Menopause is a natural stage of life, usually occurring between the ages of 45 and 55. It marks the end of ovulation and periods, as estrogen and progesterone levels fall to very low levels. The loss of these hormones can cause a wide range of symptoms affecting different parts of the body, mood and cognitive function. It can also have long-term impacts on health, including bone and heart health.

Perimenopause is the transition leading up to menopause, when ovarian function begins to decline and hormone levels become unpredictable, sometimes fluctuating dramatically. Periods may become heavier or irregular, and symptoms such as anxiety, poor sleep, brain fog and irritability can emerge. Perimenopause can begin up to 10 years before menopause, most commonly in your 40s, but sometimes earlier.

Wondering if changing hormones could be behind your symptoms? Take our free online hormone quiz.

Hormonal health remains important long after menopause. Low hormone levels can continue to affect sleep, mood, energy and cognitive function, as well as long-term bone, heart and metabolic health.

Many women in their 60s and beyond are told they're too old for hormone therapy or have missed their opportunity to start. While starting hormone therapy later in life requires careful consideration of individual risks and benefits, age alone doesn't mean treatment is off the table. There are also many other evidence-based ways to manage symptoms and support healthy ageing.

If it’s been more than 10 years since menopause, and you'd like to discuss if hormone therapy may be suitable for you, please book with Dr Beth, Nuwanthi, Clare, Cherie, Noara or Emma.

Menopause can occur earlier than expected. When it happens before the age of 45, it's considered early menopause. Premature ovarian insufficiency (POI) occurs when the ovaries stop functioning normally before age 40, sometimes as early as the teenage years. These changes can happen naturally or following medical treatments such as surgery, chemotherapy or radiation.

The loss of estrogen and other ovarian hormones at a younger age can significantly affect physical and emotional wellbeing, fertility and long-term bone, heart and brain health.

Early diagnosis and appropriate treatment are especially important. Hormone therapy is generally recommended until at least the usual age of menopause to help manage symptoms and protect long-term health, alongside support for fertility and other individual health needs.

Menopause after cancer can bring unique challenges. Treatments such as chemotherapy, surgery or radiation can cause an early or sudden menopause, sometimes with more severe symptoms. Many women are told they cannot have hormone therapy because of the type of cancer they've had, leaving them uncertain about their options.

Every woman's circumstances are different, and decisions about hormone therapy should be based on an individual assessment of the risks and benefits. At Remi, we believe women deserve clear, balanced information and support to make informed choices about their care. Our doctors can work alongside your wider care team to explore treatment options, manage symptoms and support long-term health.

If you've had breast cancer or another hormone-sensitive cancer, and would like to discuss whether hormone therapy may be suitable for you, please book with Dr Nuwanthi, Noara or Emma.

Weight changes during perimenopause and menopause are common, and they're not just about diet or willpower. Hormonal changes, poor sleep and stress can all affect metabolism, appetite and how your body stores fat, particularly around the abdomen.

The foods we eat also influence hormones such as insulin, which plays an important role in blood sugar regulation and fat storage. Understanding how your body responds to different foods can help you make more informed choices about nutrition and metabolic health.

At Remi, we take a holistic approach to weight management, considering hormonal health, nutrition, lifestyle and, where appropriate, prescription medications to support healthy weight management.

If you're interested in exploring continuous glucose monitoring (CGM) to better understand how different foods affect your blood sugar levels, please book with Dr Noara or Emma at the Ballina clinic. CGMs may be considered as part of your ongoing care following an initial appointment.

Declining estrogen levels during perimenopause and menopause can affect vaginal, bladder and sexual health. Symptoms may include vaginal dryness, painful sex, recurrent urinary tract infections, bladder urgency and reduced sexual desire. These changes can affect comfort, confidence, relationships and quality of life.

Unlike hot flushes, vaginal and bladder symptoms often persist or worsen over time without treatment. Fortunately, there are effective options available, including vaginal estrogen, moisturisers and other treatments to support vaginal and bladder health.

Testosterone also plays an important role in women's health, particularly sexual desire. At Remi, we consider testosterone therapy on an individual basis and may offer a trial where clinically appropriate, guided by the latest evidence and your individual needs.

Our doctors can help you explore treatment options to improve your intimate health, sexual wellbeing and quality of life.

Estrogen plays an important role in maintaining bone strength. As estrogen levels decline during perimenopause and menopause, bone loss can accelerate, increasing the risk of osteopenia, osteoporosis and fractures later in life.

Bone loss often occurs without symptoms, meaning many women are unaware of changes in their bone density until they have a scan or experience a fracture. Early assessment and treatment can help protect bone health and reduce future risks.

At Remi, we focus on preventing and managing bone loss through appropriate screening, hormone therapy where suitable, nutrition, strength training and other evidence-based treatments to help maintain strong, healthy bones as you age.

Hormones play an important role in mood and emotional wellbeing. Some women are particularly sensitive to hormonal fluctuations, experiencing significant mood changes at different stages of life, not just during perimenopause and menopause.

These changes can contribute to conditions such as premenstrual syndrome (PMS), premenstrual dysphoric disorder (PMDD), and postnatal anxiety or depression. Some women also experience mood changes associated with hormonal contraception.

At Remi, we understand the complex relationship between hormones and mental health. Treatment may include hormonal therapies, psychological support, lifestyle strategies and other evidence-based approaches, depending on your individual needs.

Please note that Dr Emma and Dr Kelly are not currently accepting new patients for hormonal mood concerns outside of perimenopause or menopause.

While our main focus is perimenopause, menopause and hormonal mood disorders, our doctors also support younger women with a range of hormonal and reproductive health concerns, including PCOS, endometriosis, painful or heavy periods and contraception.

We take a holistic, evidence-based approach, considering how hormones, lifestyle and other health factors may contribute to your symptoms, and exploring treatment options that suit your individual needs and goals.

Please note that Dr Emma and Dr Kelly are not currently accepting new patients for hormonal health concerns outside of perimenopause or menopause.

Not everyone experiences the expected benefits from menopause hormone therapy. Some women continue to struggle with symptoms despite treatment, while others find that hormone therapy makes their symptoms worse or causes unwanted side effects.

There are many reasons why hormone therapy may not work as expected, including differences in hormone absorption, sensitivity to estrogen or progesterone, other medical conditions and non-hormonal factors contributing to symptoms.

At Remi, our doctors can review your current treatment, explore possible reasons for persistent or worsening symptoms, and consider adjustments to hormone formulations, doses or delivery methods, as well as alternative treatment options.

If hormone therapy hasn't improved your symptoms, you can book with any of our doctors. However, if you've found that hormone therapy makes your symptoms worse or you've struggled to tolerate it, we recommend booking with Dr Noara or Emma.

Hormonal changes during perimenopause and menopause can affect women living with mast cell activation syndrome (MCAS), postural orthostatic tachycardia syndrome (POTS) and hypermobility-related conditions.

Fluctuating estrogen and progesterone levels may influence symptoms such as dizziness, fatigue, palpitations, joint pain, poor sleep and histamine-related reactions, making the menopause transition particularly challenging.

At Remi, we understand how these conditions can influence your experience of menopause and response to hormone therapy. We consider these complexities as part of your overall menopause management, including careful selection and adjustment of hormone treatments where appropriate.

If you've previously struggled with hormone therapy and suspect MCAS or histamine sensitivity may be contributing, we recommend booking with Dr Noara or Emma. Otherwise, any of our doctors can support you with menopause management alongside these conditions.

The terms bioidentical, body-identical and compounded hormones can be confusing, particularly as doctors overseas often use bioidentical and body-identical interchangeably.

Both terms describe hormones that have the same chemical structure as those naturally produced by the body. The important distinction is whether they are regulated medications or custom-compounded preparations.

Body-identical hormones are TGA-approved medications that have been assessed for safety, quality and effectiveness. They are available through regular pharmacies, with many subsidised under the PBS. These are the first-line hormone treatments prescribed by Remi doctors.

Compounded bioidentical hormones are individually prepared by compounding pharmacies and have not undergone the same regulatory assessment. They may be considered in specific circumstances when approved treatments are unsuitable, such as an intolerance to an ingredient or the need for a particular dose or formulation.

At Remi, we prioritise regulated hormone therapies but may prescribe compounded hormones when clinically appropriate.