Perimenopause is the transitional phase prior to natural menopause usually beginning three to five years prior to a woman’s final menstrual period. Fluctuations in hormone levels commonly characterize this phase.

Women begin noticing changes occurring in their bodies due to declining levels of estrogen. Menstrual changes and short-term physical symptoms (similar to menopause symptoms) may occur including the following:

• Hot flashes/night sweats/crawly skin/li>
• Insomnia
• Irritability, mood swings/panic attacks/anxiety
• Cognitive difficulties/memory lapses, fuzzy thinking
• Joint aches
• Headaches
• Palpitations, particularly premenstrually
• Loss of libido
• Vaginal dryness
• Skin changes
• Urinary tract infections, bladder control difficulty
• Possibly some weight gain (some studies show a 5 to 8-pound perimenopausal gain)

Symptoms that differ from those of menopause include bleeding difficulties (heavy menses, prolonged menses, irregular menses and intermenstrual spotting). It is common during the perimenopausal transition to experience a combination of PMS and menopausal symptoms (or no symptoms at all).

Moodiness, sleeplessness, depression and anxiety can accompany both PMS and perimenopause. Evaluate the patterns of your symptoms. Symptoms of PMS usually increase before your period and are relieved after your period. If the symptoms are fairly persistent and regular throughout your cycle, you are probably experiencing perimenopause.

Perimenopause usually starts in the forties but can be as early as the thirties and can last for a couple months to a few years. The experience is different for everyone.

There is no true diagnosis for perimenopause but there are options to control symptoms. For symptoms that do not respond to simple relief measures, many women prefer non-medical interventions such as vitamins and herbal preparations.

If these symptoms are such an annoyance to you and are getting in the way of your daily activities, you might consider a hormone therapy as a treatment option. Also remember you can still become pregnant during perimenopause. Low dose oral contraceptives can be used right up to menopause.