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    The Change Before 'The Change'

    Hot Flashes, Infertility, Happen Earlier Than You'd Expect
    By
    WebMD Feature

    Mom put up with hot flashes and night sweats. We used to think they meant menopause. Well, guess again. Many women experience these symptoms in their 40s, even 30s.

    "Everybody used to think 'this can't be happening to me, I'm still menstruating,'" says Laura Corio, MD. "Doctors were saying to patients, 'I can't do anything for you, you're still having your period.'"

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    It's a transitional time of life called perimenopause, and as early as age 35, women can begin feeling the symptoms, says Corio, a gynecologist and instructor at Mount Sinai Medical Center in New York. She is author of the book, The Change Before the Change.

    "I empathize with my patients," Corio tells WebMD. "It's not fun."

    Every woman's tale is different, she says. "Some will sail right through it without anything, others might have every symptom in the book -- irregular periods, hot flashes, vaginal dryness, mood swings, fatigue, heart palpitations, decreased libido."

    Despite the numbers of women hitting their perimenopausal years, a lot of doctors still have their heads in the sand when it comes to recognizing and treating symptoms, says Corio. "It's a fallacy that nothing can be done."

    Used to be, doctors said the same thing about cramps, adds Elizabeth McGee, MD, assistant professor of obstetrics, gynecology, and reproductive sciences at Magee-Womens Hospital in Pittsburgh.

    "It wasn't that long ago that doctors told women they didn't have cramps, that it was all in their heads," McGee tells WebMD. "Now we know cramps do exist, that the pain is real, and we have very effective treatments for it. It's the same thing with perimenopause."

    There's another reason why women need to know about all this, says Corio. Your chances of becoming pregnant dwindle after age 24. "I see it so often, 35-year-olds and 37-year-olds, and the egg quality is just not there," she tells WebMD. "They're in perimenopause and they don't even know it."

    It's All About Estrogen

    Recognizing perimenopause isn't easy for doctors: "Patients will complain of hot flashes, but hormone levels will be normal, so the patient isn't really taken seriously," says Bill Meyer, MD, associate professor of obstetrics and gynecology and a reproductive endocrinologist at the University of North Carolina Hospital in Chapel Hill.

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