**3.1 Menstrual irregularities**

Menstrual irregularities are a common complaint during menopause transition. Infrequent **ovulation** and anovulation lead to changes in the length of proliferative phase, and in the absence of progesterone, decline of estrogen leads to heavier and irregular menstruation. In some women scanty periods with long cycles may be the main symptom. The changes of bleeding pattern due to hormonal fluctuation usually occurs during perimenopause. The analysuisreported median age at inception of perimenopause is 47.5 years and smokers have not only early but a shorter perimenopause [2]. However, postcoital bleeding, prolonged bleeding, and postmenopausal bleeding require further investigation.
