Your hormone levels fluctuate wildly in the lead-up to menopause, which may cause you to have very heavy periods one month, and then no periods for several months. Menstrual irregularity is a key sign that menopause may be imminent, but check that this is not due to pregnancy first. 

The drop in estrogen levels causes increased blood circulation, making you feel excessively warm. Hot flashes are especially uncomfortable at night, making you perspire profusely.

Vaginal dryness is one side effect of menopause, and the drop in levels of estrogen, progesterone and testosterone all contribute to a loss of desire. 

Progesterone, the hormone that helps regulate sleep, dips during menopause, making it hard to hit the hay at night. Those hot flushes don’t help either, which can make you sleepless, cranky and irritable. 

During menopause, the tissues in your vagina and urethra lose their elasticity and the lining thins. Your pelvic muscles may also weaken, causing you to run to the bathroom more often though your bladder may not be full. 

Your weaker vaginal tissues, pelvic floor muscles and urethra lining also mean you may lose a few drops of urine when coughing, sneezing or laughing. Any activity that puts pressure on your bladder – including lifting heavy objects – could also cause this.

Just as hormonal changes cause you to be irritable around the time of your period (think PMS), the lack of hormones like estrogen during perimenopause can cause lower levels of serotonin, a mood-regulating neurotransmitter.

You may find yourself more emotionally unstable, moody, and sad for reasons you can’t explain. Your stress and anxiety levels may rise, too. Seek professional help if your mood swings are extreme, or you are struggling to cope with your emotions.