Ajax Harwood Clinic
Menopause — what to expect, and what can help
Menopause is the point when periods stop for good, usually somewhere around the early fifties, and the years of change either side of it are called perimenopause.
What usually happens
The symptoms are real and they are treatable. Hot flushes, night sweats, disturbed sleep, mood changes, and vaginal dryness or discomfort are the common ones, and none of them are something to simply put up with.
It is not one decision. Treatment ranges from things that need no prescription at all, through vaginal treatments that act locally, to hormone therapy taken by mouth or through the skin. What suits you depends on which symptoms bother you most and on your own health history.
The picture has changed. Advice about hormone therapy shifted substantially after the early 2000s, and much of what circulates is out of date — so if you were told something years ago, it is worth asking again.
At your appointment
We will ask which symptoms affect you most and how much they interfere with your sleep, work and relationships — that is what steers the choice, more than your age or your blood tests.
We will go through your own history: periods, whether you still have a uterus, blood pressure, clots, breast and heart history. Those are what decide which options are open to you.
Blood tests are usually not needed to diagnose menopause in someone over about forty-five with typical symptoms; the pattern is enough.
Should I be tested?
Last reviewed 2026-09-23
Common questions about testing for menopause and perimenopause, including a couple of popular labels you may have come across.
You may wonder if a blood test can confirm menopause. If you're over 45 with typical symptoms, no blood test is needed. Your symptoms and period pattern already tell us enough. Hormone levels change a lot during this time. One blood test can look normal one day and different the next. This makes it an unreliable way to confirm perimenopause. Testing is more useful if you are under 45, especially under 40, with periods that stopped or became irregular early. In that case, it may point to early menopause, which needs its own follow-up plan. If you use certain birth control, hormone tests don't work well and aren't used. Bleeding after menopause, or bleeding after sex, always needs prompt checking, whatever your age.
Tests you may hear about
"Estrogen dominance" / "progesterone deficiency"
Not a recognized medical diagnosis — here’s what it usually means and what to ask about instead.
You may have heard the term estrogen dominance for symptoms like mood swings, weight gain, or heavy periods. This idea often comes from saliva or urine hormone tests. These tests aren't standardized. They don't reliably measure your hormones. It's true that progesterone often drops before estrogen during perimenopause. This shift is a normal, if uncomfortable, part of this life stage. It doesn't need its own lab-confirmed diagnosis or special protocol. Your symptoms are real and worth treating. Let's look at what's actually driving them. That could be the normal hormone shift, your thyroid, your mood, or your uterus.
Worth asking
- Which of my symptoms would you expect treatment to help, and which not?
- What are my options if I would rather not take hormones?
- Given my own history, is there anything that rules an option out for me?
- How long would I stay on this, and when would we review it?
Curious what your doctor is weighing up? The clinical tool we use for menopause is open to anyone — it is detailed and written for clinicians, and you are welcome to read it.
Open the clinician reference →General health information for Ajax Harwood Clinic patients and the public — not medical advice, and not a substitute for seeing your own doctor. In an emergency call 911.