Perimenopause, Menopause Hormone Therapy & Long-Acting Contraception

The menopausal transition (perimenopause) often begins in a woman's 40s, years before the final menstrual period, bringing fluctuating oestrogen and progesterone levels that can cause vasomotor hot flushes, night sweats, disrupted sleep, brain fog, joint aches, mood shifts, and irregular heavy bleeding.

Dr Tebo Rasenyai provides thorough menopause consultations that evaluate your symptom profile, personal and family breast and cardiovascular history, blood pressure, and mammography screening status to prescribe safe, individualised transdermal or oral Menopause Hormone Therapy (MHT/HRT) or evidence-based non-hormonal alternatives.

• Perimenopausal Cycle & Symptom Control: Managing erratic perimenopausal bleeding while relieving vasomotor symptoms.
• Systemic & Local Oestrogen Therapy: Transdermal patches, gels, or oral preparations paired with micronised progesterone or a levonorgestrel IUS for endometrial protection.
• Bone & Urogenital Health: Prevention of post-menopausal osteoporosis (DEXA bone density referral) and targeted treatment of vaginal dryness and recurrent urinary tract infections.

Long-Acting Reversible Contraception (LARC) methods — including the levonorgestrel intrauterine system (Mirena and Kyleena), Copper intrauterine devices (Copper T / Cu-IUD), and subdermal progestogen implants (Implanon NXT) — provide over 99% contraceptive efficacy for 3 to 10 years without relying on daily pill adherence, while allowing rapid return of fertility upon removal.

In addition to contraception, the hormonal IUS (Mirena) reduces menstrual blood loss by up to 90% and is a first-line medical therapy for heavy menstrual bleeding (menorrhagia), adenomyosis, and endometrial protection during perimenopause.

When booking an intrauterine device (IUCD) insertion at Suite D, Room 2, we recommend scheduling the procedure during the first 7 days of your menstrual period if possible. During menstruation, the cervical canal is naturally slightly dilated and early pregnancy is reliably ruled out.

Taking a standard dose of an oral anti-inflammatory analgesic (such as 400 mg ibuprofen after food, provided you have no allergy or peptic ulcer contraindication) one hour before your appointment helps relax the uterine muscle. Every IUCD insertion is immediately verified with a point-of-care pelvic ultrasound to confirm accurate fundal placement.

Important Warning on Post-Menopausal Bleeding: Any vaginal bleeding or spotting that occurs 12 months or more after your final menstrual period requires prompt gynaecological evaluation and transvaginal ultrasound measurement of the endometrial lining.

Our practice provides rapid diagnostic assessment of post-menopausal bleeding alongside compassionate long-term care for urogenital comfort, pelvic floor health, and healthy ageing.