Early perimenopause symptoms are subtle and can be very confusing and unnerving.

Perimenopause sort of sneaks up on you with a lot of small changes like an irregular period or two, a strange hot feeling, or waking up in the middle of the night soaking wet. But the first symptoms come and go. Things can be normal again for some time and you don't realize they all add up to one big change coming.

Your body is giving you some hints about the hormonal shifts. The trick is recognizing which ones are signaling menopause and finding out what to do about them.

Menopause is a natural biological process that marks the permanent end of menstruation and fertility in a woman resulting from reduced ovarian hormone secretion that occurs naturally or is induced by surgery, chemotherapy, or radiation. Natural menopause is recognized after 12 months of amenorrhea that is not associated with a pathologic cause. In the West, the average age of natural menopause is 51. Most women experience a natural menopause between the ages of 45 and 55, but some women go through menopause as early as their 30s and as late as the 60s.

Perimenopause is the time of changes associated with menopause and may begin from two to ten years before actual menopause — the date of your last-ever period. During perimenopause, estrogen and other hormone levels gradually decline. However the transition is not smooth and these erratic fluctuations in hormones can cause a variety of physical, mental and emotional symptoms. When perimenopause starts, how long it lasts, and the type and severity of the symptoms vary significantly from woman to woman.

When perimenopause starts, how long it lasts, and the type and severity of the symptoms vary significantly from woman to woman.  Sometime around age 40, you might notice that your periods are different -- usually shorter at first then longer. Bleeding can be heavier, lighter or just spotting. Flooding is common. Or suddenly you find yourself feeling very hot during the day or wake up in the middle of the night soaking wet.

At the beginning of perimenopause, symptoms come and go. Your periods might be irregular for a few months and then become normal again. You might have weeks of horrible night sweats and then weeks with nothing unusual. This variation in perimenopausal  symptoms makes it particularly difficult to understand what is going on with your body and what treatments are working. 

All women experience menopause, but each in a different way. Some women struggle with perimenopause for years, while others sail through in just a few months. Everyone has different symptoms at different times and at different ages. In fact, there is no blueprint to menopause. So it's really hard to determine exactly when you started into the perimenopause phase or where you are in the process.

Perimenopause causes some subtle — and some not-so-subtle — changes in your body. Common signs that you are in perimenopause include:

• Menstrual irregularity: As ovulation becomes more erratic, the intervals between periods may be longer or shorter, your flow may be scanty to profuse, and you may skip some periods.
• Hot Flashes or Flushes/Night Sweats/Cold Flashes: First you're hot, then cold. Hot flashes can range from feeling a strong blush to profuse sweating with intense heat. Their intensity, duration and frequency vary. Night sweats can wake you up in the middle of the night, soaking wet.
• Emotional Turmoil: Many women find themselves feeling more irritable, teary and anxious than usual. Hormonal shifts can also cause mood swings, similar to what some women experience during a menstrual cycle, only less predictable.
• Sleep Disturbances: Many women start having difficulties going to sleep, or waking in the middle of the night or early morning and not being able to go back to sleep. Night sweats can also disturb your sleep.
• Lower Libido (sex drive): Some women experience a decrease in sexual desire during perimenopause. The thinning of the vaginal lining which is normally maintained by adequate estrogen levels, can cause uncomfortable vaginal dryness and itching and with decreased lubrication can make intercourse painful and uncomfortable.
• Fatigue: Dealing with perimenopause symptoms such as changing periods, hot flashes, night sweats, lack of sleep, mood swings is exhausting. In addition, some of the fatigue can be caused by a decrease in testosterone which is the hormone that keeps women feeling energized. Thyroid imbalances can also cause fatigue.
• Weight Gain/Food Cravings: Most women gain weight during perimenopause. You may notice that maintaining your usual weight becomes more difficult and that the inches tend to accumulate around your abdomen, rather than your hips and thighs. Food cravings may intensify, especially for chocolate and other carbohydrates.

There are many other symptoms that you may experience during the pre-menopause years.

Please visit my new blog for more information about perimenopause symptoms.