Your grandmother called it her “change of life.” Gynecologists know it as perimenopause, the natural transition leading up to menopause. Although it is inevitable, it may hit you earlier, depending upon your lifestyle.

First, let's define an important term. Menopause begins after you have gone a full 12 months without having your period. In the run-up to this – perimenopause – your body's production of estrogen and progesterone will wax and wane, and this will be the cause of most of the symptoms you will experience.

These may include:

• Decreasing fertility. As your ovulation becomes irregular, your ability to conceive decreases. Note that as long as you are having periods, you can still become pregnant.
• Loss of bone. With declining estrogen levels, you start to lose bone more quickly than you replace it, increasing your risk of osteoporosis.
• Changes in sexual function. During perimenopause, sexual arousal and desire may change.
• Mood swings, irritability or increased risk of depression may happen during perimenopause.
• Hot flashes are common during perimenopause. The intensity, length and frequency vary.
• Sleep problems are often an issue during perimenopause. These may be directly related to your hot flashes or night sweats, or occur without them.
• Vaginal problems may arise when your vaginal tissues lose their elasticity and lubrication from the drop in estrogen, and this in turn can make intercourse painful.
• A change in your cholesterol levels can also be triggered by a decline in your estrogen production. This can mean an increase in your “bad” cholesterol and a decrease in your “good” cholesterol, both contributing to an increased risk of cardiovascular disease.

By definition, during perimenopause your periods will become irregular as your ovulation becomes more unpredictable. Your flows may vary from heavy to light, and you may even skip periods.

Certain factors can contribute to you entering perimenopause earlier. Most of these, such as having undergone chemotherapy, or having had a hysterectomy, you cannot change. But smoking – which you can control – may cause you to enter perimenopause up to two years earlier.

Menopause and its precursor are a part of life and cannot be “fixed,” but your doctor may prescribe some treatments to alleviate the symptoms. These may include hormone therapy, antidepressants or the drug gabapentin to relieve perimenopausal hot flashes and night sweats; or vaginal estrogen to relieve dryness.

Sources: The Mayo Clinic