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Symptoms of Perimenopause

Updated at: Feb 18, 2012
Written by: Dr Poonam SachdevPublished at: Feb 18, 2012
Symptoms of Perimenopause

Some symptoms of perimenopause are changes in sexual function, decreased fertility, vaginal and bladder problems and osteoporosis.

Perimenopausal symptoms can be subtle to severe. The symptoms occur due to change in levels of the female hormones in your body.

Some symptoms you might experience include:

Menstrual irregularity


Changes in menstrual flow and cycle.  The periods may become irregular, longer, shorter, heavier/ lighter than your usual cycle, your menstrual cycle may sometimes be less than 28 days in duration or you may skip some periods. These are some of the commonest symptoms of perimenopause. This change in periods is a result of erratic ovulation. In early perimenopause, the change in length of menstrual cycles is about seven days, whereas in late perimenopause, two or more periods may be missed and there is an interval of 60 days or more between periods.

Hot flushes

Many women experience hot flushes (65 to 75 percent), most commonly during late perimenopause. Hot flushes can happen at any time of the day, even several times in an hour. Each episode of hot flush lasts about three to six minutes. The exact reason why flushes and sweating attacks occur is not known.

Sleep disturbance


Some of the sleep problems of perimenopause include problems falling asleep, restlessness or night-time sweats. In most women, the cause of sleep problems is hot flushes or night sweats. The sweating can be so heavy in some women that they may have to get up to change the sheets several times a night.

Mood changes


Common psychological or emotional problems of perimenopause include mood swings, irritability or increased risk of depression. The exact cause of mood swings is not known but some of these symptoms may be caused as result hormonal imbalance or sleep disruption due to hot flushes.


Vaginal and bladder problems


Decrease in oestrogen levels cause the vaginal tissues to lose lubrication and elasticity, making sex uncomfortable and in fact painful. Thinning of vaginal mucosa due to low oestrogen levels increases the risk of urinary or vaginal infections. Decreased in level of oestrogen affects the bladder as well and many women feel the need to urinate more often or may even have urinary incontinence.


Decreased fertility


Irregular or erratic ovulation decreases your ability to conceive. However, there is a risk/chance of pregnancy if you have periods (even though irregular). If you want to avoid pregnancy, use some type of birth control measure until you've entered menopause (that is you don’t have periods for 12 consecutive months).


Changes in sexual function


Some women may experience decrease in sexual arousal and desire during perimenopause. However, most women with satisfactory sexual intimacy before the change continue to experience the same throughout the period of perimenopause and beyond.



Loss of bone occurs in women when the level of hormone oestrogen decreases. Oestrogen stimulates bone-building cells. Decrease in oestrogen, during perimenopause and menopause, causes loss of bone mass and strength in the years following menopause. This increases the risk of collapse or fractures.


Read more articles on Perimenopause




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