Menopause, the cessation of menstrual periods for one year, occurs on average at age 51 and rarely happens without warning. The period before menopause, called perimenopause, can last from six months to 10 years before menstrual cycles stop forever. Perimenopause has many recognizable signs, caused mostly by fluctuating estrogen levels and rising luteinizing and follicle stimulating hormone levels.
Hot Flashes
Hot flashes, sometimes called flushes, are perimenopause symptoms that affect 75 to 85 percent of women, the Merck Manual states. Hot flash symptoms include reddening of the skin, especially on the face. The skin may feel hot to touch, and sweating, which can be profuse, occurs. Hot flashes last from between one to five years, but most women experience them for two years or less, according to the Ohio State University Medical Center. An individual hot flash lasts from 30 seconds to five minutes. Chills often follow hot flashes. Spicy foods, alcohol, hot drinks and smoking may precipitate hot flashes.
Hot flashes that occur during the night are often termed "night sweats." Night sweats can be so severe that a woman needs to change her sleepwear as well as the sheets. Tachycardia, a rise in heart rate, may also accompany hot flashes. Women who take corticosteroids to treat autoimmune diseases, as well as women with multiple sclerosis and other neurological diseases, tend to have more severe hot flashes.
Menstrual Cycle Changes
When women near menopause, menstrual cycles become irregular, often occurring more frequently. Periods may become lighter or heavier, or bleeding may occur between periods. Eventually, periods may be missed altogether. Not all changes in menstrual cycles are caused by perimenopause; very heavy bleeding, bleeding that last more than two weeks, or spotting after sex should be investigated to make sure a more serious problem isn't causing these symptoms, Baylor College of Medicine suggests.
Genitourinary Changes
Vaginal and urinary changes during perimenopause are related to changes in estrogen levels. Common warning signs of menopause include vaginal dryness, vaginal atrophy, vaginitis, an inflammation of vaginal tissue, and a decrease in the size of the uterus, ovaries and clitoris. Urinary tracts often increase, along with frequent urination and urinary incontinence, which is related to pelvic muscle relaxation. Interest in sex may decrease, often because of pain during sex due to thinning and dry vaginal tissue.
Mood Swings
Mood changes are common in perimenopause. Hormone fluctuations cause some mood swings; other may be related to changing body image and loss of the ability to become pregnant. Fatigue, irritability and nervousness may be related to estrogen drops, the Ohio State University Medical Center explains. Insomnia may also contribute to mood swings, according to the Baylor College of Medicine.
