PERIMENOPAUSE – A second puberty

Sometimes we go through that twice in a lifetime. It’s not easy being a woman, is it?

So, you’re a kid and then you hit puberty – everything gets crazy and out of your control.

You have a dance of estrogen, progesterone, and testosterone in your body. Changes in mood, body, and behavior. You are growing and trying to understand what is happening to you.

Then this period passes, and you stabilize. It stabilizes for years and years – in theory, because many women struggle with imbalanced hormones and estrogen dominance in most cases.

And then, when you hit a certain age, everything can come back, but a little different. Now you are a mature woman having the emotions of a teenager.

What is Perimenopause?

Perimenopause is the transition between reproductive and non-reproductive life (menopause). On average, women enter this transition in the late 40s or early 50s.

I have clients who enter perimenopause in their late 30s (and this is not cool). Some women spend many years in this transition. Some women go through a short period and don’t feel the transition too much. During this period, estradiol fluctuates a lot. Sometimes it gets super high! Progesterone, on the other hand, drops significantly.

Remember that progesterone counterbalances estradiol for a woman to be calmer. Now, think about estradiol going super high and progesterone going super low…

For some women, the mood swings will be VERY intense, and the patience will be super short!

What exactly happens in Perimenopause?

Changes in hormonal levels. This is the main thing that happens.

The changes in hormone levels during perimenopause occur as a natural part of the aging process and the transition toward menopause. Remember that menopause is defined as the cessation of menstruation for 12 consecutive months and typically occurs around the age of 50, although it can vary.

The exact reasons for the hormonal changes are not well understood, but there are a few factors that contribute to them:

1-   Ovarian Function: The ovaries, which produce and release eggs, also play a crucial role in hormone production, including estrogen and progesterone. As women age, the number of viable eggs in the ovaries declines, and the ovaries become less responsive to the hormones that regulate the menstrual cycle. This leads to a decrease in hormone production and the irregular fluctuations seen during perimenopause.

2-   Follicle-Stimulating Hormone (FSH): As the ovaries become less responsive, the pituitary gland in the brain releases higher levels of follicle-stimulating hormone (FSH) in an attempt to stimulate the ovaries to produce more estrogen. However, this increased FSH production does not always result in consistent estrogen levels, leading to hormonal fluctuations experienced during perimenopause. Your doctor will ask for the FSH blood work to check if you are entering menopause.

3-   Hormonal Feedback Mechanism: The balance between estrogen and progesterone is important for regulating the menstrual cycle. As ovarian function declines, the feedback mechanism between the ovaries, pituitary gland, and hypothalamus (the part of the brain that controls hormone production) becomes disrupted. This disruption can contribute to the irregular hormonal patterns observed during perimenopause.

Other factors also lead to perimenopause such as genetics ( look at your mommy and see if she suffered from entering menopause) , lifestyle, stress, and unhealthy habits.

What happens to the hormones?

As I said before, the hormonal axis changes a lot. Estrogen, progesterone, and testosterone are affected in different ways:

• Estrogen: Estrogen levels fluctuate unpredictably during perimenopause. In the early stages, estrogen levels may be higher than normal, leading to symptoms like breast tenderness and heavy or irregular periods. However, as a woman progresses through perimenopause, estrogen levels gradually decline. These fluctuations can cause various symptoms such as hot flashes, night sweats, vaginal dryness, mood swings, and changes in menstrual patterns.

• Progesterone: Progesterone levels tend to decline more steadily during perimenopause. Progesterone is responsible for regulating the menstrual cycle and preparing the uterus for pregnancy. As levels drop, women may experience irregular or missed periods. Low progesterone levels can also contribute to symptoms such as mood swings, anxiety, and sleep disturbances

• Testosterone: testosterone levels may fluctuate as well. Some women may experience a decline in testosterone production, while others may experience an increase or have normal levels. These fluctuations can vary from woman to woman and can also change over time during the perimenopausal phase.

Body and behavior changes:

In perimenopause, many changes can happen:

• Weight gain out of nowhere, you haven’t changed your diet and level of activity, but the weight gain just happened.

• Sleep is horrible (it takes a long time to fall asleep, and you wake up to pee and can’t sleep anymore)

• Hot flashes, especially at night

• Memory is terrible (you just put an object in a place and can’t remember where that was),

• Libido decreases

• Vaginal infections are more frequent

• Headaches become part of your routine.

• You can’t control your mood, and people around you suffer

• Resilience to stress decreases significantly

It looks a lot, right? But most of these problems pass, and you will feel better and more realistic in menopause. The only thing that may bother you is the weight gain, especially in your waist circumference, but this is subject to another post.

Perimenopause can be difficult, but there are some ways to minimize the symptoms.

Here is how I help my clients, and we evaluate together some of the options below:

Magnesium supplementation: magnesium is involved in the production, metabolism, and regulation of various hormones in the body, including estrogen and progesterone. It also improves sleep quality

Bioidentical Hormone Therapy: in certain cases, if we modulate estradiol and progesterone, many of the symptoms will be reduced because what is causing them in the majority is the imbalance between the two hormones. Progesterone is essential to boost GABA ( a neurotransmitter that promotes relaxation and dampening excessive neuronal firing, everything that a woman needs)

Focus on sleep hygiene: sleep is so important! If you don’t sleep well, you can’t cope with stress, and your cortisol gets out of control – and also your insulin/blood glucose – a cascade.

Stress Management: Stress triggers hormonal imbalances and everything that we don’t want to have is more problem with hormones

Physical exercise: Regular exercise can help regulate hormonal levels, including estrogen and progesterone, by reducing insulin resistance and promoting a healthy weight. It also regulates mood and reduces stress

A clean diet: it also helps to regulate hormone levels, keeps a healthy weight, gives energy, reduces stress and anxiety

Use of herbs to naturally reduce the symptoms. The quantity and type of herbs will vary depending on the person’s needs but the most commonly used are Black Cohosh, Dong Quai, Red Clover, Maca, Chasteberry, and Sage.

I also ask my client’s husbands and family to collaborate and take it easy, they need to understand what is going on and know that it will pass soon.

In the end, anyone who follows a healthy lifestyle will suffer MUCH LESS from this kind of thing.

I hope you liked this post and I see you soon!