What Every Woman Should Know About Perimenopause, Menopause, and Hormone Therapy
An interview with Dr. Katherine Lambert, Verde Clinic
For many women, the years leading up to menopause feel like a slow unravelling — low energy, disrupted sleep, mood changes, a vague sense of not quite feeling like themselves. And yet, too often, those symptoms are dismissed, misattributed, or left untreated. Dr. Katie Lombert, a GP with a specialist interest in women's health at Verde Clinic in Mount Hawthorn, is working to change that.
We sat down with Dr. Lombert to talk about what perimenopause and menopause actually look like, why hormone replacement therapy (HRT) has such an unfair reputation, and what better care for women in this life stage really means.
A path shaped by purpose
Dr. Lambert’s route into medicine wasn’t straightforward. She began medical school, moved into nursing, then returned to medicine - drawn back by a desire for greater autonomy, deeper clinical knowledge, and a genuine enjoyment of helping people.
Her focus on women’s health and menopause has a personal dimension too. Her mother, also a GP, pioneered a women’s health menopause clinic - an influence that planted the seed early. After completing her GP training, Dr. Lambert deepened her expertise through clinical practice, mentorship, and her own ongoing research.
“My approach is about treating the whole person, not just an isolated symptom,” she says. “For me, it’s always been about quality of life and long-term wellbeing.”
Perimenopause: the phase that often goes unrecognised
One of the most important things Dr. Lambert wants women to understand is that menopause doesn’t arrive without warning. Perimenopause - the hormonal transition that precedes it - can begin seven to ten years before a woman’s final menstrual period.
Menopause itself is a retrospective diagnosis: twelve months without a period after the age of 50. But the symptoms that accompany it? They can begin long before that milestone.
“The symptoms are highly individual,” Dr. Lambert explains. “Some women experience the classic signs - hot flushes, night sweats, disrupted sleep. But others just feel ‘off.’ Low energy, difficulty concentrating, changes in their cycle. Increased PMS, mood changes, irritability. There are around 70 recognised menopause symptoms, and no two women will have the same experience.”
Compounding the problem is that diagnosis is genuinely difficult. Blood tests, she notes, are unreliable for confirming perimenopause because hormone levels can fluctuate even within a matter of hours. A “normal” result doesn’t rule anything out.
“For busy women in their thirties and forties, these symptoms get attributed to stress, burnout, or lifestyle factors,” she says. “And so women go years without the right support.”
Setting the record straight on HRT
Few topics in women’s health are more laden with fear and misinformation than hormone replacement therapy. Dr. Lambert is direct about where that fear came from - and why it’s largely unfounded.
The Women’s Health Initiative (WHI) study, published in the early 2000s, triggered widespread alarm when it suggested HRT increased the risk of cancer and heart attacks. But the story is more complicated than the headlines.
“The study used synthetic hormones in an older cohort,” Dr. Lambert explains. “It was leaked to the media before proper analysis had been done, and it caused enormous scaremongering that we’re still dealing with today.”
Later analysis of the same WHI data told a different story. The group using synthetic progestins showed a non-statistically significant increase in breast cancer risk. The estrogen-only group actually showed a reduced risk. And critically, all-cause mortality was lower in both HRT groups.
The distinction Dr. Lambert draws is between synthetic and body-identical hormones. Body-identical HRT uses oestradiol, progesterone, and testosterone that are structurally identical to the hormones produced by the ovaries. Synthetic hormones are different a and that difference matters.
“Transdermal body-identical estrogen is now considered to be protective against breast cancer,” she says. “And because it’s delivered through the skin rather than taken orally, it avoids the elevated blood clot risk associated with oral estrogen.”
On the cardiovascular side, she’s equally clear. While HRT isn’t prescribed purely as a cardiovascular prevention strategy due to limited trial data in that specific context, evidence does show lower rates of heart disease among women on HRT.
Care that actually fits the person
At Verde Clinic, Dr. Lambert’s approach to treatment is built around one core principle: there is no one-size-fits-all solution.
“Effective care means finding the right hormone, the right dose, and the right timing for the right person,” she says. “The balance between progesterone, estradiol, and testosterone shifts over time. It’s an ongoing process, not a prescription you set and forget.”
This is why longer consultations are central to how she practises. Extended appointments give her the space to take a thorough history, work through the full range of potential symptoms, rule out other causes, and build the kind of collaborative relationship that good care depends on.
“We’re covering around 70 recognised menopause symptoms in those consultations,” she notes. “It’s about patient education, setting realistic expectations, and making a plan together.”
Follow-up appointments, typically every six months, are equally important. Hormonal needs evolve, and Dr. Lambert emphasises that those visits aren’t just for tweaking a prescription - they’re an opportunity to look at the full picture: diet, lifestyle, sleep, and stress management alongside hormonal health.
Empowering women to advocate for themselves
Underlying all of this is a philosophy of partnership. Dr. Lambert sees her role not as the authority telling a patient what to do, but as a collaborator - someone who equips women with the evidence-based knowledge they need to make informed decisions about their own health.
“When women are given accurate information and the right support, the improvements in quality of life can be transformative,” she says. “And the long-term health outcomes improve too.”
Her message for women who have had their symptoms dismissed or who aren’t sure where to turn is straightforward: seek help, and don’t be afraid to advocate for yourself.
That’s exactly the kind of care Verde Clinic was built to provide.
If you're navigating perimenopause or menopause and feel like you haven't been heard, Verde Clinic is here to help. Dr. Lambert offers thorough, personalised consultations - with the time and expertise to actually get to the bottom of what you're experiencing.
Ladies, you don’t have to navigate Women’s Health alone.We’re here with you on this journey.
Whether you're navigating perimenopause, cycle changes, or persistent symptoms, our team offers evidence-based support tailored to your needs.
