Perimenopause is the transitional time around menopause, which marks the end of the reproductive years. Women start perimenopause at different ages, but some may notice changes as early as their mid-30s. The level of estrogen in the body rises and falls unevenly during perimenopause. The first signs of perimenopause include:

• Irregular periods: As ovulation becomes more unpredictable, the length of time between periods may be longer or shorter, the flow may be light to heavy, and some periods may be skipped.

• Hot flashes and night sweats: These are common during perimenopause, and their intensity, length, and frequency vary.

• Mood changes: Mood swings, irritability, or increased risk of depression may happen during perimenopause.

• Vaginal and bladder problems: Vaginal dryness, discomfort during sex, and urine leakage when coughing or sneezing may occur.

• Decreasing fertility: The body becomes less fertile during perimenopause.

The length of time that perimenopausal symptoms last can vary between a few months to many years. The decrease in estrogen during perimenopause can also lead to bone thinning or changing cholesterol levels. If you are experiencing changes in your menstrual cycle or other new symptoms, there is a chance that you could be experiencing the early symptoms of perimenopause. If you have concerns about your symptoms, it is important to talk to your healthcare provider for a diagnosis.