Perimenopause - The Second Puberty

Everyone seems to know about menopause - when menstrual cycles are gone forever, but the transition to getting there is one that is rarely discussed despite it being a significant amount of time in many women’s lives. 

Perimenopause is the 1-10 year transition into menopause which is where a person hasn’t menstruated 12 months and is no longer making estrogen and progesterone.  During this transition, many people are still menstruating, but significant hormonal changes are occurring.  We often see major changes in the menstrual cycles (closer together, further apart, heavier bleeding…), but can also see significant mood changes, increases in joint pain, hot flashes, insomnia, vaginal dryness, and changes in body composition.  

During this perimenopausal period we can have some cycles where ovulation is occurring, but others where it is not.  This can cause the hormones and symptoms to be ALL OVER THE PLACE - your blood estrogen levels might be <40 one day (the level we expect to see in menopause), and at 1200 another day.  Some cycles you’ll have a surge in progesterone and other cycles you’ll make none.  While we can’t necessarily change your production of estrogen and progesterone in this window, we CAN address a number of the other hormonal symptoms and nutrients that can make this experience better or worse: thyroid, blood sugar regulation/insulin, Vitamin D, iron (deficiency is very common in this window), B12…  We can also put in support for sleep and stress management.  Poor sleep and stress make everything harder and worse!

We can’t stop the process of perimenopause.  We can’t necessarily regulate your cycles as that can be part of the natural change that occurs.   But we CAN make the experience much smoother.  We CAN make sure you have the foundations to feel your best self and manage your symptoms. We can make sure you know your options in terms of treatment.  

If you’re between 38-50 and experiencing menstrual cycle changes along with the symptoms described above, it very well could be perimenopause.  We don’t want to blame everything on that transition, so it’s still important to do our due diligence to understand what’s going on.  But I do want you to know you’re not crazy, hormones DO impact your mood, and there ARE safe and effective solutions.