Around the age of 40-45, women enter a physiological period called premenopause, or more accurately, perimenopause. This stage can last as long as 5-10 years before menopause and is characterized by various symptoms and signs.

Physical and mental health status can influence how a woman experiences menopause, making it essential to recognize the signs of premenopause and seek medical advice when needed.

Symptoms of Premenopause

Altered Menstrual Cycle 

An altered menstrual cycle is not the only sign of premenopause, but it is the most common. Women may experience irregular menstrual cycles in terms of frequency and intensity, with significant delays (oligomenorrhea) or menstruation every 20-25 days. These are the first signs of a physiological decline in the production of female hormones and a gradual decrease in ovarian function. 

Irregularity of the menstrual cycle, including the absence of menstruation (amenorrhea), occurs in most women before menopause due to irregular and fluctuating estrogen levels, while progesterone tends to decrease. Women should consult their gynecologist when experiencing menstrual cycle alterations to rule out other problems.

Fatigue, Muscle Aches, and Decreased Energy:

During premenopause, a healthy lifestyle positively impacts a woman’s life. In contrast, smoking can negatively affect secondary symptoms. Fatigue, muscle aches, and decreased energy may be expected due to gradual estrogen and progesterone deficiency, which appear to be linked to reduced muscle mass. Regular physical activity can help counteract fatigue and decreased energy. 

Headaches, Difficulty Concentrating, and Memory:

The gradual deficiency of estrogen and progesterone may also be associated with neurological symptoms, including difficulty with attention and memory, mental fog, and frequent headaches. A significant reduction in progesterone levels affects the brain areas involved in memory. Women should seek advice from their doctor to regain focus.

Mood Swings and Irregular Sleep:

Not all women experience sudden mood swings. Mood swings and irregular sleep are also affected by a woman’s lifestyle. However, progesterone deficiency, which works synergistically with serotonin, the so-called feel-good neurotransmitter, can promote increased sensitivity to stress, moodiness, and irregularity in sleep-wake rhythm. Prolonged irregular sleep or insomnia can be a health problem, and women should talk to their doctor about it to regain sleep with beneficial effects on mood.

Decline in Sexual Desire:

Sexual desire may be altered during this phase, especially if the woman is particularly exposed to stress. Talking to a gynecologist can help identify the source of the problem.

Urogenital Problems:

Some women may experience genitourinary changes, including vaginal dryness (and dyspareunia, with intercourse that can be painful) or increased frequency of cystitis. Women should consult their gynecologist to address these conditions and regain a peaceful sex life

Loss of Skin Tone and Thin Hair:

Some women experience a loss of tone and sagging of the skin of the face, neck, and arms due to the physiological thinning of skin tissue and deep layers of the dermis. Skin may appear dry and dull, and hair may become thinner, brittle, and fall out. A healthy lifestyle that avoids or limits alcohol and smoking can help reduce these manifestations.

Weight Gain:

With advancing age, metabolism physiologically slows down, and along with the reduction of estrogen, weight gain may occur. Regular physical activity, proper and balanced diet, and body weight control can help keep weight in the normal range during menopause. Consulting a nutritionist can help prevent diabetes and metabolic syndrome associated with being overweight if there is a weight change that is not related to changes in diet.