
Perimenopause Symptoms: What Is Normal and When to Get Help
The common signs of perimenopause, how it is diagnosed, which symptoms need a prompt visit and the treatment options worth discussing.
Read articleHormone Replacement Therapy and menopause care are available exclusively virtually at AuraWell. Patients are assessed by our Nurse Practitioner, with individualized recommendations and ongoing monitoring where appropriate.

For our rehabilitation services, direct insurance billing may be available depending on your provider and plan. If direct billing is unavailable, we will provide the appropriate receipt to submit to your insurer.
Somewhere between the night sweats, the 3 a.m. ceilings, the mood weather and the sense of being a stranger in your own body, too many women are told this is simply their new normal. Perimenopause and menopause are treatable, and you deserve a clinician who takes the whole picture seriously, without a referral and without a drive across the city.
AuraWell provides dedicated menopause and hormone therapy care exclusively by virtual appointment across Ontario.
Hot flashes and night sweats. Broken sleep. Mood changes, anxiety and brain fog. Weight redistribution that diets do not touch. Genitourinary symptoms such as dryness, discomfort and bladder leaks, which women are wrongly expected to whisper about.
Your initial consultation runs 60 to 90 minutes by secure video with our Nurse Practitioner, covering your symptoms, cycle changes, health history, risks and goals.
Perimenopause is diagnosed mainly from your pattern of symptoms and cycle changes, because hormone levels swing too much to be definitive. Blood work is sometimes useful to rule out other causes such as thyroid disease or iron deficiency, and routine hormone panels are not required.
Current menopause guidelines describe hormone therapy, using patches, gels, pills and progesterone options, as the most effective treatment for hot flashes and night sweats, with a risk picture far more nuanced than the headlines of twenty years ago. Ontario NPs can prescribe and manage HRT, and our care follows current Menopause Society-aligned evidence: the right candidate, the right dose and the right follow-up.
Hormones are never the only tool. Non-hormonal medications, sleep and mood support, and nutrition and strength strategy can be woven into one plan. For bladder symptoms, Emsella pelvic floor treatment is available in person at our Woodbridge clinic, and medical weight management is coming soon.
Hormone therapy is reviewed rather than set and forgotten. Your Nurse Practitioner books a follow-up visit after a new prescription begins to check symptom relief, side effects such as breast tenderness or spotting, and whether the dose or delivery method should change. Once your plan is stable, reviews move to a routine schedule agreed with you.
Each review revisits the reasons for treatment, your personal and family history, blood pressure and routine screening such as mammography and cervical screening through Ontario programs.
Falling estrogen affects more than hot flashes. Bone density declines faster in the years around menopause, and heart and metabolic risk factors such as blood pressure, cholesterol and blood sugar deserve closer attention.
Your Nurse Practitioner reviews these risks with you, orders blood work or a bone density test when appropriate and explains how diet, strength training, vitamin D and calcium fit alongside any treatment you choose.
Night sweats, broken sleep, low mood, anxiety and brain fog are common reasons people book menopause care. They often feed each other, so the plan looks at them together rather than one at a time.
Options may include hormone therapy, non-hormonal medication, sleep and lifestyle strategies, or a referral when another service is a better fit. The aim is a plan you understand and can adjust at each follow-up visit.
The initial virtual consultation is $300 for 60 to 90 minutes, and follow-up visits are $135 for 30 minutes.
Yes. Ontario NPs are authorized to assess menopause, prescribe hormone therapy and manage ongoing monitoring. Our care follows current Menopause Society-aligned guidance.
The initial virtual consultation is $300 for 60 to 90 minutes, and follow-up visits are $135 for 30 minutes.
For most healthy women within roughly ten years of menopause, current evidence supports HRT with a favourable balance of benefits and risks, while certain histories change that balance. Your personal risks are assessed individually and explained plainly.
Perimenopause is diagnosed mainly from your pattern of symptoms and cycle changes, not a single hormone test, because hormone levels swing too much to be definitive. That is why the assessment is a real conversation rather than a lab slip.
Sometimes, to rule out other causes such as thyroid disease or iron deficiency. Routine hormone panels are not required to diagnose menopause, and we will not order ones you do not need.
HRT and menopause care at AuraWell are available only virtually, including initial assessments and follow-up appointments, by secure video anywhere in Ontario.
Hot flashes, night sweats, disrupted sleep, mood changes, brain fog, vaginal dryness and joint aches are the symptoms women most often bring to us. Hormone therapy is one option among several. Non-hormonal medications and practical lifestyle measures are discussed as well, and the plan follows your symptoms, your history and your preferences.