A: The hormonal changes of perimenopause often begin in the late 30s and early 40s. The menstrual periods may not be affected by hormonal changes until we get close to menopause, although some women notice changes in the frequency or amount of bleeding during their 40s. More commonly women start to experience other symptoms first, such as anxiety, insomnia, hot flashes, night sweats, mood swings, depression and heart palpitations. Even if you are not experiencing any symptoms, it is likely that your hormones are changing.

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