Perimenopause begins with a change in a woman's menstrual cycle. During perimenopause, a woman's periods may be irregular in that they could last for a longer or shorter amount of time or be lighter or heavier. Although such changes are expected, women should consult a health care provider if they experience heavy bleeding, periods that occur very close together, spotting, or periods that last longer than a week.
A common symptom of menopause is the appearance of hot flashes (sometimes called a hot flush). Hot flashes occur because of changing estrogen levels in a woman's body.1 A hot flash consists of a sudden feeling of heat and may include flushing of the face and neck, red blotches on the chest and arms, and sweating followed by shivering. A hot flash can last 30 seconds to 10 minutes.
During menopause, many women experience vaginal dryness, which can make sexual intercourse uncomfortable and can lead to vaginal or urinary tract infections. In addition, the bladder muscles may weaken, which could lead to urine leakage when sneezing, coughing, laughing, or running. This condition is called urinary incontinence (pronounced in-KON-tn-uhns).
Some women find that they're not as interested in sex, while others find that they enjoy sex more during the years around menopause. It's important to note that women can still become pregnant during perimenopause and should take appropriate contraceptive measures. Also, menopause does not change the risk of contracting a sexually transmitted disease.
In addition, getting a good night's sleep can sometimes be difficult for menopausal women. Whether sleep is disrupted due to night sweats or other reasons, long-term lack of sleep can lead to fatigue, lack of energy, and memory problems.2
Mood changes such as irritability or anxiety can occur when a woman is going through menopause. These symptoms could be due to shifts in hormones or lifestyle factors, such as caring for elderly parents, that are likely to occur during this time in a woman's life.
Other physical changes occur that can put menopausal women at risk for osteoporosis and heart disease. The loss of estrogen causes women to lose bone density, a condition called osteoporosis. This can cause the bones to become weak and prone to breakage.
Heart disease may develop after menopause due to the loss of estrogen or to other problems related to normal aging. Weight gain, high blood pressure, and diabetes all put stress on the heart and can increase the risk of a heart attack or stroke.1