Throughout a woman's transition to menopause, her body's production of estrogen and progesterone fluctuates, causing perimenopausal changes. Many women begin noticing shifts in their menstrual cycle years before they actually have their final period. Obstetrics and gynecology physician and author Dr. Christine Northrup says, "this transitional perimenopause period usually lasts five to ten years, though the entire process can sometimes take up to 13 years." Some common signs of perimenopause include irregular periods, hot flashes, sleep disturbance, mood swings, loss of libido and weight gain.
Changes in Monthly Cycle
Hormones determine women's monthly cycles. During perimenopause, estrogen levels drop and cycles become irregular, resulting in more or less frequent menstrual periods, heavy bleeding or intermittent menses.
Hot Flashes
Hot flashes, described as sudden rushes of heat within the body, and night sweats, which are hot flashes that happen while women sleep, are "due to the hypothalamic response to declining ovarian estrogen production," according to the Association of Women for the Advancement of Research and Education. The decline of estrogen induces a physiological process that stimulates the release of a luteinizing hormone, and because this hormone can cause blood vessels to dilate, flushing occurs.
About 65 to 75 percent of women experience hot flashes during perimenopause, with varying intensity, frequency and duration.
Mood Swings and Depression
Estrogen is the hormone that is usually associated with menopausal symptoms, and as menopause approaches, the production of estrogen by the ovaries slows down. Estrogen is produced throughout a woman's life, but this dramatic drop in the estrogen level can cause depression, decreased energy, lethargy, irritability, anxiety and disorientation. Hormonal shifts can also cause mood swings that are similar but less predictable and often more extreme than those experienced during regular periods or by women who have premenstrual syndrome.
Hair Loss and Weight Gain
Early signs of perimenopause may include testosterone-induced thinning or loss of hair on the head or pubic area and facial hair growth. Some women gain weight, possibly from water retention.
Some women notice a weight gain during perimenopause. One reason for this is that hormones influence the body's metabolism, and imbalances during menopause sometimes lower the metabolic indicators that control water retention.
Sleep Problems
Hormonal shifts during perimenopause can cause sleep disturbances. Hot flashes and night sweats are the usual cause of perimenopausal sleeplessness because they wake women and make falling back to sleep difficult. Erratic, disrupted sleep leads to fatigue and a decreased sense of well-being. The hormonally triggered mood swings, depression and worry some women suffer from may make them feel nervous and cause them to stay awake at night.
Cognitive Changes
Cognitive signs women notice during perimenopause include difficulty concentrating, mental confusion, fuzzy thinking, memory lapses and problems with multitasking. Some women complain of short-term memory impairment and an inability to focus. All of these cognitive signs stem either directly from hormonal imbalances or are the result of other perimenopausal symptoms, such as sleeplessness, anxiety or depression.
