Peri-menopause, which literally means “around menopause”, refers to a transition period when your menstrual cycles start becoming irregular and slowly stop altogether. Most women become peri-menopausal sometime in their 40s. However, some women may experience peri-menopausal symptoms in their late 30s.


  • Irregular periods
  • Hot flashes
  • Sleep problems
  • Mood swings and irritability
  • Vaginal dryness
  • Urinary incontinence
  • Loss of sexual desire
  • Decreased fertility
  • Loss of bone mineral density
  • Increased risk of heart disease


Most of the changes that occur during peri-menopause are caused by the decreasing levels of estrogen due to advancing age, which results in an imbalance in the female hormones.

Risk Factors

Risk factors that can quicken the development of peri-menopause include:

  • Smoking
  • Cancer treatment
  • Family history
  • Hysterectomy


Common complications include:

  • Heavy bleeding
  • Prolonged bleeding
  • Bleeding in between periods
  • Short menstrual cycles (Less than 21 days)


As peri-menopause is a gradual transition, your doctor will make the diagnosis based on your age, menstrual history, and symptoms. Occasionally, a blood test to determine hormone levels or a thyroid function test may also be recommended.


Treatment options will depend on the severity of symptoms and may include:

  • Hormone replacement to restore hormone balance
  • Application of vaginal estrogen to relieve symptoms of vaginal dryness
  • Antidepressants to treat mood swings and depression