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Perimenopause is when a woman begins transitioning into menopause. It starts several years before menopause, when the ovaries gradually produce less estrogen and progesterone. These hormonal fluctuations cause the body to experience numerous changes.
Also called pre-menopause, it usually starts in the 40s, but some women begin noticing signs in their 30s, and others in their early 50s.
The average length of perimenopause is four years, but for some it lasts only a few months or as long as 10 years. Perimenopause ends the first year after menopause, which is when a woman has gone 12 months without a menstrual cycle.
Many women don't experience any perimenopause symptoms. For others, they can be extremely unpleasant. The following symptoms are signs of perimenopause:
The most common is changes in the menstrual cycle. As ovulation fluctuates, it can be a longer or shorter time between periods and/or irregular flow. Some even skip periods.
Headaches can increase for women in perimenopause.
Hot flashes, sweating and heart palpitations are other symptoms. Hot flashes are a sudden feeling of intense heat over the entire body which can be followed by day or night sweats. The intensity, length and frequency may vary.
Other women skip the heat and have cold flashes and clamminess.
These flashes can cause sleep problems. But sleep can be challenging even without them which can lead to fatigue.
Some women get lumpy breasts or experience breast tenderness. Another symptom is the worsening of premenstrual syndrome (PMS).
During perimenopause, sexual arousal and libido may change. Add to that, surveys report 30 to 40 percent of perimenopausal women experience vaginal dryness. When estrogen levels decline, vaginal tissues can lose elasticity and lubrication. This can lead to discomfort or pain during sexual intercourse.
Low estrogen levels may also leave women more vulnerable to urinary or vaginal infections. Loss of tissue tone may also cause urine leakage when coughing or sneezing; urinary urgency and/or frequency.
Dips in estrogen don’t just cause vaginal dryness; dry eyes can be another symptom of perimenopause.