Is it possible for me to be starting "the change" at age 39? My periods seem to have gotten very heavy and my mood swings are terrible -- it's almost to the point of breaking up my marriage! I need help!

--D.

Many women begin to experience changes in their menstrual periods beginning in the late 30s to early 40s. This is the start of perimenopause, the variable amount of time before menopause, the complete loss of ovarian hormone function. During perimenopause, ovulation may become sporadic as hormone levels fluctuate. Some women may begin to skip periods or have heavier flow. More PMS-type symptoms, especially mood swings, may occur. There are many options for treatment, including use of low-dose birth control pills (for non-smokers), vitamins and soy products. Always remember to check with your doctor before starting any new types of medication.

Other possible causes for your symptoms include thyroid imbalance, especially an underactive thyroid. This can be detected by a simple blood test. Your periods may be heavier due to polyps or fibroids protruding into the uterine cavity. An ultrasound, especially one in which a small amount of fluid is instilled into your uterine cavity, can be done to make this diagnosis. Or you may be more moody simply because you have too many stresses in your life at this point -- job, husband, children, aging parents, etc.