Perimenopause is the period immediately before menopause begins, and many women find it helpful to know what are the symptoms of perimenopause. Typically, this period happens in a woman’s mid ’40s, and can last for several years; one of the most noticeable symptoms during this time is is periods that are irregular. Other signs include difficulty sleeping, along with hot flashes, which can vary in frequency and intensity. Changes in mood, often sudden or unpredictable, are also common, sometimes caused by the sleeping problems. Many women find intercourse painful during this time, as the vaginal tissues lose some of their lubrication because of lower estrogen levels. The chances of conceiving are less during this time, and the lower estrogen levels can also lead to a greater risk of osteoporosis. Cholesterol levels can also change, meaning more of what is known as bad cholesterol, and lower amounts of good cholesterol.