Ever since menopause ceased to be a subject only whispered about among women of a certain age, the world has come to more fully understand what women face as they go through this stage of life.

Although current wisdom talks about the perimenopause as beginning in the mid 40's there is a segment of the medical community that is developing data that supports the proposition that a women's hormone production can begin to become erratic as early as somewhere between 35 and 40 years of age. As these hormone changes begin to create subtle changes, women in their late 30's can and often do begin to experience subtle and hard to explain quality of life issues.

This means that as many as 20 million American women are now going through the early stages of perimenopause, with symptoms that include insomnia, moodiness, forgetfulness or depression. Previously it was thought that these problems were only associated with women in their 40's or 50's, where this hormone roller coaster ride is further complicated with the addition of hot-flashes and migraines.

The interaction of estrogen, progesterone, and other reproductive hormones with the diminished supply of a finite number of eggs, has been described as the stage where a women's body is no longer working together with the precision of a Rolex, but instead begins acting like a rusty Swiss watch.

Understanding the perimenopause has important implications for treatment. Although perimenopause has been recognized by the medical community since the 1970’s, it is still not part of most medical school curricula, and many physicians dismiss women’s complaints as being "All in their heads."

Women as early as their late 30's may begin to notice that their memory and cognitive skills are "not normal" but aren't sure what is happening to them. An early indication may be an awareness that they are having difficulty performing mental functions that previously were effortless.

Describing this problem to a doctor is difficult for women. When confronted with this problem most doctors either dismiss it out of hand as some form of hysteria, or they prescribe a battery of medical tests which provide no information for the doctor to use to perform a diagnosis. With no ability to diagnose and therefore treat, a doctor may resort to prescribing pharmaceutical antidepressants, when what the woman needs is a way to balance her hormones so she can get a full 8 hours of sleep each night.

Because of the fear of being ridiculed or judged as being emotionally unstable, women tend not to tell anyone, including their doctor, their significant other or their closest friends. However, when engaged in a serious and meaningful discussion, in a non judgmental environment, they will reveal their innermost feelings and tell you they feel like they are "losing their mind!"

Hot flashes bring women to their doctor, but impaired cognitive function caused by sleep disruption is more subtle, harder to explain and most likely under diagnosed. Yet the impact of this problem may have a greater negative impact on a woman's ability to function than previously realized.

It is well known that women have problems with sleep during the traditionally defined perimenopause (45 - 55) phase of their life, however, what may be under reported and under diagnosed is how changing hormone levels are affecting their sleep patterns much earlier than previous believed.

Sleep deprivation that results in chronic fatigue affects the ability of the brain to function properly. Chronic fatigue can cause personality changes, short term memory loss, and poor concentration. Is it possible then, that millions of women in their 30s and 40s are suffering from various stages of chronic fatigue due to sleep disruption?