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The menopause begins when your ovaries cease to work. After age 40, they tend to produce decreased amounts of hormones and fewer eggs. You are in the perimenopausal period when your hormonal balance changes, and you see physiological, psychological and sexual changes. 

Here's what you need to know about the perimenopause.

  • Your  periods are now unpredictable: Cycles will be irregular, scanty and often heavy. You cannot predict either your cycle or flow. Gradually, the flow becomes scanty and ultimately ceases. You will be labeled as menopausal after attaining one year of amenorrhoea.
  • Hot flushes will bother you: Due to the lack of the hormone estrogen, you will feel sudden profuse sweating along with warmth. There may be night sweats also causing sleeping difficulties.
  • Your mood changes could be out of your control: You may experience mood swings, even if you never experienced sudden mood changes before in your life. You may have features of depression, anxiety, and a loss of temper along with easy fatigue.
  • Your skin may look dull: The skin's collagen content is reduced iin women who have entered the menopause. Beginning during the perimenopause, your skin will be dry, thin and prone to infection.
  • You may lose interest in sex: Yes, the perimenopause can be a bad time for your partner, as many women lose their libido during this point of life. Sex may be painful, as you lose your vaginal lubrication and elasticity. 
  • You may experience urinary problems: You may feel urinary urgency, frequency, or even some form of urge incontinence. This is due to the loss of muscle tone around your bladder.
  • Chances are that you may feel exhausted:  A common feature during the perimenopause is easy fatigue. You may feel tired easily, may lose interest in your profession or may feel weak and unmotivated.
  • Your private parts will bother you: You may face vaginal dryness during menopause and itching. You may lose muscle tone and even feel like something is prolapsing from your vagina.
  • Bones are now brittle: Estrogen is responsible for a good part of your bone health, and in menopause, your bones will become more brittle.You may well starting getting backaches and pain in the knee joint. You may be advised to undergo a bone-mineral density [BMD] test to assess the calcium content of your bones.
  • You have more major health risks: This is the period when you are at risk of developing heart diseases and strokes. Estrogen prevents the development of heart diseases by increasing the level of friendly cholesterol in your blood. Thus, a lack of this hormone may make you more prone to these diseases.

Finally, you should know that not all perimenopausal women will experience the same symptoms. While some women will really suffer during the perimenopause, others will not find this transitional period to be more than a minor annoyance. Most women will experience a range of symptoms, but not all will need treatment to cope.

Hormone replacement therapy to relieve menopause symptoms should be reserved for those who are highly intolerant to hot flashes or suffer from major complications of the menopause, like repeated urinary tract infections or fractures.

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