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Perimenopause is the transition, often starting in the 40s, when hormone levels fluctuate and periods become irregular. Menopause is confirmed once you have had no periods for 12 months in a row.

Most women reach menopause between 45 and 55. Menopause before 45 is considered early, and before 40 it is called premature ovarian insufficiency. Both need medical review.

Yes. Ovulation can still happen while periods are irregular, so contraception is advised until 12 months after your last period if you are over 50, or 24 months if you are under 50.

For most healthy women under 60, or within ten years of menopause, the benefits usually outweigh the risks. It may not suit women with a history of breast cancer, blood clots or certain heart conditions, so your gynaecologist assesses your individual risk first.

There is no fixed time limit. Your gynaecologist reviews the need each year, considering how your symptoms respond and any change in your health.

Not necessarily. Lifestyle changes may be enough for mild symptoms. A consultation still helps to check bone, heart and screening needs, which matter even without troublesome symptoms.

Bleeding a year or more after your last period is not normal and should be checked promptly. Most causes are benign, such as thinning of the vaginal lining, but an ultrasound and sometimes a biopsy are needed to rule out problems with the womb lining.

Falling oestrogen speeds up bone loss and raises cholesterol, increasing the risk of osteoporosis and heart disease over time. Regular checks and early action can reduce both risks.

Yes. M'Brace offers menopause care in LB Nagar and menopause care in King Koti, with consultations, blood tests and pelvic ultrasound at both Kamineni Hospitals units.

Note when your periods changed, your main symptoms and how long they have lasted. Bring a list of current medicines and any recent blood test or screening reports.

Yes. A Pap smear, breast examination and blood tests can often be arranged alongside your consultation, or through a preventive women's health package.