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This pattern becomes more frequent and periods can become more erratic early in perimenopausal phase.
This was unlike women in the late stages of the perimenopausal spectrum and postmeno- pausal women, where elevated BMI was associated with elevated levels of estrogen.
As women undergo transition from perimenopause to menopause, they often report a variety of symptoms, including vaginal symptoms (e.g.
BMD decreases as the level of estrogen declines in the perimenopausal to postmenopausal transition.
The SWAN study reported that there were eth- nic differences in the decline in bone density in pre- menopausal versus perimenopausal bone loss, but this decline was also affected by body weight.183 Unlike in postmenopausal women, the BMD and rate of bone loss of premenopausal and early perimenopausal women is better correlated inversely with serum FSH than estra- diol.183 Bone loss becomes more pronounced as the men- ses become less frequent with rapid loss during the years shortly after the last menses.183
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