Every two weeks, then not for two months; lasts three days, then three weeks: Menstrual mayhem is the poster symptom for perimenopause. Got irregular periods? Do this: The surefire way to regulate your cycle is to start on very-low-dose birth control pills. Their 20 micrograms of estrogen (versus 30 to 50 in other types) offer pregnancy protection — and bonus hot-flash reduction. Or this: Long bleeds result when hormones tell your uterus to start a period but not to stop it. "In some cases, your doctor can prescribe progesterone pills — either natural or synthetic — to provide the missing signal," says Andrew E. Good, MD, of the Mayo Clinic in Rochester, Minnesota.

One surprising finding of a large project known as the Penn Ovarian Aging Study: Nearly twice as many perimenopausal women complained of joint pain or other stiffness as women who were not yet in perimenopause. Got joint pain? Do this: Talk to your doctor if pain is stubborn or severe; you may need a workup to determine the cause. If pain is mild to moderate, consider these soothers: When joints revolt, relax them with a few minutes of heat (in the form of pads or baths) or numb them with ice. Or this: Give yourself a massage. Apply a small amount of oil or lotion to your hands, and gently glide them over sore spots. (Skip joints that are very swollen.) Or use the discomfort as an excuse to head to the spa!

Surveys show that 30 to 40 percent of perimenopausal women complain of vaginal dryness, says Nanette Santoro, MD, of the Albert Einstein College of Medicine/Montefiore Medical Center, in New York. Got vaginal dryness? Do this: Lube up during sex. "There are so many natural-feeling products on the market now," says Cheryl B. Iglesia, MD, of the Washington Hospital Center, in Washington, D.C. "Just avoid any brand that contains drying alcohol." If itching and burning occur at other times of the day, use a vaginal moisturizer. Newer products like KY Liquibeads or Replens Long Lasting need to be applied only once every few days. Or this: Your doctor may prescribe vaginal estrogen rings, creams, or tablets. "These deliver much lower doses of estrogen than systemic hormone therapy and go right to the source of your problem, so they’re much safer," Iglesia says. Still, this is only for those near menopause who aren’t producing much estrogen themselves.

The link between this problem and shifting hormones isn’t clearly understood, but estrogen receptors in the bowel may play a role, says Nanette Santoro, MD, of the Albert Einstein College of Medicine/Montefiore Medical Center, in New York. Got gas or bloating? Do this: Consider peppermint as a digestive aid, says gastroenterologist Anil Minocha, MD, author of Natural Stomach Care. He recommends a peppermint oil capsule of 0.2 to 0.4 milliliters, three times daily. (The capsules are sold in health food stores.) Or this: One popular yoga posture is so well known for helping bloating it’s actually referred to as the wind-relieving pose. Here’s how to do it: Lie on your back with your legs extended. Inhaling, draw the right knee toward the chest as you raise your head (as if to kiss the knee); exhale as you lower your head and leg. Repeat three times and switch sides. Then, do both legs together three times.

Dips in estrogen reduce secretions in many parts of the body, and the eyes are no exception, says Lama A. Al-Aswad, MD, assistant professor of clinical ophthalmology at New York’s Columbia University College of Physicians and Surgeons. Got dry eyes? Do this: Lubricate your eyes with drugstore drops. "If you use drops more than four times a day, choose brands that are preservative-free, or the preservative may further dry out the eyes," Al-Aswad advises. Or this: Turn away from the computer every few minutes to an hour (depending on how dry your eyes get), and blink, blink, blink. We tend to keep our eyes open when intensively reading, which causes our tear film to evaporate, Al-Aswad explains.