Perimenopause is a time of transition to menopause for women, a period when certain menopausal symptoms begin. The condition can start as early as the mid-30s for some women and extends into the 40s and 50s for others. Because it is associated with decreased fertility and the onset of old age, it can be a traumatic time for women, one of the first signs of mortality and the end of the child-bearing years.

Perimenopause has a major effect on estrogen, the main female hormone. Levels will be in flux during perimenopause, rising and falling in uneven cycles. That will make menstrual cycles shorten or lengthen, and in some cases, ovulation may not occur.

Other symptoms include vaginal dryness, hot flashes and sleep problems. While a woman can still become pregnant during these stages, it becomes more difficult. Once women have gone 12 consecutive months without a menstrual period, perimenopause ends and menopause begins.

Because it is a gradual transition, there is no test available to indicate perimenopause, and some of its signs can happen for other reasons. Some doctors will check thyroid levels to make sure the changes are not attributable to problems with that gland.

What Doctors Look for to Diagnose Perimenopause

Doctors will usually look for the following:

·         Menstrual irregularity – The flow can change from heavy to light, the length of time may change and there may be some skipped periods. A persistent change – one in which there are seven days or more in the length of the cycle – can be a sign of perimenopause. If there’s a 60-day gap or more between periods, it’s a sign of perimenopause in the later stages.