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    Perimenopause SymptomsPerimenopause is the period of time when menstrual cycle and hormone changes occur as the ovaries release variable amounts of estrogen. Symptoms of perimenopause may include irregular cycles, heavy cycles, cramps, and worsening PMS.

    When perimenopause starts, the bleeding changes may occur in stages.

    Stage one begins in the 40s and is due to poor functioning of the ovaries and decreasing estrogen and progesterone production. This is why it may be difficult to get pregnant after 40 years of age. The length of the menstrual cycle may vary from 21 to 40 days. Instead of a normal menstrual flow, there can be significant clotting and/or bleeding through clothing. Emotional changes may occur such as anger, rage, crying, excessive worrying, or anxiety. This is generally not a great time for husbands.

    Stage two also starts in the 40s and results in even less ovarian estrogen function and a complete disruption of the estrogen and progesterone environment. Menstrual cycles may only occur every couple of months intermixed with periods of very heavy bleeding and clotting. This is when hot flashes may start. Usually, they start at night and cause you to wake up soaked and hot. Then you may promptly become freezing cold. The hot flashes may start happening during the day, causing your scalp and head to drip sweat at the most inopportune times. This stage ends 12 months after the last menstrual period (at which time you are officially menopausal). This is generally a really bad time for husbands.

    If you have any of the many bleeding problems associated with the perimenopausal transition, contact the Memorial Center for Menopausal Medicine.