PERIMENOPAUSE is defined as the time from when symptoms and signs of approaching menopause begin until 12 months after the final period. 

It is characterised by irregular cycles (length, volume and pattern of flow) and is the result of erratic hormone secretion by the hypothalamus, pituitary and the ovaries.

Many women experience symptoms of perimenopause and typically present with vasomotor symptoms, a change in their cycles and/or mood disturbance. 

The median age of perimenopause in longitudinal studies is between 45.5 and 47.5 years, and the mean duration estimated at between 3.8 and 6.25 years.1.2 Early perimenopause is characterised hormonally by a fall in inhibin B and clinically by a change in cycle frequency. 

By late perimenopause further hormonal changes include a rise in FSH levels and falls in oestradiol and inhibin A, and