Q: Perimenopause doesn’t just bring on a greater lapse of time between periods—it can also make some periods lighter, others heavier, and even decrease the time between them. You are likely in the early stages of perimenopause if the length of your cycle is changed by about seven days.  If your periods have two months between them, this is an indication you are in the late stages of perimenopause, just before menopause. Menopause is complete when you haven’t had a period for 12 months. You may begin to notice the occurrence of hot flashes, or a sudden sensation of heat over your body that triggers sweating, increased heart rate, and skin redness, lasting one to five minutes. This is a normal part of the hormone changes leading up to menopause.  Hot flashes may end with a cold chill.  The intensity varies as much as the length, and can contribute to sleep discomfort. Also accompanying the changes in estrogen and progesterone hormone levels during perimenopause are mood swings, although these can also be due to lack of sleep caused by hot flashes. Women can become irritable or depressed. Mood swings can also be caused by or mid-life stressors like children leaving home, aging parents, and changes within marriage. More rarely, they can be caused by thyroid issues. Because estrogen levels drop during perimenopause, the lining of your vaginal tissues thin, leading to loss of lubrication. This can cause pain during sex. The same thinning of vaginal tissues that causes pain during intercourse can increase risk of vaginal infections, and lead to urinary tract infections. Loss of muscle tone in the vaginal area can also contribute to loss of bladder control. Night sweats occur during perimenopause, but they are nothing to be alarmed about. They are the nighttime version of hot flashes. Loss of sleep due to a hot flash can greatly contribute to the irritability a woman displays during perimenopause. Although the hormonal change of perimenopause may not directly cause an increase of anxiety, there are so many things occurring around a woman in perimenopause that anxiety can be a normal part of the process.  Hot flashes and night sweats cause sleep loss, leading to an increase in stress and a lowered ability to cope with it.  A vicious cycle of stress-symptoms-anxiety can be enacted during perimenopause, where your stress level causes your perimenopause symptoms to be worse, leading to anxiety.  You’re also at a time in life where a lot of changes occur, such as children leaving home and parents aging, increasing your anxiety levels. Some women experience an increase of headaches or migraines at the onset of perimenopause. If you notice more headaches than usual, or an increase in their intensity partnered with other perimenopause symptoms, you may be able to confirm that you are indeed experiencing perimenopause. Some of these symptoms can continue for several years after menopause.
A: Notice irregularity in your periods. Expect hot flashes. Anticipate mood swings. Expect pain during intercourse. Watch for increased risk of urinary and vaginal infections. Expect night sweats. Notice an increase in anxiety. Anticipate an increase in headaches.

Q: You may see your ex-friend regularly and find yourself having to interact with them. Stay polite and respectful, even if you are hurting. You don’t have to carry on a conversation with them, but you do need to remain civil.  Say hello to them if you see them in the hall at school. It will probably feel awkward, but it makes you look like the bigger person. If you feel yourself getting emotional around your ex-friend, find a way to remove yourself from the situation. Leave the room, bury yourself in your phone or a book, or start a conversation with someone else. While you may want nothing more than to vent about how hurt you are over what happened, find someone who is not in your shared circle of friends to do that with. Around people who still may be friends with your ex-friend, refuse to say anything bad about your ex-friend. Remember that it will likely get back to them if you do.  If someone asks you what happened between the two of you, you could say, “We’re no longer friends. I’m still pretty upset by it, so I don’t want to talk about it right now.” Don’t force your friends to take sides. If you want to, you can let them know what happened, but try to recount the events without blaming the other person. You could say, “He made his decision, and I’m trying not to badmouth him about it. I’m sad, but there’s not much I can do.” You should also avoid talking about the breakup with people who are still friends with the person. You can always say, "I don't feel comfortable speaking about this," and then change the subject. Don’t talk incessantly about what happened. Your friends will quickly tire of it. If you are finding that you need to really process this breakup with somebody, it might be helpful for you to talk to a counselor or other trusted adult who can listen to you objectively. Do not vent about your friend on social media. The internet never forgets, and you could find yourself in even more trouble for ranting about your friend. Hide or unfriend your ex-friend on social media, if they haven’t already. It might help you be less upset to not see everything they are doing. You may have some anxiety about running into your ex-friend somewhere, particularly if you don’t see them often. You may want to consider coming up with something to say to them if you ran into them. Having a script may help you feel more confident.  Rehearse what you want to say until you feel confident that you would be able to deliver your lines effectively if you ran into the person. For example, if you weren’t sure why your friend cut you off and you wanted to get some closure, you could ask, “Lauren, I know you don’t want to talk to me anymore, and that’s fine, but I would like to understand what happened that made you do this. You can just tell me, because you really can’t hurt my feelings any more than you already have by ignoring me.” Keep in mind they may not answer, in which case you will need to accept it and let it go. Things may have ended badly for you and your ex-friend, but that doesn’t mean there aren’t still good friends out there for you. Stick with the friends who have helped you through this difficult time with your ex-friend.  Your ex-friend may have helped teach you what kind of qualities you want in your friends. Look for current friends or new friends that have qualities you admire.  For example, maybe your ex-friend made fun of others a lot, and you never really liked that about them. Look for friends and acquaintances who avoid that kind of behavior. Maybe you can think of a person you’d like to be friends with who you don’t really know. Take the initiative to ask them to hang out. It may feel a bit awkward, like asking to go out on a first date, but sometimes you need to take a risk to start a new relationship. While it may be hard to see far down the road right now, understand that friendships, just like people, grow and change. While you and your ex-friend may think you are completely finished today, there may come a time at some point in the future where you reconnect. Maybe you will be close again, or maybe you will just be casually friendly. You may find your hurt feelings dissipate with time.  You and your ex-friend may reconnect when you are at a different place in life. If you and your friend are young, you may reconnect as you age, because people often like to reconnect with those who remember what it was like when they were young.  At some point, you may find that your lives will be similar again, causing a desire to reconnect. For example, you both may go to the same college, find out that you are getting married around the same time, or may end up in the same city far from your hometown. You never know what life will throw at you! If you are older when your friendship ends, you may find that as you enter a different stage in life (for example, your kids leave home) or you get involved in the same community activity, you may be able to strike up a relationship again in a few years.
A:
Remain polite. Avoid gossiping about your ex-friend. Step away from social media. Decide on what you’ll say. Find friends who respect you for who you are. Take the long-term view.