Perimenopause Treatment in Dubai
Perimenopause treatment with Dr Felix starts from your symptoms, not from a single hormone test. Hot flushes, night sweats, broken sleep, mood swings and irregular periods in your 40s are treated while your periods are still coming.
Your first visit looks at your cycle, sleep, mood, contraception and risks together. You leave with a clear plan, with or without hormones.
Symptoms decide, not one blood test
Hormone levels swing from day to day in perimenopause, so a single FSH result often misleads. Women over 45 are diagnosed from their symptoms and cycle.
Treatment while periods continue
Perimenopause needs its own regimens, with cyclic progesterone or a low-dose pill, because the ovaries still work on some days.
Your doctor at every visit
This is a personal practice. Dr Felix Happich, German-trained and licensed by the Dubai Health Authority, sees you at every appointment.
Straight answers before you book
What does perimenopause treatment with Dr Felix include?
Perimenopause treatment with Dr Felix includes 5 steps, and hormone therapy is one possible result of them. Perimenopause is the time of changing cycles and symptoms before the last period, on average about 4 years, and it is treated by symptoms rather than by blood levels.
- Symptom and cycle review: hot flushes, night sweats, sleep, mood, memory, joint pain, libido and how your periods have changed.
- Diagnosis without guesswork: women over 45 are diagnosed from symptoms and cycle, as NICE guidance advises; FSH is measured only under 45 or when the picture is unclear.
- Look-alike causes: thyroid disease, anaemia from heavy periods, pregnancy, low mood and medicines are ruled out.
- Risk check: blood pressure, migraine, clots, breast history and family history.
- Contraception: HRT does not prevent pregnancy. With natural periods, contraception is generally needed for 24 months after the last period under age 50, or 12 months at age 50 or older. Hormonal contraception can mask periods and needs separate advice.
Which treatment fits perimenopause?
The treatment of perimenopause follows your main symptom and whether you need contraception. Estradiol through the skin with cyclic progesterone is the usual first choice, because it relieves hot flushes and keeps bleeding predictable.
- Hot flushes and night sweats: HRT patch or oestrogen gel with cyclic progesterone, or HRT tablets when the liver route suits you.
- Contraception or heavy bleeding as well: a low-dose combined pill with 20 micrograms of ethinyl estradiol, for women without obesity, smoking, high blood pressure or migraine, or a levonorgestrel coil with oestrogen.
- Mood swings with hot flushes: hormone therapy, alone or with an SSRI.
- Hormones not suitable: non-hormonal treatment such as low-dose SSRIs or fezolinetant.
Is perimenopause mood change a reason to see a doctor?
Yes, because depression becomes more common in perimenopause than before or after it. The risk of new depression in perimenopause is about 30 percent, about 1 in 3 women, and about 60 percent in women who have had depression before, according to clinical guidance.
Oestrogen improves mood in perimenopause, but not after menopause. When hot flushes dominate and low mood is mild, hormone therapy comes first; when low mood dominates, an SSRI comes first; when both are severe, both are started. In a UAE study of 279 women published in 2026, 16.7 percent of perimenopausal women had severe depression, against 4.3 percent after menopause, about 1 in 6 against 1 in 23 (Frontiers in Global Women’s Health, 2026). Poor sleep with repeated waking, inactivity and smoking were linked with depression as well.
The mood side of hormones in detail: hormonal mood changes.
Can you start HRT while you still have periods?
Yes, HRT is started in perimenopause while periods continue, and there is no benefit in waiting for the last period. For healthy women under 60 or within 10 years of menopause, the benefits of hormone therapy for symptoms outweigh the risks, according to The Menopause Society (Menopause, 2022).
- Cyclic regimen first: oestrogen every day and progesterone on 12 days a month, because continuous progesterone causes irregular bleeding while the ovaries still work.
- Switch later: 2 to 3 years after the last period, a continuous regimen usually stops the bleeds.
- Irregular bleeding: common in perimenopause and followed up; very heavy or persistent bleeding is assessed: bleeding on HRT.
Do you still need contraception in perimenopause?
Yes, contraception is needed until 12 months after the last period over 50, or 24 months under 50, as UK contraception guidance (FSRH) advises. HRT is not contraception. The chance of pregnancy without contraception is 2 to 3 percent a year between 45 and 49, about 1 in 40 women, and falls below 1 percent after 50.
A low-dose combined pill treats symptoms, controls heavy bleeding and prevents pregnancy in one step for women without risk factors. A levonorgestrel coil prevents pregnancy and protects the womb lining when oestrogen is added. At 50 to 51, the pill is stopped or changed to menopausal hormone therapy.
Why see a doctor for perimenopause?
Dr Felix Happich is a German-trained physician licensed by the Dubai Health Authority. He sees every patient himself, diagnoses perimenopause from symptoms and cycle, and chooses a regimen that fits a body whose hormones still change from month to month.
In a Dubai study of 591 women, 82 percent had fair or poor knowledge of menopause, about 8 in 10 (Menopause, 2021). A clear explanation is part of every consultation.
Dr Felix treats within the scope of his Dubai Health Authority licence. When a case needs a specialist view, for example very heavy bleeding, a womb or ovary finding, or breast cancer in the past, the treatment decision is made together with a gynaecologist, endocrinologist or oncologist.
What perimenopause is: perimenopause. Symptoms under 45: early menopause treatment. A first check at home: the menopause self-check. All options: Menopause & HRT Clinic Dubai.
Your first consultation with Dr Felix
Symptoms and cycle
Hot flushes, sleep, mood, memory, libido and how your periods have changed over the last year.
History and risks
Migraine, clots, blood pressure, breast and family history, contraception and current medicines.
Tests where they help
Thyroid, blood count and ferritin with heavy periods, FSH only under 45 or when the picture is unclear.
Decision and plan
Dr Felix explains what causes your symptoms, which regimen fits and what bleeding to expect.
More questions about perimenopause treatment
What does perimenopause treatment cost in Dubai?
The cost of perimenopause treatment in Dubai depends on the tests you need and on the treatment that fits your symptoms. You get the full cost in the consultation before anything starts.
Can a blood test confirm perimenopause?
A single blood test does not confirm perimenopause, because FSH and oestradiol swing from day to day while the ovaries still work. Women over 45 are diagnosed from symptoms and cycle; FSH helps under 45.
How long does perimenopause last?
Perimenopause lasts about 4 years on average and ends 12 months after the last period. Hot flushes often continue for several years after the last period.
Can I get pregnant in perimenopause?
Yes, pregnancy is still possible in perimenopause, at about 2 to 3 percent a year between 45 and 49. Contraception is needed until 12 months after the last period over 50, or 24 months under 50.
Perimenopause symptoms, a plan that fits your cycle
One consultation with Dr Felix in Dubai Healthcare City. You leave knowing what causes your symptoms and which treatment fits while your periods continue.
Book your consultationSources
- The 2022 hormone therapy position statement of The North American Menopause Society, Menopause 2022, PubMed abstract. Benefit and risk by age and time since menopause
- Menopause: identification and management (NG23), National Institute for Health and Care Excellence. Diagnosis without FSH over 45
- Executive summary of the Stages of Reproductive Aging Workshop + 10 (STRAW+10), Fertility and Sterility 2012, PubMed abstract. Stages of perimenopause
- Depression in peri- and postmenopausal women in the UAE, Frontiers in Global Women’s Health 2026. 279 women in the UAE
- Women’s knowledge and awareness on menopause symptoms and its treatment options remains inadequate: a report from the United Arab Emirates, Menopause 2021, PubMed abstract. 591 women in Dubai