Dr. Patricia Kaufert, a scientist from Canada who has done one of the best

studies about what women experience during perimenopause, found that

women are likely to have a flooding menstruation just before their periods

changed from regular to skipping.

5 phases of perimenopause

Dr Jerilynn C. Prior, MD and founder of The Centre for Menstrual Cycle and

Ovulation Research

Phase A is a time of regular and ovulatory cycles with increased breast

tenderness, mood swings, fluid retention, and premenstrual symptoms. You

may experience shorter cycles. You may experience early morning hot

flashes for the first time. Weight gain, migraine headaches, and abnormally

heavy or flooding menstruation may occur. Estrogen levels are intermittently

high. FSH levels are normal

Phase B, you are likely to continue to have basically regular cycles but

disturbances of ovulation become more common. Episodes of heavy flow

may occur. You may experience increased PMS symptoms and menstrual

cramps. Hot flashes may return or increase in the days just prior to menstrual

flow. Estrogen levels are often high. Your FSH level is intermittenly elevated

Phase C, you will experience unpredictable flow and alternating short and

long or skipped cycles. Hot flashes will become more common during waking

hours, but will be minor for most women. Night sweats will become more

persistent. FSH levels are usually at least slightly elevated. Estrogen levels

will fluctuate

Phase D, you will experience irregular or infrequent menstrual periods with

intervals of more than 35 days – however, the duration may vary. One flow

can be light and the next one heavy. This is the phase of skipped periods.

You will experience more hot flashes. There may be times of high estrogen

levels. Your FSH level will be persistently elevated

Phase E begins with your final menstrual period and includes the year after,

during which you dont have a period. It is during this stage that hot flashes

and night sweats become more frequent and more intense. However, PMS

symptoms and cramps are usually less, but sometimes occur without any

subsequent flow. Breast, fluid, and mood symptoms decrease. Estrogen

levels are low or normal. FSH level is high