an App. Check this guide for ideas, including:
• Cognitive Behavioural Therapy (CBT) for mood regulation and thought patterns
• Mindfulness-based stress reduction (MBSR)
• Exercise physiology programs for structured movement support
• Counselling or psychotherapy for emotional processing and life-stage stressors
• Breathwork, yoga, and nervous system regulation practices
• Menopause education and support programs
Over-the-counter options:
- Magnesium: supports nervous system regulation and sleep quality
- Omega-3 fatty acids: may support mood stability and brain health
- Vitamin D: associated with mood regulation in deficiency states
- B-complex vitamins: support energy metabolism and nervous system function
- Herbal options (variable evidence):
– St John’s Wort (mild depressive symptoms; interactions possible)
– Saffron extract (emerging evidence for mood support)
Medical treatments:
You will need a thorough assessment by a doctor who is knowledgeable about midlife hormonal issues and mental health for a discussion of options and prescribing, such as a GP or Psychiatrist.
- Menopausal Hormone Therapy (MHT/HRT): may improve mood stability in perimenopause and early menopause
- Antidepressants: may support anxiety, irritability, sleep and depressive symptoms
- Short-term sleep support medications (if sleep disruption is driving mood changes)
- Thyroid assessment and treatment if clinically indicated
- Mental health review if symptoms are persistent or significantly impacting function
- Your GP can write a Mental Health Care Plan for reduced-cost psychology support
When to See a Doctor
Ongoing mood or cognitive changes such as anxiety, low mood, irritability, brain fog, poor concentration, memory difficulties, or mental fatigue should be medically assessed, particularly if they are worsening or affecting daily functioning, relationships, sleep, or work performance.
If you can’t find the professional help you need for your menopausal symptoms then book a Telehealth consultation today with an expert WellFemme menopause doctor.
Disclaimer: This content is for informational purposes only and does not constitute medical advice or a clinical consultation. Always discuss your symptoms and treatment options with a qualified health professional for an individualised assessment and recommendations.
Sleep disturbance affects up to 60% of women during the menopausal transition, roughly double the rate seen before perimenopause. Around one in four experience symptoms severe enough to qualify as clinical insomnia, with significant impacts on mood, energy, work performance, and overall health.
What it feels like:
Difficulty falling asleep, frequent waking, early morning waking, waking at 2–3am with racing thoughts, or non-restorative sleep with persistent fatigue.
The most common sleep disorder of midlife women in Australia is Obstructive Sleep Apnoea (OSA)- 24% of women. Restless legs syndrome affects around 3-4% of women, and there are other sleep movement disorders too.
What it can be caused by:
Sleep disturbance is often multifactorial during perimenopause and menopause. Contributing factors specific to this life stage include:
- Hormonal changes — declining oestrogen and progesterone disrupt circadian rhythm regulation; rapid hormonal shifts (as in surgical menopause) are associated with more severe symptoms
- Vasomotor symptoms — hot flushes and night sweats strongly correlate with waking, though not every flush causes waking and not every waking is flush-related
- Sleep-disordered breathing — snoring and obstructive sleep apnoea (OSA) become more common post-menopause; women often present differently than men, with fatigue and insomnia rather than witnessed apnoeas
- Restless legs syndrome — increases around menopause
- Mood changes — anxiety and depression both cause and are worsened by poor sleep
- Life stressors — caring for ageing parents, relationship changes, career pressures
Practical steps:
- Maintain consistent sleep and wake times
- Create a cool, dark, quiet bedroom environment
- Avoid screens 1 hour before bed
- Use wind-down routines such as reading or breathing exercises
- Get morning light exposure
- Limit naps
- Reduce caffeine and alcohol
- Use cooling strategies if needed
Over-the-counter options:
- Melatonin
- Magnesium glycinate – Magnesium glycinate is a well-tolerated form of magnesium often used to support relaxation and sleep. Australian sleep health guidance does not position magnesium as a primary treatment for insomnia; however, magnesium plays a role in neuromuscular relaxation and may be used as an adjunct in some individuals. Evidence for direct improvement in sleep quality remains limited.
Medical Treatments:
Medication is typically considered when behavioural and lifestyle strategies alone are insufficient, or when there is a clear underlying medical contributor such as significant insomnia, anxiety, pain, or vasomotor symptoms. All pharmacological options should be used under medical supervision, with careful consideration of risks, benefits, interactions, and suitability for long-term versus short-term use.
Specialist Assessment:
Your GP should conduct screening and possibly refer you for a sleep study and/or specialist advice for:
- Suspected sleep apnoea (especially if snoring, witnessed pauses, or excessive daytime sleepiness)
- Restless legs syndrome not responding to simple measures
- Insomnia persisting despite CBT-I and treatment of vasomotor symptoms
- Complex presentations or multiple sleep disorders
Important note:
Persistent sleep disturbance should be medically assessed to rule out conditions such as sleep apnoea, thyroid dysfunction, anxiety disorders, or other underlying causes.
When to See a Doctor
Persistent sleep disturbance should be medically assessed to rule out conditions such as sleep apnoea, thyroid dysfunction, anxiety disorders, or other underlying causes
If you can’t find the professional help you need for your menopausal symptoms then book a Telehealth consultation today with an expert WellFemme menopause doctor.
Disclaimer: This content is for informational purposes only and does not constitute medical advice or a clinical consultation. Always discuss your symptoms and treatment options with a qualified health professional for an individualised assessment and recommendations.
What it feels like:
Symptoms may include vaginal dryness, irritation, burning, itching, or a feeling of tightness. Pain may occur at the vaginal entrance, during penetration, or as a deeper aching pain with thrusting. Some women also experience soreness or sensitivity that persists after intercourse, which can lead to anxiety, muscle guarding, or avoidance of intimacy.
What it can be caused by:
Vaginal dryness and sexual pain (dyspareunia) are commonly caused by declining estrogen levels during perimenopause and menopause, which lead to reduced vaginal lubrication, decreased blood flow, and thinning and loss of elasticity of the vaginal and vulval tissues. This is part of a broader condition known as Genitourinary Syndrome of Menopause (GSM).
Other contributing factors may include insufficient arousal, pelvic floor muscle tension, infections (such as thrush or bacterial vaginosis), skin sensitivity or allergic reactions to products (including condoms or lubricants), endometriosis, vaginismus (involuntary pelvic floor tightening), and psychological or relational factors. Sexual pain is often multifactorial and may require a comprehensive assessment to identify contributing causes.
Practical steps:
- Avoid irritants such as fragranced soaps, washes, douches, wipes, and perfumed products around the vulva or vagina
- Avoid products containing glycerin, propylene glycol, petroleum-based products, and nonoxynol-9 (spermicides) where possible
- Minimise constant use of panty liners or pads, particularly if contributing to irritation
- Avoid very hot water on the genital area
- Wear loose clothing and 100% cotton underwear where possible
- Allow extended foreplay (20+ minutes) to support natural lubrication
- Use lubricants generously before and during intercourse
- Try positions that allow control of depth and pace (e.g. woman on top) or consider spacer devices such as Ohnut
- Practice pelvic floor relaxation techniques (deep breathing, reverse Kegels)
- Communicate openly with your partner about comfort and pain
- Empty bladder before sex to reduce discomfort or pressure
- Avoid intercourse during active irritation, infection, or significant dryness until symptoms settle
Over-the-counter options:
- Vaginal moisturisers: used regularly (2–3 times per week) to hydrate tissues, improve elasticity, and support baseline comfort. Choose pH-balanced, fragrance-free products, ideally with hyaluronic acid. Water-based options are generally preferred for internal use
- Vaginal lubricants: used before or during sex to reduce friction and pain. Water-based lubricants are generally low-irritant and condom-safe; silicone-based lubricants may last longer but should be avoided with silicone toys; oil-based products are not compatible with latex condoms
- Barrier creams (external use only): may help protect vulval skin from irritation or friction (e.g. zinc-based or bland emollients)
- Simple analgesia (e.g. paracetamol or ibuprofen): may be used before sex if pain or muscle tension contributes
- Lidocaine 2–5% gel: short-term use for entry pain under guidance where appropriate
Medications & hormonal options:
Prescription treatments should be discussed with a doctor or nurse practitioner following assessment. These may include treatment of underlying infection or inflammation, as well as symptom-directed therapies:
- Antifungal or antibiotic treatment if infection is present
- Low-dose topical steroid creams for vulval skin inflammation or dermatitis
- STI testing and treatment where appropriate
Hormonal treatments:
- Vaginal oestrogen cream: applied locally to improve tissue thickness, elasticity, and moisture
- Vaginal oestrogen pessary/tablet: low-dose local oestrogen delivered intravaginally
- Vaginal DHEA pessary: converted locally into oestrogen and androgens within vaginal tissues
- Systemic menopausal hormone therapy (MHT/HRT): may be considered if vaginal symptoms occur alongside other menopausal symptoms
- Note: Vaginal oestrogen therapies are highly effective and generally considered very safe for local treatment of GSM. They act primarily on local tissues with minimal systemic absorption and may be suitable in many women after individual clinical assessment.
For muscle tension and pain-related contributors:
• Pelvic floor physiotherapy for muscle relaxation and coordination
• Psychological therapy or sexual counselling for pain-related anxiety, trauma, or relationship factors
• Muscle relaxant treatments or specialist interventions (e.g. Botox) in selected cases under specialist care
When to See a Doctor
Persistent vaginal dryness or sexual pain should be medically assessed, particularly if symptoms are ongoing or worsening, or to exclude underlying causes such as infection, dermatological conditions, pelvic floor dysfunction, endometriosis, or other gynaecological conditions.
If you can’t find the professional help you need for your menopausal symptoms then book a Telehealth consultation today with an expert WellFemme menopause doctor.
Disclaimer: This content is for informational purposes only and does not constitute medical advice or a clinical consultation. Always discuss your symptoms and treatment options with a qualified health professional for an individualised assessment and recommendations.
Low libido in perimenopause and menopause is influenced by fluctuating and declining estrogen and testosterone levels, which affect sexual desire, arousal, and sensitivity. These hormonal changes also impact vaginal tissue health, blood flow, and lubrication, which can make intimacy feel less comfortable or less rewarding.
Beyond hormones, libido is closely linked to sleep quality, stress, fatigue, mood changes, relationships (or the lack of) and the overall nervous system state. Many women also experience a shift in identity, body confidence, and emotional connection during midlife, which can further influence desire.
What it feels like:
A reduction or absence of sexual desire, less spontaneous interest in intimacy, or feeling emotionally or physically “disconnected” from sexual response. Some women notice reduced arousal, less sensitivity during intimacy, or needing more time and stimulation than previously. It may also feel like sex becomes something avoided rather than desired, particularly if there is vaginal dryness, discomfort, fatigue, or mental overload.
Practical steps:
- Prioritise sleep and rest to support energy and hormonal balance
- Use regular vaginal moisturisers to support tissue comfort
- Use lubricants during intimacy to reduce discomfort
- Reduce stress load where possible, including mental and emotional fatigue
- Rebuild intimacy without pressure or expectation of performance
- Incorporate pelvic floor relaxation and gentle movement
- Support circulation through regular exercise and walking
- Discuss with a trusted friend or health professional
Over-the-counter options:
- Vaginal moisturisers are designed for ongoing dryness, not just sex-related lubrication. Used regularly, often a few times per week, they help hydrate the vaginal tissues, provide a protective barrier, improve elasticity and help reduce discomfort. It is important to read the label carefully and choose products that are pH balanced, fragrance free and ideally contain hyaluronic acid. Water based options are generally more soothing and safer for internal use. They can also be used with condoms and toys. Oil and silicone based moisturisers may last longer but may be more irritating and are unsafe with condoms
- Vaginal lubricants are used before or during intercourse to help reduce friction and/or pain. Water-based lubricants are low irritant and can be used safely with condoms and toys. They can soak quickly into dry tissues during sex however, whereas oil and silicone lubricants stay slick and slippery for longer. Silicone lubes should be avoided with silicone-coated toys, and oil-based lubricants should be avoided with condoms. Once again, choose products that are fragrance and flavour free, pH balanced and avoid the same ingredients as moisturisers
- Barrier creams. For those times when your vulval area might be exposed to chemicals or soaps (like swimming or baths), or friction from bike/ horse riding or chafing clothes, a barrier layer will help to coat and protect the delicate tissues. Ask your pharmacist about bland baby-safe zinc or barrier creams (external use only), or even an oil-based lubricant (we love Olive and Bee for this job, as well as intimate lubrication
- Omega-3 fatty acids: may support mood and hormonal balance
- Magnesium: supports sleep, stress regulation, and nervous system balance
- There are also a range of comfort, support and arousal devices to help with pleasure (and avoid pain); your pelvic floor physio can help with recommendations.
Medical treatments:
You will need a thorough assessment by a doctor who is knowledgeable about intimacy issues and hormones for a discussion of options and prescribing. Seek out a trusted health professional who you feel comfortable with and trust… these things shouldn’t be rushed.
- Menopausal Hormone Therapy (MHT/HRT): may improve libido indirectly via sleep, mood, and vaginal symptom improvement
- Vaginal oestrogen therapy: improves tissue health, comfort, and sexual function
- Testosterone therapy (selected postmenopausal cases): may improve sexual desire
- Medication review (e.g. antidepressants): SSRIs: some medications, such as antidepressants may reduce libido in some cases and orgasms
Local / non-pharmacological treatments:
- Sex therapy or relationship counselling
- Pelvic floor physiotherapy
- Cognitive Behavioural Therapy (CBT) for desire, stress, and body image
- Mindfulness-based stress reduction approaches
- Menopause education and coaching support
When to See a Doctor
Persistent low libido or reduced sexual desire should be medically assessed, particularly if it is distressing, affecting relationships or quality of life, or to exclude underlying causes such as hormonal changes, mood disorders, medication effects, thyroid dysfunction, or chronic medical conditions.
If you can’t find the professional help you need for your menopausal symptoms then book a Telehealth consultation today with an expert WellFemme menopause doctor.
Disclaimer: This content is for informational purposes only and does not constitute medical advice or a clinical consultation. Always discuss your symptoms and treatment options with a qualified health professional for an individualised assessment and recommendations.
What it feels like:
Changes in menstrual patterns can present in different ways, including missed periods, very frequent cycles, irregular timing, heavier or lighter bleeding than usual, prolonged bleeding, or significant menstrual pain. Some women experience fatigue, dizziness, or breathlessness related to heavy blood loss, while others may notice disruptive cramping, pelvic pain, or pain that interferes with daily activities. Emotional symptoms such as frustration or anxiety around unpredictable bleeding are also common.
What it can be caused by:
Irregularity is common during early adolescence and the perimenopausal transition due to fluctuating and declining ovarian hormone production. Outside these life stages, changes in menstrual frequency, flow, or pain may reflect hormonal imbalance, structural conditions (such as fibroids or adenomyosis), ovulatory dysfunction, thyroid disorders, polycystic ovarian syndrome (PCOS), endometriosis, stress, nutritional factors, or (less commonly) more serious underlying conditions. Family history of menstrual disorders, early menopause, infertility, or endometriosis may increase individual risk.
Practical steps:
- Track cycle length, bleeding days, and symptoms using a diary or app
- Record severity of pain using a 1–10 scale
- Track bleeding volume (e.g. number of pads/tampons used per day)
- Note associated symptoms such as fatigue, clots, or intermenstrual bleeding
- Seek medical review if cycles fall consistently outside 21–35 days outside perimenopause/adolescence
- Pay attention to family history of menstrual or gynaecological conditions
- Seek early assessment for heavy bleeding, severe pain, or significant cycle change
- Consider iron levels if experiencing fatigue, heavy bleeding, or breathlessness
Over-the-counter options:
- Non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen or naproxen (when used at period onset, can reduce pain and bleeding)
- Heat therapy (heat packs) for cramp relief
- Magnesium: may support muscle relaxation and reduce cramping in some individuals
- Iron supplementation if iron deficiency is present or suspected
Medical treatments:
- Combined oral contraceptive pill: regulates cycles, reduces bleeding, and may reduce pain
- Progestin therapies: regulate endometrial growth and bleeding patterns
- Tranexamic acid (where appropriate and prescribed in some settings) for heavy menstrual bleeding
- Levonorgestrel intrauterine device (Mirena): highly effective for reducing heavy bleeding
- Hormonal contraceptive implants or injections (may alter bleeding patterns variably)
- Menopausal Hormone Therapy (in perimenopause, where appropriate)
- Treatment of underlying conditions such as PCOS, thyroid disorders, fibroids, or endometriosis
- Specialist gynaecological procedures (e.g. fibroid management, endometrial ablation)
- Surgery (e.g. hysterectomy) in severe or treatment-resistant cases
Local / non-pharmacological treatments:
- Gynaecology or GP assessment for diagnosis and management planning
- Pelvic ultrasound or further investigation where indicated
- Pelvic physiotherapy for chronic pelvic pain
- Dietary and lifestyle support (iron intake, nutrition, stress management)
- Cognitive Behavioural Therapy (CBT) for chronic pain coping strategies
- Endometriosis education and support services
- Fertility and hormonal counselling where relevant
When to See a Doctor
Abnormal menstrual changes such as very heavy, prolonged, frequent, infrequent, irregular, or painful periods should be medically assessed, particularly if they are new, worsening, or to exclude underlying causes such as hormonal imbalance, fibroids, endometriosis, thyroid disorders, PCOS, or other gynaecological conditions.
If you can’t find the professional help you need for your menopausal symptoms then book a Telehealth consultation today with an expert WellFemme menopause doctor.
Disclaimer: This content is for informational purposes only and does not constitute medical advice or a clinical consultation. Always discuss your symptoms and treatment options with a qualified health professional for an individualised assessment and recommendations.
What it feels like:
Gradual weight gain, often centred around the abdomen, with clothes feeling tighter at the waist despite little or no change in lifestyle. Many women notice a change in body shape rather than just overall weight, along with increased bloating, fluid retention, and a sense that their body is “resisting” previous diet and exercise approaches. Everyday activities such as walking upstairs or carrying groceries may feel more effortful. Fatigue, low mood, and sleep disruption are often present and can make lifestyle changes feel harder to maintain, contributing to frustration and a loss of control over energy and body composition.
What it can be caused by:
Weight gain during perimenopause and menopause is driven by the interaction of declining oestrogen levels, ageing, and lifestyle changes, which together alter how the body stores and uses energy. Falling oestrogen influences fat distribution, leading to increased abdominal (visceral) fat rather than hip and thigh storage. This shift is associated with increased insulin resistance, inflammation, and higher cardiovascular risk.
At the same time, loss of muscle mass (sarcopenia) reduces resting metabolic rate, meaning the same dietary intake may now result in gradual weight gain. Hormonal changes affecting appetite regulation (including leptin and ghrelin), along with sleep disruption, chronic stress, and elevated cortisol, further contribute to increased cravings, reduced energy expenditure, and difficulty maintaining previous habits. These factors combine to create a metabolic environment that is less forgiving than in earlier life stages.
Practical steps:
- Aim for at least 150 minutes per week of moderate-intensity aerobic activity (e.g. brisk walking, cycling)
- Include 2–3 sessions per week of resistance or strength training to preserve and rebuild muscle mass
- Prioritise protein intake (approximately 1–1.2g per kg body weight) to support muscle maintenance and satiety
- Increase fibre intake (at least ~25g per day) from vegetables, fruit, legumes, whole grains, nuts, and seeds
- Focus on whole, minimally processed foods and reduce refined carbohydrates where possible
- Use mindful energy balance strategies (e.g. smaller portions, reducing energy-dense snacks)
- Prioritise 7–8 hours of sleep to support appetite regulation and metabolic hormones
- Manage stress through movement, breathwork, mindfulness, or relaxation practices
- Track progress using strength, energy, and measurements rather than weight alone
Over-the-counter options:
- Protein supplements (powders or bars): may support muscle maintenance and satiety when dietary intake is insufficient
- Creatine monohydrate: evidence supports improved strength and lean muscle mass in midlife women when combined with resistance training
- Fibre supplements (e.g. psyllium): may support satiety and blood sugar regulation
- Vitamin D: supports muscle function and metabolic health where deficiency is present
- Omega-3 fatty acids: support inflammation and cardiometabolic health
- Prebiotic and probiotic supplements: may support gut microbiome balance
These should be discussed with a pharmacist or healthcare provider, particularly in the presence of kidney, liver, or metabolic conditions.
Medical treatments:
Medical assessment is important to identify contributing factors such as thyroid dysfunction, insulin resistance, medication effects, or other metabolic conditions.
Treatment options may include:
- Menopausal Hormone Therapy (MHT/HRT): may support fat distribution, energy, mood, and metabolic changes in suitable candidates
- Metformin (where insulin resistance or pre-diabetes is present): may improve insulin sensitivity and reduce visceral fat
- GLP-1 receptor agonists (e.g. semaglutide, liraglutide): may be considered for weight management in eligible patients under medical supervision
- Thyroid assessment and treatment where clinically indicated
- Comprehensive metabolic and cardiovascular risk assessment
When to See a Doctor
Weight gain, particularly if rapid, progressive, or associated with other symptoms, should be medically assessed to exclude underlying causes such as hormonal changes, thyroid dysfunction, metabolic conditions, medication effects, or other medical issues.
If you can’t find the professional help you need for your menopausal symptoms then book a Telehealth consultation today with an expert WellFemme menopause doctor.
Disclaimer: This content is for informational purposes only and does not constitute medical advice or a clinical consultation. Always discuss your symptoms and treatment options with a qualified health professional for an individualised assessment and recommendations.
Mediterranean Diet/Diet Resources
For looking at ways increase protein/fibre/nutritional content of meals.
NutritionTracking Apps
Great for getting an understanding of the nutritional content of food, particularly protein and fibre. To be used with caution if you have had a previous eating disorder or unhealthy relationship with food.
Mindfulness/Meditation Apps:
Yoga Nidra (free)
iBreathe (free)
Calm (paid)
Headspace (paid)
Movement
What Our Patients Are Saying
(Verified Customer)
(Verified Customer)
(Verified Customer)
Start your menopause journey with confidence, from anywhere in Australia.
Many women put up with menopause symptoms, unsure if what they’re going through is “normal” or not knowing where to turn for support. WellFemme was created to change that, giving women across Australia access to personalised, evidence-based menopause care through simple Telehealth consultations.
No matter where you live, you can now connect with a qualified menopause doctor from the comfort of your home.
Not sure where to begin?
Take our quick assessment to find out where you’re at in your menopause journey and how WellFemme can support you.
Support That Doesn’t Stop With a Script
Important Notes
- No referral needed. Medicare rebate processed afterwards.
- Make sure to use the same name and email throughout the booking process.
- You must be in Australia at the time of your online consultation.
- Pre-payment of 50% is required at booking.
