menopause symptom : Perimenopause

Estrogen doesn't disappear suddenly. Even though American women don't reach menopause until about age 51, the effects of declining estrogen may be noticeable as early as age 35 in the form of declining fertility and irregular periods. This time of early symptoms caused by hormonal changes related to aging ovaries is known as perimenopause. Some experts also refer to this time as the menopausal transition. Perimenopause varies greatly from one woman to the next. It may last only a few months or several years. Symptoms may be mild or severe. Only a small percentage of women have no symptoms at all. The earliest sign of perimenopause can be declining fertility; for someone planning a pregnancy, this can be a major issue. Even for those who aren't planning a pregnancy, early symptoms of menopause such as fluctuating periods or hot flashes well before age 50 can be bewildering.

How do you know if irregular periods, hot flashes, or insomnia are caused by perimenopause or a medical condition? At the present time, there is no reliable test to tell if you're entering perimenopause. Your doctor could measure your FSH level to see if it is elevated. But during perimenopause, estrogen levels rise and fall erratically and so do FSH levels. Results from an FSH test can vary from day to day, so a single test won't provide clinicians with a clear picture of what is happening. But a mildly elevated FSH level on day 3 of the cycle has been shown to correlate with diminished fertility -- a harbinger of menopause.

There may not be a clear-cut test for perimenopause, but many women are very sensitive to and aware of changes in their bodies. Is your menstrual cycle noticeably different in a consistent pattern from a few years ago? Is your cycle shorter or your flow heavier? Some women also notice that their hair and skin and vagina become dryer. Weight gain may tend to go to the midsection rather than the hips and thighs. Insomnia and persistent changes in mood or memory may also coincide with the hormonal fluctuations of perimenopause. Science hasn't clarified why, but some women have reported feeling so forgetful that they wonder if premature Alzheimer's disease has struck. The first appearance of some of these symptoms can be alarming for women who aren't aware that perimenopause can begin years in advance of menopause. Recognizing these changes as a normal part of aging will help you and your physician manage them effectively and plan for a healthy future.
Symptoms of perimenopause
Irregular periods

Declining fertility

Thickening in the waistline

Hot flashes

Heart palpitations

Insomnia and disrupted sleep

Mood changes

Irritability

Memory and concentration problems

Vaginal dryness

Dry skin and hair

Thinning hair

Decreased sexual response

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