Perimenopause, or menopause transition, is the stage of a woman's reproductive life that begin several years before menopause, when the ovaries gradually begin to produce less estrogen. It usualy starts in a woman's 40s, but can start in the 30s as well. Perimenopause lasts up until menopause, the point when the ovaries stop releasing eggs. In the last one to two years of perimenopause, the reduction of estrogen accelerates. At this stage, many women experience menopausal symptoms.

The transition into the menopause begins when a women begins experiencing a variety of symptoms including hot flushes, night sweats, difficulty sleeping, breast tenderness, mood swings, reduced sex drive, irregular periods, vaginal dryness, urinary problems just to name a few

Irregular periods are common and normal during perimenopause. But, other conditions can cause abnormalities in menstrual bleeding during the menopause transition. Potential causes of abnormal bleeding include hormonal imbalances, hormonal contraception, pregnancy, fibroids, blood clotting problems or, rarely, cancer.

Post Menopausal Bleeding is bleeding form the genital tract one or more years following the cessation of menses. This symptom is always abnormal and must be taken seriously. Most cases are benign in nature but it is important to exclude cancer of the genital tract in every women who complains of PMB.