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Actually premenopause begins at the age of 40 and is heralded by menstrual disturbances and mostly by symptoms of neural origin. Pregnancies may occur, but the contingent of abnormalities is high. The ovary lessens its estrogenic production and raises the androgenic production. The isolated elevation of FSH attributed to the fall of inhibin seems to be responsible for the accelerated disappearance of the ovarian follicles in this phase. In spite of the existence of menstruations, the low estrogen levels may cause vulvovaginal dryness and dispareunia. At the end of premenopause appear the hot flushes in > 80% of women and had consequences in work, family milieu and also in sexual relationships.

Moreira JR Editora