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Your symptom checklists- perimenopause and menopause

1. Perimenopause is different from menopause

Menopause refers to a single episode in a woman's life, her "last" period and the end of female reproduction . Menopause is confirmed when a woman has gone one full year without having a period. The day after that one-year mark, she's now postmenopausal yet people refer to it as menopause. Typically, this occurs around age 52 but the age range runs 40–60, with many who experience it earlier or later.

Although perimenopause is defined as the time before "the change," its starting point isn't so definitive. It's a nebulous concept and you enter into it gradually and come out of it gradually. So, there is no easy, identifying place of how or when it starts. It can last for 8-10 years

Perimenopause is a result of a woman's aging ovaries, specifically when the coordinated patterns of the hormones estrogen and progesterone begin to vary, throwing the delicate system out of balance. It may take a while to detect symptoms, with a period still evident (although possibly shorter in duration, not as regular for instance), and then you may start to notice other small changes or not until you suddenly do...

Perimenopause can start when a woman is in her 30s or 40s, but the 40s are more common. It typically lasts 6–10 years and the experience varies considerably for many.

Perimenopause is marked by a drop in estrogen which is the main female hormone produced by the ovaries. The estrogen levels can also go up and down more sporadically than they do in a typical 28-day cycle. This can cause irregular periods and other symptoms.

During the final stages of perimenopause, your body will produce less and less estrogen. Despite the sharp drop in estrogen, it’s still possible to get pregnant. Perimenopause can last for as little as a few months and as long as 4 years

.

Menopause officially kicks in when the ovaries produce so little estrogen that eggs are no longer released. This also causes your period to stop

.

Your doctor will diagnose menopause once you haven’t had a period for a full year.

You may enter menopause earlier than normal

if you:

have a family history of early menopause

are a smoker

have had a hysterectomy or oophorectomy

have undergone cancer treatments.

Can you tell by a blood test if I am in perimenopause?

Most people can tell by the symptoms that they've started menopause. If you have worries about irregular periods or hot flashes, talk with your healthcare professional.

Tests most often aren't needed to diagnose menopause. But sometimes, your healthcare professional may suggest blood tests to check your levels of:

Follicle-stimulating hormone (FSH) and estrogen (estradiol).

FSHgoes up and estrogen goes down during menopause. Because hormones go up and down during perimenopause, it can be hard to tell from these tests whether you're in menopause.

Thyroid-stimulating hormone (TSH). Overactive thyroid, called hyperthyroidism, can cause symptoms like those of menopause.

You can get home tests to check FSH levels in your urine without a prescription. The tests show whether you have higher FSH levels. This might mean that you're in perimenopause or menopause, But FSH levels rise and fall during your menstrual cycle. So home FSH tests can't really tell you whether you're in menopause.

Symptoms of perimenopause and menopause


When hormone levels begin to decline in the lead-up to menopause, every system that has hormone receptors registers the change, including your brain. Ongoing fluctuation in hormone levels during this time can cause a range of symptoms, which may vary greatly between women and even change over time. Symptoms can range from mild to severe, and while some women may not experience many symptoms, others may experience a variety of issues that can significantly impact their quality of life. Even minor symptoms can have a major effect, especially if they persist over time. The long-term effects of menopause include an increased risk of osteoporosis and cardiovascular disease. If you are experiencing symptoms, it is important to discuss them with your GP or gynaecologist to explore appropriate management strategies.

As estrogen levels drop, you might start experiencing symptoms of menopause. Some of these can occur while you’re still at the perimenopause stage.

night sweats

hot flashes

depression

anxiety

irritability and mood swings

insomnia

fatigue

dry skin

vaginal dryness

frequent urination

Cholesterol

Perimenopause and menopause can also increase cholesterol levels. This is one reason why women in postmenopause are at an even higher risk for heart disease.

Continue to have your cholesterol levels measured at least once a year.

When to call a doctor

You don’t necessarily have to call your doctor to obtain a perimenopause or menopause diagnosis but you should see your your doctor if the symptoms of either perimenopause or menopause become severe enough to interfere with your daily life.

For a checklist on what to ask and discuss with your doctor, refer to our website at "What to discuss with your GP"

For details on Treatment options to ease your symptoms refer to our website "Treatment options"

Potential treatments to ease the symptoms

There are various ways to treat the symptoms of menopause, again often depending on the severity of the symptoms. Lifestyle changes outlined on this website including strategies such as exercise, nutrition, stress reduction techniques, sleep help strategies often help many menopause symptoms but, subject to obtaining your own independent medical advice, the following prescription and over-the-counter (OTC) treatments may available for perimenopause and menopause.

Treatment

Menopause treatments aim to ease symptoms and prevent or manage ongoing conditions that may happen with aging. Any treatment will depend on the person, their family history and medical background, the medication they are already having, their mental health, the severity of their symptoms and their own independent doctor's advice.

Below however are some of the more common treatments used to ease symptoms:

Hormone therapy.

Estrogen therapy works best for easing menopausal hot flashes. It also eases other menopause symptoms and slows bone loss.

Your healthcare professional may suggest estrogen in the lowest dose and for the time needed to relieve your symptoms. It's best used by people who are younger than 60 and within 10 years of the onset of menopause. If you still have your uterus, you'll need progestin with estrogen. Estrogen also helps prevent bone loss. Long-term use of hormone therapy may have some heart disease and breast cancer risks. But starting hormones around the time of menopause has shown benefits for some people. Talk with your healthcare professional about whether hormone therapy may be safe for you.

Vaginal estrogen.

To relieve vaginal dryness, you can apply estrogen to the vagina using a vaginal cream, tablet or ring. This treatment gives you a small amount of estrogen, which the vaginal tissues take in. It can help ease vaginal dryness, pain with intercourse and some urinary symptoms.

Medications to help prevent bone thinning osteoporosis.

Your healthcare professional might suggest medicine to prevent or treat osteoporosis. Several medicines can help reduce bone loss and risk of fractures. Your healthcare professional also might prescribe vitamin D supplements to help strengthen bones.

Oral contraceptives

Heavy or irregular periods and hot flashes may benefit from this medicine that evens out hormonal fluctuations.

Menopausal hormonal therapy

: (Formerly known as HRT) Like oral contraceptives, this is a low dose of hormones to supplement estrogen levels. It helps with hot flashes, night sweats, insomnia, emotional issues and vaginal dryness.

Low-dose antidepressants

Selective serotonin reuptake inhibitors (SSRIs) like Prozac may relieve hot flashes, mood swings and irritability by modifying the brain signals.

Counselling, Menopause Coaches, Psychologist

Brain fog, anxiety, depression, dependence on alcohol, sleep issues - cognitive behaviour and other talking therapy with a qualified psychologist

Lifestyle changes

A healthier diet with less animal fat and processed sugar, exercise, relaxation techniques such as meditation, yoga, and a consistent sleep schedule may relieve some of the symptoms, including weight gain, irritability and insomnia.

Vaginal lubricants

For vaginal irritations, use water-based vaginal lubricants or prescription vaginal creams

Allied health services and holistic integrative therapy

Acupuncture, naturopathy, breathwork, nutritionists, psychologists, counsellors, hypnosis, dermatologist, pelvic floor exercise support, yoga, thi chai mindfulness techniques and massages.

Talk with other people

Reach out and be open about it with others in your life and stay connected socially with people. Don't forget this affects 50% of the population and we can openly chat about our labours, pregnancy, periods etc!


Various supplements may be of help but there is unfortunately little evidence to prove:

Ginseng

St Johns Wart

Melatonin

Symptom outline

  • Hot Flushes

    Lorem ipsum dolor sit amet consectetur. Aliquam odio enim pharetra et. Diam varius magna lobortis consequat id pharetra. At ac eu nulla faucibus ullamcorper. Elit varius malesuada egestas pretium eget sit bibendum urna scelerisque.

  • Night Sweats

    Lorem ipsum dolor sit amet consectetur. Aliquam odio enim pharetra et. Diam varius magna lobortis consequat id pharetra. At ac eu nulla faucibus ullamcorper. Elit varius malesuada egestas pretium eget sit bibendum urna scelerisque.

  • Sleep Disorders

    Lorem ipsum dolor sit amet consectetur. Aliquam odio enim pharetra et. Diam varius magna lobortis consequat id pharetra. At ac eu nulla faucibus ullamcorper. Elit varius malesuada egestas pretium eget sit bibendum urna scelerisque.

  • Mood Swings

    Lorem ipsum dolor sit amet consectetur. Aliquam odio enim pharetra et. Diam varius magna lobortis consequat id pharetra. At ac eu nulla faucibus ullamcorper. Elit varius malesuada egestas pretium eget sit bibendum urna scelerisque.

  • Irritability

    Lorem ipsum dolor sit amet consectetur. Aliquam odio enim pharetra et. Diam varius magna lobortis consequat id pharetra. At ac eu nulla faucibus ullamcorper. Elit varius malesuada egestas pretium eget sit bibendum urna scelerisque.

  • Vaginal changes

    Lorem ipsum dolor sit amet consectetur. Aliquam odio enim pharetra et. Diam varius magna lobortis consequat id pharetra. At ac eu nulla faucibus ullamcorper. Elit varius malesuada egestas pretium eget sit bibendum urna scelerisque.

  • Low Libido

    met consectetur. Aliquam odio enim pharetra et. Diam varius magna lobortis consequat id pharetra. At ac eu nulla faucibus ullamcorper. Elit varius malesuada egestas pretium eget sit bibendum urna scelerisque.

  • Fatigue

    Lorem ipsum dolor sit amet consectetur. Aliquam odio enim pharetra et. Diam varius magna lobortis consequat id pharetra. At ac eu nulla faucibus ullamcorper. Elit varius malesuada egestas pretium eget sit bibendum urna scelerisque.

  • Weight Gain

    Lorem ipsum dolor sit amet consectetur. Aliquam odio enim pharetra et. Diam varius magna lobortis consequat id pharetra. At ac eu nulla faucibus ullamcorper. Elit varius malesuada egestas pretium eget sit bibendum urna scelerisque.

  • Muscle Tension

    Lorem ipsum dolor sit amet consectetur. Aliquam odio enim pharetra et. Diam varius magna lobortis consequat id pharetra. At ac eu nulla faucibus ullamcorper. Elit varius malesuada egestas pretium eget sit bibendum urna scelerisque.

  • Memory Loss

    Lorem ipsum dolor sit amet consectetur. Aliquam odio enim pharetra et. Diam varius magna lobortis consequat id pharetra. At ac eu nulla faucibus ullamcorper. Elit varius malesuada egestas pretium eget sit bibendum urna scelerisque.

  • Breast Pain & Tenderness

    Lorem ipsum dolor sit amet consectetur. Aliquam odio enim pharetra et. Diam varius magna lobortis consequat id pharetra. At ac eu nulla faucibus ullamcorper. Elit varius malesuada egestas pretium eget sit bibendum urna scelerisque.

  • Bloating

    Lorem ipsum dolor sit amet consectetur. Aliquam odio enim pharetra et. Diam varius magna lobortis consequat id pharetra. At ac eu nulla faucibus ullamcorper. Elit varius malesuada egestas pretium eget sit bibendum urna scelerisque.

  • Lack of Concentration

    Lorem ipsum dolor sit amet consectetur. Aliquam odio enim pharetra et. Diam varius magna lobortis consequat id pharetra. At ac eu nulla faucibus ullamcorper. Elit varius malesuada egestas pretium eget sit bibendum urna scelerisque.

  • skin issues

    amet consectetur. Aliquam odio enim pharetra et. Diam varius magna lobortis consequat id pharetra. At ac eu nulla faucibus ullamcorper. Elit varius malesuada egestas pretium eget sit bibendum urna scelerisque.

  • Irregular Periods

    Lorem ipsum dolor sit amet consectetur. Aliquam odio enim pharetra et. Diam varius magna lobortis consequat id pharetra. At ac eu nulla faucibus ullamcorper. Elit varius malesuada egestas pretium eget sit bibendum urna scelerisque.

  • Hormonal Headaches

    Lorem ipsum dolor sit amet consectetur. Aliquam odio enim pharetra et. Diam varius magna lobortis consequat id pharetra. At ac eu nulla faucibus ullamcorper. Elit varius malesuada egestas pretium eget sit bibendum urna scelerisque.

  • Heart Palpitations

    Lorem ipsum dolor sit amet consectetur. Aliquam odio enim pharetra et. Diam varius magna lobortis consequat id pharetra. At ac eu nulla faucibus ullamcorper. Elit varius malesuada egestas pretium eget sit bibendum urna scelerisque.

  • Hair Loss

    Lorem ipsum dolor sit amet consectetur. Aliquam odio enim pharetra et. Diam varius magna lobortis consequat id pharetra. At ac eu nulla faucibus ullamcorper. Elit varius malesuada egestas pretium eget sit bibendum urna scelerisque.

  • Osteoporosis

    Lorem ipsum dolor sit amet consectetur. Aliquam odio enim pharetra et. Diam varius magna lobortis consequat id pharetra. At ac eu nulla faucibus ullamcorper. Elit varius malesuada egestas pretium eget sit bibendum urna scelerisque.

  • Panic Disorder

    Lorem ipsum dolor sit amet consectetur. Aliquam odio enim pharetra et. Diam varius magna lobortis consequat id pharetra. At ac eu nulla faucibus ullamcorper. Elit varius malesuada egestas pretium eget sit bibendum urna scelerisque.

  • Dizziness/faint

    Dizziness/faint Lorem ipsum dolor sit amet consectetur. Aliquam odio enim pharetra et. Diam varius magna lobortis consequat id pharetra. At ac eu nulla faucibus ullamcorper. Elit varius malesuada egestas pretium eget sit bibendum urna scelerisque.

  • Digestive Problems

    Lorem ipsum dolor sit amet consectetur. Aliquam odio enim pharetra et. Diam varius magna lobortis consequat id pharetra. At ac eu nulla faucibus ullamcorper. Elit varius malesuada egestas pretium eget sit bibendum urna scelerisque. Digestive Problems

  • Burning Tongue

    Lorem ipsum dolor sit amet consectetur. Aliquam odio enim pharetra et. Diam varius magna lobortis consequat id pharetra. At ac eu nulla faucibus ullamcorper. Elit varius malesuada egestas pretium eget sit bibendum urna scelerisque.Burning Tongue

  • Increased Allergies

    Lorem ipsum dolor sit amet consectetur. Aliquam odio enim pharetra et. Diam varius magna lobortis consequat id pharetra. At ac eu nulla faucibus ullamcorper. Elit varius malesuada egestas pretium eget sit bibendum urna scelerisque.

  • Sleep Disorders

    Lorem ipsum dolor sit amet consectetur. Aliquam odio enim pharetra et. Diam varius magna lobortis consequat id pharetra. At ac eu nulla faucibus ullamcorper. Elit varius malesuada egestas pretium eget sit bibendum urna scelerisque.

  • anxiety/depression

    Lorem ipsum dolor sit amet consectetur. Aliquam odio enim pharetra et. Diam varius magna lobortis consequat id pharetra. At ac eu nulla faucibus ullamcorper. Elit varius malesuada egestas pretium eget sit bibendum urna scelerisque.

  • Sleep Disorders

    Lorem ipsum dolor sit amet consectetur. Aliquam odio enim pharetra et. Diam varius magna lobortis consequat id pharetra. At ac eu nulla faucibus ullamcorper. Elit varius malesuada egestas pretium eget sit bibendum urna scelerisque.

  • digestive issues

    Lorem ipsum dolor sit amet consectetur. Aliquam odio enim pharetra et. Diam varius magna lobortis consequat id pharetra. At ac eu nulla faucibus ullamcorper. Elit varius malesuada egestas pretium eget sit bibendum urna scelerisque.

  • tinnitus

    Lorem ipsum dolor sit amet consectetur. Aliquam odio enim pharetra et. Diam varius magna lobortis consequat id pharetra. At ac eu nulla faucibus ullamcorper. Elit varius malesuada egestas pretium eget sit bibendum urna scelerisque.

  • dry, itchy eyes, ears, skin

    Lorem ipsum dolor sit amet consectetur. Aliquam odio enim pharetra et. Diam varius magna lobortis consequat id pharetra. At ac eu nulla faucibus ullamcorper. Elit varius malesuada egestas pretium eget sit bibendum urna scelerisque.

  • loss of confidence/self esteem

    Lorem ipsum dolor sit amet consectetur. Aliquam odio enim pharetra et. Diam varius magna lobortis consequat id pharetra. At ac eu nulla faucibus ullamcorper. Elit varius malesuada egestas pretium eget sit bibendum urna scelerisque.

  • quickly angered/rage

    Lorem ipsum dolor sit amet consectetur. Aliquam odio enim pharetra et. Diam varius magna lobortis consequat id pharetra. At ac eu nulla faucibus ullamcorper. Elit varius malesuada egestas pretium eget sit bibendum urna scelerisque.

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Mediation Guide

January 17, 20259 min read

Mediation Tips

Separation and divorce can be difficult, stressful, emotional and expensive.

Even if you and your former partner are relatively amicable, you may still need assistance to work out how to disentangle and split your finances and property in a fair way and to determine what will work best for your children and your family going forward.

The Family Court expects that people involved in family law disputes will only make an application to the Court to have their matter heard when there is no other way possible to resolve their dispute. There is an expectation in other words that people will attempt to resolve their differences and find a way to settle through compromise, discussion and if required, dispute resolution, if it is safe to do so.

Mediation and Family Dispute Resolution (FDR) can help you work through your parenting and financial agreements, resolve dispute and find solutions that provide the best outcome for all parties involved. It can provide an affordable, less stressful and faster method for resolving disputes while still allowing you to have significant input into the process and the outcomes. When a matter goes to court, you lose a lot of this input and control around outcomes.

Below is an overview of the mediation process and some hints we commonly provide our client on how to best navigate the process.

An Overview

When compared to the high levels of stress and onerous and unpredictable costs of litigation, mediation is a relatively simple and expensive way to resolve disputes, sort out the division of assets and liabiliteis and create a co-parenting plan that is in the best interests ultimately of the children, and workable for the parents.

In Australia, both government-funded and private centres offer a variety of options for mediation, depending on your individual circumstances.

The role of an independent mediator is to guide you to a resolution usually through a combination of joint and individual sessions. A mediator's role is to stay neutral and not 'take sides.' They make sure each party understandsthe issues at hand, is aware of each other's position, and will help find a fair and workable solution that is acceptable.

While the sessions can be held just with the separating couple and the mediator, under certain circumstances, if both parties agree, the parties lawyers, and/or a support person may attend. Children may under very limited circumstances be involved.

Some mediations may be held face to face, in person, or via zoom, or in certain circumstances, including where there has been domestic and family violence, 'shuttle mediation' can be used to keep the parties separate and in a safe space.

Communication in the course of dispute resolution are, except in certain circumstances, confidential and inadmissible in any court. The dispute resolution practitioner however may be required by law to report certain disclosures or risk.

What is Family Dispute Resolution (FDR)?

FDR is a special type of medication that is focussed on considering the needs of the children while hehlping you come to an agreement. It is often used to resolve parenting matters but property division can also be included in FDR.

It provides you with an opportunity to improve your relationship with the other party/ies and reach an agreement about legal, practical and co-parenting issues that are important to you. Because all parties are involved in reaching a resoution, it is chance to be heard properly in a more controlled and less overwhelming way compared to court, and improves usually the chances that the agreement will last into the future and reduce conflict for you and your children. You may also learn more effective ways to communicate with the other party througout the process to help you resolve any future issues/disputes.

Under the Australian Family Law system, with limited exceptions, it is compulsory for separated parents to go through the proess of FDR before applying to a Family Law Court for parenting orders.

Dispute Resolution may happen within the Court, with officers of the Court, such as a judicial registrar and court appointed child expert. The Court will make orders for these events and it is essential that you attend.

Dispute resolution may also take place externally to the Court. You can source Mediation and Family Dispute Resolution privately or through government funded services such as Legal Aid, Relationships Australia and other Family Relationship Centres.

If you are looking to source a private Mediator or FDRP, we can recommend one of our regularly appointed mediators to assist.

You should ensure that any person you engage to assist with FDR is registered as a Famiy DIspute Resolution Practitioner (FDPR) with the Commonwealth Attorney-General's Department, or if conducting arbitration, is accredited with AIFLAM, the Australian Institute of Family Law Arbitrators and Mediators.

Judicial Registrars and private mediators or FRDPs must provide a Certificate of Dispute Resolution at the conclusion of these events. There can be cost consequences for non-compliance with court orders for dispute resoluton.

What does Mediation and/or FDR cost?

Mediation has varying costs and can take anything from hours to days to complete, depending on the complexity of your situation and depending on whether financial and children issues are being considered.

Government-assisted FDR may be free or subsidised if you meet the eligibility criteria.

Fees are payable to mediators and dispute resolution practitioners in private practice.

If you have been ordered to undertake a post-separation parenting program, unless the order otherwise states, you will be required to pay for the costs of your attendance at that program.

In most cases, mediation or FDR is going to be much cheaper and faster, and a lot less stressful than battling it out in court.

Our Top Tips to Prepare for Mediation

Learn about the options available to you and what is best suited to your needs and budget.

Your FDR practitioner, lawyer or mediator will advise what documents you will be required to produce prior to, and on the day of, the mediation.

Prior to the mediation date, a complete understanding of your finances including assets, liabilities/debt, income, superannuation, parenting, child support, and other legal matters will greatly help the process. Get your documents well organised and labelled. We can assist you to prepare this list and the organisation.

When a court orders you to attend dispute resolution, orders will also be made about what documents are required to be completed exhanged and provided to the person conducting the dispute resolution. These may include for instance, any court documents such as applications, responses and affidavits, expert reports, any child impact report, confidential case summaries, and valuations.

Determine your Priorities 

Think about all the issues that you may want to consider including your parenting arrangements, financial and property matters before the mediation and consider what is important to you and why and what you hope to achive through mediation or FDR.

Try to keep an open mind and consider what is really motivating your priorities - is it emotionally based reasoning or is it based on what you genuinely believe is fair and in the children's best interests.

Know the Cost of Mediation 

Be aware of the various costs involved in the types of mediation and FDR options available before you commit - mediator costs, lawyer costs, travel expenses, your time off work etc. Make phone calls to find out what costs are anticipated on an hourly/daily basis and any potential post mediation expense for example the costs of formalising your agreed terms of the mediation into a formal agreement which you may want to file in the Family Court to make enforceable.

Make sure you are actually available for the set mediation date and not running late. If there is any chance you will miss the date or the time, let the mediator and other party know well in advance to avoid financial consequences.

Try to Manage your Emotions 

We know this can be very difficult to do, we hear you! This can be a highly emotional and confronting time which can make you feel overwhelmed and vulnerable. If is often a time in the separation/divorce process when we highly recommend that our clients reach out for additional emotional support and invest in their own self-care.

I know your head may be racing, but try to get a good nights sleep the night before mediation. We highly recommend you do not drink too much caffeine or consume other stimulants on the day or drink any alcohol throughout the day, you eat well so your sugar levels are ok, stay hydrated, take your medication as and when needed, make plans for the children after school as the mediation may go all day. You may plan to take a friend/support person if you have previously obtained the other sides consent to do this.

Ask for short breaks throughout the day to clear your head, visit the bathroom, calm down.

If you need an interpreter for the mediation, please make sure you let them know well in advance of the mediation day.

Be Aware of your Communication 

Mediation is not the right opportunity or time to express your frustration, play games, be aggressive or point score.

If you can get your emotions in check and communicate effectively enough to convey your wishes, it can be an excellent way to resolve things and to help you and your children move on.

Try to stay focused on your objectives and achieving good outcomes for the children and yourself for the long term.

We always suggest to our clients that they should try to approach the mediation as a business meeting and to be as professional in their communication as possible throughout the mediation process - imagine they are talking and planning a meeting at work, asking for a pay rise with their employer or negotiating the purchase of a house. Poor behaviour such as shouting, swearing, accusing and blaming will likely derail the whole process, and make it difficult to arrive at any resolutions. Ignore the other parties potential outbursts as much as possible - don't bite! The mediator will usually help with this, so be guided by them (and your lawyer if you have one there with you.)

If you don't understand something that is explained to you, speak up and get clarification. You have the right to be heard and to ask. No question is too stupid. Don't let yourself be bullied.

Safety concerns

If you feel unsafe, make sure you communicate this with the mediator in your initial intake consultation and provide them with any safety orders you may have.

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