The premenopausal period of transition from reproductive years to menopause is also called perimenopause. It usually begins around the age of 45, but can begin earlier. A wide variety of symptoms are associated with premenopause in addition to irregular menstrual periods, but according to a review published in a 2006 issue of the the New England Journal of Medicine, only three types of symptoms are routinely associated with this transition: vasomotor fluctuations, vaginal symptoms and insomnia. Other problems associated with perimenopause, such as mood swings and fatigue, may occur as a result of these primary symptoms.
Irregular Periods
Menstrual periods often become erratic as you transition from the early stages of premenopause to menopause itself. The time between periods may be shorter or longer than usual and the flow may be heavy or scant. Several months may go by between periods. Perimenopause ends and menopause begins when there hasn't been a menstrual period for at least one full year.
Vasomotor Symptoms
Hot flushes (also called hot flashes), which are sudden feelings of warmth often accompanied by sweating in the face and neck area, and night sweating are very common, yet poorly understood, symptoms of perimenopause. About 65 percent of women experience hot flushes and in up to half of those cases, symptoms disappear within several months. Others may experience hot flushes for up to four or five years, and for a small percentage, the condition continues for years into menopause.
Sleep Disturbances
Because hot flashes often occur at night, they are associated with sleep difficulties, such as difficulty staying asleep and poor sleep quality. A survey conducted by researchers at Stanford University School of Medicine and published in a 2006 issue of Archives of Internal Medicine found that more than 81 percent of women who experienced severe hot flashes also reported problems with chronic insomnia. These problems included falling asleep, staying asleep and generally poor sleep quality. Factors other than vasomotor symptoms may be responsible for sleep disturbances. Overall, the researchers found that perimenopausal women who have begun to skip periods were more likely to have difficulty falling asleep and to experience non-restful sleep than those in an earlier stage of premenopause.
Vaginal Irritation
In the early stages of premenopause, vaginal symptoms such as dryness, irritation and painful intercourse reportedly affect less than one-third of women. These symptoms often get worse after menopause and with age, but are readily treated with vaginal estrogen creams or over-the-counter moisturizers developed specifically to relieve vaginal dryness. As with hot flushes, the specific cause of vaginal symptoms is unclear, but they are associated with hormonal changes that reduce vaginal moisture.
