Perimenopause in menopause

Perimenopause is the transitional phase before official menopause, usually starting in the mid-40s and lasting 4-10 years. During this phase, the ovaries begin producing estrogen inconsistently, causing irregular menstrual cycles and symptoms like hot flushes, sleep difficulties, and mood changes. Malaysian women typically enter perimenopause at 42-48 years. Diagnosis is clinical - based on symptoms and menstrual patterns, not a single blood test.