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Several years before a woman reaches menopause, her ovaries begin to produce less estrogen. This can trigger symptoms that indicate she has entered into pre-menopause, also called perimenopause. This generally occurs three to four years before actual menopause occurs.

Doctors can attempt to diagnose pre-menopause in a woman by assessing her symptoms. They can perform a blood test as well to see if there are abnormal hormone levels, but there can be a variety of reasons why the hormone levels may not be normal. The best method is to recognize the symptoms and ask a doctor whether they believe this is pre-menopause.

One of the first symptoms that may be noticed is hot flashes. This is when the body suddenly begins to feel very hot. Sweating may accompany this feeling as well. This is a symptom that is experienced during menopause as well.

A woman's period can also be affected by pre-menopause. Periods may become less regular. The symptoms of pre-menstruation may become more acute. However, medical attention should be sought if a woman's period is very heavy or lasts longer than expected.

Pre-menopause may be the cause of a reduced sex drive or dryness of the vagina. There can be other causes of these symptoms such as stress, so it is important to consider whether other factors are involved if these are the only symptoms being experienced.

A woman may experience the sense of having to suddenly use the bathroom. This may be accompanied by being unable to control small urinary leaks when the body is jarred such as a hard bump in a car or sneezing. This can occur because the tissue of the urethra relies on estrogen to remain taut and changes in the hormone level can cause some loosening.

Pre-menopause can also have psychological effects. These can include mood swings due to the shift in hormone levels, sleeplessness and fatigue. Again, if these are the only symptoms, they may be cause by outside factors and not perimenopause.

These symptoms are all cause by the slowly decreasing levels of estrogen in a woman's body. It is not suggested that hormone replacement therapy be started at this stage since menopause is a naturally occurring process. Also, despite some medical myths, it is possible to become pregnant while going through pre-menopause.

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