Several years before menopause, you may begin to experience a variety of symptoms that your ovaries are failing. Premenopausal women may experience such a wide range of symptoms -- headaches, joint aches, hot flashes, sleep disturbances -- that one woman's journey may be completely different from that of her friends. Because women experience so many symptoms over a span of several years, it is virtually impossible to compose a complete list of potential premenopausal symptoms, but many women do experience certain common symptoms.
Many premenopausal women experience hot flashes, also commonly called hot flushes, which typically begin on the face or upper chest and then spread to other parts of the body before dissipating a few minutes later. These can occur spontaneously, with no obvious cause, or they can be brought on by emotional stress. This sudden onset of heat, sweating and flushing can occur at any time, but hot flashes tend to occur most frequently at night. They vary in intensity. While some women only experience slight warmth, others become drenching wet.
A woman's declining estrogen levels frequently make her menstrual cycles more erratic. Some women bleed more heavily than usual, while others experience lighter cycles. Not surprisingly, women are less fertile as they approach menopause. Women with fibroid tumors or endometriosis may notice worsening symptoms associated with those conditions. Vaginal lubrication may decline as estrogen levels fall, causing vaginal itching, irritation or even pain during intercourse. Women may also notice decreased libido and breast pain.
Neurologic and Emotional Symptoms
Some premenopausal women experience difficulty concentrating or memory loss. Irritability, anxiety or even depression plague some women. Migraines during the menstrual cycle may occur as well or may change in frequency or intensity. Keeping a headache diary for at least three months can help health-care providers diagnose these menstrual migraines. Sleep disturbances can have a significant impact on some women's lives. While nighttime hot flashes can certainly disturb sleep, some women have problems sleeping even in the absence of hot flashes.
Estrogen impacts a surprising number of body systems, which may not be fully appreciated until a woman begins to experience a variety of unrelated symptoms attributable to estrogen deficiency. For instance, some women notice aches and pains in their joints. Others have an increased heart rate. Even the urinary tract relies on estrogen for optimal function. In the years leading up to menopause, women may lose control of their bladder simply by coughing or sneezing, so-called stress incontinence, or urine may leak from the bladder for no apparent reason. Some women suffer from fatigue in the premenopausal period.
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- UpToDate.com: Menopausal Hot Flashes
- Current Medical Diagnosis & Treatment 2014; Maxine A. Papadakis and Stephen J. McPhee
- The Washington Manual of Outpatient Internal Medicine; Thomas M. De Fer
- UpToDate.com: Clinical Manifestations and Diagnosis of Menopause
- Primary Care of Women: A Guide for Midwives and Women's Health Providers: Barbara Hackley, et al