All about each symptom of menopause
women going through menopause

What Happens at the Start of Menopause?


When many people talk about menopause, they are actually referring to perimenopause. Menopause is defined as the moment when one year has passed since your last period and you are no longer fertile. Perimenopause is the period that leads up to this, and is rife with symptoms and hormonal fluctuations characteristic of the menopause transition.

What Is Perimenopause?

Most women are surprised to learn that menopause happens in stages. From the time that a woman begins to menstruate until the time she begins to notice irregularities in her periods, she is said to be in premenopause, or the time before menopause. Premenopause is followed by perimenopause, or the years leading up to the cessation of the menstrual cycle.

This is the stage that you've probably heard about. It's characterized by hot flashes, mood swings, low sex drive, and many other symptoms. Some of the most common symptoms include:

Irregular periods


This is the only universal symptom of menopause that affects all women. Changes in estrogen will render your monthly cycle unpredictable. Sometimes it will be extremely heavy and PMS symptoms will be more severe, while other times it will disappear for months at a time.

Mood swings

Some women experience severe and sudden mood swings during menopause. If you are prone to mood swings during PMS, then you will be more likely to be affected by this symptom. It's not uncommon for perimenopausal women to experience short bouts of depression during this time, as well.



This symptom is usually a result of other menopause symptoms. Night sweats and insomnia, for example, can keep you from getting enough sleep. Also, mood swings and anxiety can make it more likely that you'll become exhausted throughout the day.

Hot flashes

Changes in your body's hormones may lead to hot flashes and night sweats. These are usually caused by a malfunction in the way that the hypothalamus communicates with estrogen, a hormone that can fluctuate wildly during perimenopause. This leads your body to think that its cold, causing a hot flash. When it realizes its mistake, it causes you to sweat severely.

Loss of libido

If you start to notice that your sex drive is lagging, it is likely the result of perimenopause. This could be an indirect symptom of vaginal dryness, which can make intercourse painful, or a symptom all of its own.

For More Information

Menopause is different for everyone, and these symptoms are just a few of the ones you may experience. Learn more about the onset and ways to cope with menopausal symptoms.

34 Menopause Symptoms and Nausea

During menopause, women can suffer from a wide range of symptoms, one of which is nausea. Learn more about the 34 menopause symptoms and nausea.

How to Reduce the 34 Menopause Symptoms

Menopause symptoms can be difficult and uncomfortable. Click on the link below to learn more about treatments.

When Do Menopause Symptoms Start?

Most women go through menopause in their late 40s or early 50s, this process is called perimenopause. Menopause symptoms begin during perimenopause due to hormonal fluctuations. Keep reading to find out more.

  • BMJ Group. "Menopause: What is it?" Patient Leaflet. 2007.
  • Hopkins, Virginia. Lee, John R. M.D. What Your Doctor May Not Tell You About Menopause. New York: Warner Books Inc., 1996.
  • Love, Susan M.D. Menopause and Hormone Book. New York: Three Rivers Press, 2003.
  • Martin, Raquel. The Estrogen Alternative. Rochester, VT: Healing Arts Press, 2000.