You may be in your early 40s or younger and menopause may be far from your mind. However, you have noticed changes in your body.

Your menstrual periods are erratic or you might have lost your sex drive. When you notice such changes, you should see your doctor who can determine if these symptoms are due to perimenopause.

Here are some common perimenopausal symptoms and how you can best deal with them:

Hot flushes

This is the most common symptom of perimenopause. It usually comes on as a mild, sudden feeling of warmth in the face or in the upper body. Your pulse rate may increase.

Dr Khong Chit Chong of KK Women's and Children's Hospital said hot flushes can occur up to a year or so before the onset of menopause.

What you can do: Wear light cotton clothing and sleep in a cool room. Avoid food that might trigger hot flushes like spicy dishes, alcohol and caffeine.

Consult your doctor to decide if you should get started on hormone replacement therapy (HRT).

Irregular menstrual periods

Menstrual cycles may become erratic and bleeding may be lighter or heavier. You may even stop menstruating for some months, then return to a regular cycle.

What you can do: Consult your doctor to determine the causes of the changes in your menstrual pattern.

Trouble sleeping through the night

Sleep problems are often due to hot flushes or night sweats but sometimes sleep becomes erratic even without them.

What you can do: Dr Christopher Ng of GynaeMD Women's and Rejuvenation Clinic at Camden Medical Centre said that regular exercise and reduced stress improve sleep.

Consult your doctor about taking a short course of sedatives.

Vaginal and bladder problems

Dr Ng said that when oestrogen levels diminish, physiological vaginal secretions reduce and vaginal tissues may lose lubrication and elasticity, causing discomfort during sex.

Dr Khong said that many perimenopausal women need to urinate more often, or suddenly feel the urge to urinate even when the bladder is not full. Some women may also suffer from urinary incontinence.

What you can do: Consult your doctor to determine the causes of vaginal or bladder problems.

Vaginal lubricants can help alleviate dryness.

Emotional and psychological changes

Dr Ng said that some women experience mood swings, irritability or depression during perimenopause. However, he said the cause of these symptoms may not always be due to the hormonal changes of perimenopause.

What you can do: Dr Ng said that meditation and yoga can promote relaxation and good health.

Share your experiences with friends and family or join a support group.

Changes in sexual function

Perimenopause can affect a woman's sexual activity and libido. Dr Khong said lack of sleep, urinary incontinence and certain medicines like those for depression may dampen a woman's inclination for sex.

What you can do: Lubricants could alleviate vaginal dryness.

Studies have also shown that certain hormonal therapy such as testosterone could help lift sagging libido.

Dr Khong said that most women who have enjoyed an active sex life when younger will likely continue to do so even way past middle age.

This article was first published in Mind Your Body, The Straits Times on Oct 30, 2008.