Perimenopause is a process that begins several years before menopause, when the ovaries gradually begin to produce less estrogen. As a woman reaches the end of her reproductive years, production of her ovarian hormones begins to fluctuate, causing her periods to become shorter and then more and more irregular until they stop.

This is a gradual transition, a puberty in reverse, that can take between a year and 10 years, but averages about 4 years. After a full year without a period, a woman is considered to have gone through menopause and enters what is called the postmenopausal period.

There are many signs and symptoms for perimenopause, although no two women will experience it the same way. Irregular periods, breast tenderness, hot flashes, night sweats, vaginal dryness and diminished libido can all be signs of perimenopause. Women may also notice skin changes, fatigue, weight gain, depression, anxiety, difficulty in concentrating, sleep disturbance, nausea, joint paints, headaches, urinary incontinence and similar symptoms as experienced with premenstrual syndrome (PMS). Symptoms can be mild, moderate, or severe.

There are many treatment options to bring relief from these symptoms. We can separate them into 3 categories: medical treatment, natural remedies and lifestyle changes. Which treatment to choose depends on the severity of the symptoms and medical history of the patient. One should always start with the least risky approach (natural remedies, lifestyle changes) and go on to riskier approaches (medical treatment) only if necessary.

Making healthy lifestyle choices, such as eating a balanced diet, exercising regularly, getting enough sleep, etc., can greatly ease some of the symptoms as well as promote good health and overall well-being for the future. Learning about perimenopause and what to expect from it is also very important.

Menopausal transition is not one event, but a complex process that can last for up to 10 years. By learning everything about it and how it can affect your live, you can be better prepared to manage it. Lack of education in this matter is one of the major reasons why women have so many difficulties coping with all the challenges they are faced with.

Always remember, menopause is not a disease, it's a natural transition.