What is Perimenopause?

Smiling Woman

Perimenopause can be a very challenging time for many women both physically and emotionally due to their changing and fluctuating hormone levels.  It usually starts in the late 30's through to the late 40's in most women and can actually go on for around 10 to 15 years.

Here is an outline of the stages:

  • Perimenopause - the time leading up to menopause AND a year after the final menstrual period if you are over 50.  If you are under 50 it is two years after the final menstrual period.  So you have your final bleed, then for one year (or two years) after that you are still considered in perimenopause.

  • Menopause – the day that a year (or two years) has gone by since your last period (menopause is one day)

  • Post menopause – any days after the day of menopause 

In perimenopause the first stage is dropping progesterone and fluctuating oestrogen.  The second stage is low progesterone and low oestrogen and low testosterone.


With perimenopause your menstrual cycles start to get shorter, then longer, then may be non-existent for a few months, and then start again.  Basically, there is irregularity to your periods.  Your ovaries may stop producing eggs.  So, you may start off with periods coming closer together for a while and then over time they will start being further apart.


The most common hormonal imbalance is oestrogen to progesterone, quite often resulting in “oestrogen dominance” which means that the progesterone is not adequate enough to balance the oestrogen. 


Also, oestrogen affects the production of serotonin (the happy hormone), meaning when your body is producing less oestrogen, the production of serotonin decreases, resulting in off balance emotions, and more anger, irritation etc.  Hello cranky lady.

However, due to your hormones being out of balance these symptoms will vary over time.

Image by Cheron James

Perimenopause symptoms

  • Low sex drive

  • Irregular periods

  • Weight gain, especially in waistline, that you just can’t shift no matter what you eat or how much you exercise

  • Low mood about every day tasks

  • Feeling unsociable

  • Teary eyed and emotional

  • Unwilling to exercise

  • Sleep issues or insomnia

  • Night sweats

  • Less interest in your children

  • Forgetfulness

  • Anxiety

  • Wanting to take naps

  • Anger, irritation and more…

The End of Ovulation

When you hit your early 40’s you quite often stop ovulating every month (ovulation is when your ovary releases an egg).  You may still get your period but you may not actually produce an egg, so this means your body is not producing progesterone.  This leads to oestrogen dominance which causes many of the hormonal issues at this time of life.  Progesterone is a very calming hormone, so when that is at low levels, those feelings of peace and harmony will be harder to attain meaning you may now be dealing with anxiety, irritation, anger, insomnia and so on.  Wonderful.

At the same time your thyroid becomes sluggish (which can be the beginning of hypothyroidism, which can cause weight gain, hair loss, feeling cold and fatigued etc) and this can also cause your mood to become erratic. 


Along with this, due to your adrenal glands, your stress response is heightened, you feel irritated, you can’t focus or concentrate, you lack in energy, you have night sweats and have disrupted sleep. 


The combination of your ovaries, thyroid and adrenal glands all not functioning well causes emotional disruption.  Basically, everyone around you should run and hide.

At the Doctors

You may go to your doctor saying that you’re not feeling well emotionally and physically.  However many doctors may just encourage you to take either a birth control pill or antidepressants to manage your symptoms, instead of it being recognised that you may be experiencing perimenopause.

There is an actual test that your doctor may suggest to determine if you are in perimenopause.  This tests your FSH (folicule stimulating hormone) and LH (lutenising hormone). 


However, when you are not ovulating regularly, the pituitary gland increases the production of the FSH and LH making levels higher.  Also, when these numbers are high it means that you body is working extra hard to produce an egg so that you can ovulate.  However, these FSH and LH numbers can vary from month to month and they don’t actually give you an indication of the imbalance of oestrogen to progesterone levels – and this is actually the initial problem with perimenopause.

On the Scales

Weight Gain in Perimenopause

As your oestrogen levels start to fall, the fat from your butt starts to migrate up to your waist.  


Women then decide they need to lower their calorie intake (eat less) as well as exercise more.  However, this then raises your cortisol levels.


When cortisol levels are raised, this then deposits weight around your middle, because your body feels that it is under stress mode all of the time. 


So, therefore women quite often feel that no matter how healthy or restrictive they eat, or no matter how much or how hard they exercise, they actually no longer see any results.  This weight gain is due to hormones and cortisol, not food or exercise.

Is there a Way Out?

So, can perimenopause symtoms be managed?


The symptoms of perimenopause can quite often easily be managed with diet, supplements and herbs, lifestyle and mindset changes.

However, the sooner you start the easier it will be.  It is much easier to treat perimenopause symptoms earlier on than later.

So here are some tips to get your started:

  • Lower daily and long term stress levels to keep cortisol in balance 

  • Learn some anger management techniques

  • Have restorative sleep

  • Incorporate daily diaphragmatic breathing, yoga and/or  meditation

  • Reduce alcohol, caffeine, sugar, and processed foods

  • Increase whole foods, especially cruciferous vegetables and healthy fibre, which helps your body detox oestrogen as well as supporting your bowel.  

  • Drink water

  • Clary sage and lavendar oil applied to your body 

  • Plus, get your hormones tested (I can put you in touch with someone who does this)

In Conclusion

Even though perimenopause can be a rocky road, remember that it is a stage, it’s not forever, and with specific nutrition, lifestyle and minsdset changes plus certain vitamins, minerals and herbs, there is a way to manage yourself through it.

Get in touch with me for a free 30 minute chat if you're ready to manage your symptoms. 

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