By Xianmin Yu, Registered Acupuncturist What is perimenopause? Perimenopause refers to a period around menopause, which marks a transition period of female’s sexual function from maturity to decline or to the end of reproductive time. This transition period usually starts in the mid-40s, but some females might even start this process as early as their late-30s. Perimenopause is actually a normal process for females to have some physiological changes. Due to body constitution differences, and social and psychological factors, females who could not adapt to this physiological transition smoothly, would develop perimenopausal syndrome accordingly. Perimenopause involves a series of clinical symptoms caused by endocrine (i.e., reproductive endocrine and neuroendocrine) disorders and autonomic dysfunction which are triggered by decreased estrogen level. As ovarian function declines to complete loss, both blood estrogen and progesterone levels drop, which breaks up the balance of hypothalamus-pituitary-ovarian axis, and thus leads to autonomic dysfunction. Typical symptoms are irregular periods (i.e., the coming period is unpredictable as the length of time between two periods varies dramatically). Popular clinical symptoms include sleep disorders (i.e., insomnia, shallow sleep, easy to wake up, dreaminess), sweating after hot flashes, fatigue, palpitation, dizziness, ear ringing, irritability, depression, anxiety, joints pain (osteoarthritis), low back sore, and heel pain. Other common clinical symptoms include forgetful, breast fullness, abnormal skin sensations, knee weakness, decreased sexual desire, intercourse pain, etc. Thee symptoms vary in severity, and may show up partially or entirely in some severe cases. […]