This is a question that many women ask when they first begin having out-of- the-ordinary symptoms: hot flashes, irregular periods and mood swings. These symptoms were once labeled menopause or “the change of life.”

Today, however, your doctor is more likely to call this perimenopause, a term for the transitional years leading up to the end of menstruation. During perimenopause, which often begins around age 47 and lasts about five years, the ovaries gradually shrink and fertility declines. At the same time, the levels of two hormones, estrogen and progesterone, become unstable, rising and falling randomly.

Once a woman’s periods have stopped completely for a full year, she has reached menopause. Generally, this happens around age 51.

Telltale Signs of the Change
Many women develop one or more classic symptoms of perimenopause between ages 45 and 55. Here’s what you can expect during this life change and some tips for coping:

Hot flashes — surges in body heat causing flushing and sweating. Hot flashes that disrupt sleep are called night sweats. Dress in easy-to-shed layers, keep the room temperature cool, drink cold water, avoid spicy foods and keep a small fan handy.

Irregular menstrual cycles — changes in your period’s frequency and flow (either heavier or lighter) and spotting between periods. Your doctor may recommend low-dose birth control pills, which can regulate periods, decrease heavy bleeding and help minimize hot flashes.

Vaginal problems — dryness, itching, or irritation of the vagina and genitals, which can make sex uncomfortable. Try water-based over-the- counter vaginal lubricants and moisturizers. Or ask your doctor about prescription estrogen products (suppositories, creams or vaginal rings) that are inserted into the vagina.

Urinary issues — sudden or frequent urination or leakage and more frequent urinary tract infections (UTIs). Wiping from front to back, wearing cotton underwear, and urinating within an hour of feeling the urge and right after intercourse can all help prevent UTIs.

Perimenopausal Myths and Facts
Years ago, few women spoke openly about menopause, and myths grew about this stage of life. This information can help you learn the facts.

Myth: You’ll lose your sex drive.
Fact: Fifty percent of perimenopausal women report no change in sexual interest. For the other half, reduced sex drive may have more to do with emotional factors.

Myth: Your symptoms will make you miserable.
Fact: Only 75 percent of women experience hot flashes, and of those, only 25 percent rate them as severe.

Myth: You’ll gain weight.
Fact: Metabolism can slow down with age. But balancing exercise with your calorie intake every day can help you maintain a healthy weight.

Myth: You can’t get pregnant.
Fact: Pregnancy can happen during perimenopause. To avoid pregnancy and sexually transmitted infections, use birth control and practice safe sex.

Hormone Therapy: Pros and Cons
For years, hormone therapy was the standard prescription for middle-aged and older women to replace the estrogen their bodies no longer made. But in 2002, a large clinical study called the Women’s Health Initiative questioned the safety of this therapy. For many women in their 40s and 50s who have daily hot flashes, night sweats or vaginal discomfort, the benefits of shortterm hormone use may outweigh the risks.

However, if your concern is preventing heart disease or osteoporosis, other medications and lifestyle changes have fewer risks.

The bottom line: Talk with your doctor about choosing the best form of treatment for your symptoms when you reach perimenopause. If hormone therapy is approved for you, start with the lowest possible dose that relieves your symptoms and use it for the shortest amount of time possible. Talk with your doctor about how long you will need to use it.