Menopause & perimenopause, Johannesburg
Menopause and perimenopause care in Johannesburg.
Doctor-led care for perimenopause and menopause, including symptom assessment, hormone therapy where appropriate and attention to bone, metabolic and cardiovascular health.
In short
Perimenopause and menopause are usually diagnosed from age, menstrual pattern and symptoms rather than from a single hormone test. Treatment may include menopausal hormone therapy, non-hormonal options, vaginal oestrogen where appropriate, and management of sleep, bone, metabolic and cardiovascular health.
Medically reviewed by Dr Arnav Kapur, MBBCh Cum Laude
The approach
Understand first. Then treat.
Perimenopause can begin years before the final menstrual period. Changes in cycles, hot flushes, night sweats, sleep, mood, cognition, sexual health and body composition can all occur during this transition.
Assessment is primarily clinical. Blood tests are used selectively to exclude other causes or assess related health risks rather than to prove menopause in every patient.
What we help with
- Hot flushes and night sweats
- Sleep disturbance
- Brain fog, mood change and reduced concentration
- Changing, irregular or heavy cycles
- Vaginal dryness and genitourinary symptoms
- Reduced libido or sexual-health concerns
- Weight and body-composition changes
- Menopausal hormone therapy assessment and review
- Bone health and fracture risk
- Cardiometabolic risk through midlife
- Symptoms that may instead reflect thyroid disease, iron deficiency or another condition
Diagnosis is often clinical
In otherwise healthy people aged 45 or over with typical symptoms and cycle change, menopause and perimenopause can usually be identified without hormone testing. Testing is more useful in younger patients, unclear cases or when another diagnosis needs to be excluded.
HRT is a treatment option, not an automatic prescription
Menopausal hormone therapy can be effective for symptoms such as hot flushes and night sweats, but treatment choice depends on symptoms, age, time since menopause, medical history, contraindications and individual preference.
Midlife health is broader than hormones
Menopause coincides with changes in bone health, body composition, sleep and cardiometabolic risk. These areas are reviewed alongside symptom treatment rather than managed in isolation.
Follow-up matters
Symptoms, side effects, bleeding patterns and treatment goals can change over time. Hormone therapy and non-hormonal treatment should therefore be reviewed and adjusted when needed.
Common questions
Answers before you book.
Can I be in perimenopause with normal blood tests?
Yes. In people aged 45 or over with typical symptoms, perimenopause is often diagnosed clinically because hormone levels fluctuate and a single normal result does not exclude it.
Is HRT safe?
The balance of benefit and risk varies by patient, formulation, route, age, time since menopause and medical history. For many symptomatic women without contraindications, HRT is a reasonable option after an individual benefit-risk discussion.
Do I need hormone blood tests before starting treatment?
Not always. Testing is selected according to age, symptoms, cycle pattern, medication and whether another diagnosis needs to be excluded.
What if I cannot or do not want to use HRT?
Non-hormonal treatment options are available for several menopause symptoms. The appropriate approach depends on which symptoms are most troublesome and your medical history.
This page is general health information and is not medical advice. Hormone therapy is prescribed only after individual assessment.
Clinical references
Ready to take the next step?
- HRT for menopause
- Women's hormone health consultation
- Hot flushes and night sweats
- Fatigue and burnout consultation
- Book a consultation
Centre of Advanced Medicine · 13 Scott Street, Waverley, Johannesburg
Monday to Friday, 07:40 to 17:00
011 440 8721