The symptoms associated with menopause can begin fifteen years prior to the onset of menopause. During that early stage, called perimenopause, many women experience bewildering symptoms such as hot flashes, mood swings, irregular menstrual cycles, sleeping disorders, and what some describe as "PMS all month." Perimenopause has often been ignored in the past, and even the medical community is just becoming aware of its widespread presence in pre-menopausal women. Given that fact, it is wise to learn as much as possible about this process.