Menses may be heavier, or lighter. There may be increased or decreased cramping. Eventually, menses lighten, become less frequent and then stop. There is some suggestion that estrogen levels influence the production of serotonin. A woman with attention deficit disorder may first come for treatment at this age because declining estrogen level has exacerbated her ability to concentrate.
Insomnia is a common complaint of women in perimenopause or menopause itself.
Night sweats may disrupt sleep. Irritability and depression can impair sleep. Reduced sleep can lead to tiredness and irritability during the day. Before and after menopause, lowered estrogen levels cause the lining of the vagina to become drier and thinner. This may lead to painful intercourse and decreased interest in sexual relations.