The average age of menopause in the United States is 51 to 52 years of age, therefore the perimenopause may start as early as 40 to 45 years of age. Clinically, many practitioners note a continuum in certain patients. Patients with significant premenstrual symptoms at 30 to 40 years of age often proceed to perimenopausal symptoms. According to the Study of Women Across the Nation, irritability and fatigue are common features of the perimenopause. Diminished libido and hot flashes also occur with relative frequency.
Women also note a change in their menstrual flow patterns.
This change may include a shortening of the interval between menses as well as occasionally skipping their period for one to two months at a time. Heavier flow during the menses is also commonly mentioned by women during the transition of peri-menopause. Other conditions can mimic perimenopause symptoms. An appropriate evaluation for perimenopause symptoms should include consideration of thyroid testing and depression, depending on the symptoms. There are a number of proposed treatment options for the perimenopause.