Premenopause syptoms?

Patient: Hello, i am a 47 yr. old healthy woman with a previously high libido that has dwindled to nothing. cannot reach arousal or climax with or without a partner for past year. do not have any sexual desire at all. other issues include headaches,fever, severe digestive problems (no regular bowel movements, cramping, bloating)irregular periods. these syptoms appeared last 6 months. have tried dietary change, more exercise, laxatives, nothing has worked. are these all signs of premenopause? what can i do, am miserable. please help, thank you

Doctor: