Perimenopause

This Hormone Type means you’re likely experiencing common symptoms of perimenopausal fluctuating hormones. This is common when you’re over 40. 

If it resonates, you’re not alone!

Thankfully, there are many things you can do to improve symptoms and support a smoother menopause transition (which don’t include expensive lab tests, supplements, or meds).

It can be simple and starts with a personalized approach that includes: balancing stress and blood sugar, optimizing sleep, reducing your exposure to common endocrine disruptors, and improving elimination pathways (think sweat and gut health).

Read on to find out more.

What’s Perimenopause?

Perimenopause is the transition into menopause that comes, on average, 4 to 10 years before menopause, and usually after the age of 42, though hormones often start changing in your mid-30s.

You’ve reached menopause when you’re of menopausal age, and you’ve gone without a menstrual cycle for at least 12 months. Some medical professionals even consider it menopause after 14 or more months.

The average age to go through menopause is 51, and for most women, it will happen between the ages of 45 and 55, but it can also happen earlier or later.

Certain lifestyle factors such as stress, diet, or smoking can affect the onset of menopause or perimenopause and can cause an early onset.

Hormones shifting in perimenopause

Beginning in your late 30s or early to mid-40s, your hormones begin to shift, and your female sex hormones — namely estrogen, progesterone, and testosterone — will begin a natural decline as you approach perimenopause and menopause.

This decline is natural and normal. The closer you reach menopause, the lower these levels begin to drop. Some women will find this shift unremarkable in terms of symptoms, while other women struggle with symptoms affecting their mind, mood, sleep, energy, waistline, and more.

Common symptoms of perimenopause

There are many symptoms of perimenopause, and each woman will experience perimenopause differently. No two experiences are the same. We’re all wonderfully unique like that.

Common symptoms include:

• fatigue
• weight gain, especially around the waistline
• insulin resistance and blood sugar issues
• difficulty sleeping, including night sweats, trouble falling or staying asleep, or insomnia
• mood changes, including irritability, depression, and anxiety
• feeling emotional or crying more than normal for similar situations
• hair loss
• dry, flak,y or thinning skin
• dry eyes
• headaches or migraines
• hot flashes
• brain fog and forgetfulness
• difficulty concentrating
• low libido
• increased UTI’s
• thinning, drying, or inflammation of the vagina
• painful sex
• heart palpitations
• tender or drooping breasts
• joint pain
• decreased strength of the  pelvic floor
• urinary incontinence
• acne
• increased cholesterol or blood sugar levels, or both

Menstrual cycle changes in perimenopause

As you make your way toward menopause, menstrual changes will begin to occur and will look different in each woman. It can start with a shortening of your cycle or with menstrual flow getting heavy before cycles get further apart and your flow begins to disappear.

These changes could look like:

• light menstrual flow
• heavy menstrual flow
• fluctuating periods — heavy one month, light the next
• shorter or longer menstrual cycles
• fluctuating menstrual cycles — short cycle one month and long the next
• absent periods
• spotting

Please Note: If you’re getting your period more often, more regularly than an average cycle length of 24 to 30 days, it’s important to check with your doctor to rule out any another reason that could affect your bleeding.

Dearest Reader,

This information is for educational purposes only and not intended to diagnose or highlight imperfections. You've likely landed here following my quiz at YourHormoneQuiz.com.

No matter what you discover in these results, you're beautiful and perfect as you are. You're good enough and trying hard enough.

We're all unique and will experience hormonal shifts differently. This information is here to highlight that, despite what we've been told, we're not just little men — our bodies work differently — and if our hormones have us feeling less than our best, we absolutely can do something about it.

My aim is to support and empower you on your journey, where you need and want it. Take what you need, leave what you don't.

No judgement here, just good honest support.

XO, Laurie

What you can do about it

Perimenopause doesn’t have to be a dreadful, miserable experience. Thankfully, there are things you can do to improve it and ease common symptoms.

Here are a few ways to get started…

Keep stress hormones in check by balancing or reducing stress.

Stress is a big one! When the work of our stress hormones is chronically in demand, our sex hormones can suffer. Keeping stress in check can help support better hormone balance and less suffering.

Reduce inflammation.

This can be done by reducing known (and unknown) food allergies or intolerances and reducing exposure to known environmental toxins and endocrine disruptors (check foods, home, and beauty products).

Prioritize sleep. 

This can often be easier said than done in your perimenopausal years; however, it can be done with a bit of effort and sometimes trial and error. Seek support if sleep is an issue. I’m also happy to help here.

Opt for a diet rich in anti-inflammatory foods and reduce inflammatory ones.

Many women will require a reduction or shift in carbohydrate intake as a drop in estrogen will impact blood sugar control. A hormone-supportive diet can also help balance stress, reduce inflammation, improve overall hormone balance, and help you feel and look your best.

Choose exercise that’s a good fit for your current hormone type and body

This will look different from your 20s or early 30s. Appropriate exercise for your hormones will also help reduce stress and inflammation.

Reduce alcohol.

This is a rather unpopular suggestion, though I must mention, as it can greatly reduce your body’s stress levels and inflammation. Reducing alcohol can help keep the hormone insulin in check, reduce blood sugar issues, help you burn fat when you want, and minimize fat gain, especially around your waistline.

Improve gut motility.

If you tend to be on the constipated side or the opposite, getting things moving one to three times a day is important to support hormone balance. Daily bowel movements should mostly be solid and firm but not hard, well-formed, brown, and easy to pass. If not, there could be digestion and absorption issues impacting your hormones.

Targeted nutritional supplementation.

Getting adequate nutrients to support hormone balance and your unique situation and symptoms is important. Genes, environment, and lifestyle all have a part to play, and most often, diet is not enough at every moment to support optimal hormone health. Working with a knowledgeable practitioner can help restore nutrients to optimal levels and fill essential gaps.

When is hormone replacement therapy helpful?

Balancing hormones and managing symptoms is sometimes insufficient to feel your best or reduce disease risk.  Estrogen plays an important role in nearly 400 bodily functions, impacting our heart health, bone health, and metabolism (this means fat stores, blood sugar, cholesterol, blood pressure, and more).

You’ll likely notice as estrogen (in addition to progesterone and testosterone) declines to its lowest point.

Women have the option of restoring hormone levels with either traditional hormone replacement therapy (HRT) or bioidentical hormone replacement therapy (BHRT). I strongly suggest educating yourself on the various options, benefits, and risks to make a well-informed decision that best suits your body and needs.

Some women find that their traditional doctors dismiss the idea of hormone replacement therapy in menopause or only mention risks from outdated research without informing themselves of recent developments in hormone therapy research.

I recommend educating yourself on the research to be well-informed. There’s a lot of information out there, and it pays to seek out an expert in women’s hormone replacement therapy.

Hormone Therapy Options

Hormone therapy comes in many different forms — including a pill, transdermal creams or gels, injections, sublingual drops, lozenges,  a patch — and can have various combinations or types of bioidentical or synthetic estrogens (estradiol, estriol, or both). Not every type or form of estrogen will have the same effect on every woman.

If you choose to try hormone therapy, it’s helpful to have options to find what works for you.

There are many benefits to choosing hormone therapy, and it can be health-supportive while reducing the risk of certain age-related diseases. Working with a knowledgeable, well-informed practitioner can help you make the best choice.

In addition, taking estrogen alone without the supplementation of progesterone can also pose risks — or reduce the efficacy of (B)HRT — for many women. Some women might find they also feel better with a combination of hormone replacement, including testosterone and even DHEA. Be sure you seek a highly knowledgeable practitioner in the different types of options, combinations, and what’s required to maximize benefits and reduce risk. This will vary from person to person.

When is it a good time to consider hormone replacement?

• When you’re between the ages of 45 and 50 and having irregular or anovulatory cycles, and no later than 10 years post-menopause, within the first 5 years of menopause is often ideal.
• Women with primary ovarian failure, primary or secondary amenorrhea
• Your FSH is > 10 IU/L at day 3 of your menstrual cycle
• Estradiol is less than 50 pg/ml mid-cycle
• AMH < 1.5 ng/mL 
• Progesterone is < 2 ng/mL during your mid-luteal phase

How to best support hormone therapy

Hormone replacement therapy is not a magic pill, and for it to work well for you, diet and lifestyle are an important consideration.

Optimizing hormone health is the way to feel better, younger, and healthier — starting with your diet and lifestyle. There’s no escaping that, even with the support of well-planned, well-considered hormone therapy.

Check out this post for even more ways to get your hormones back in harmony.

This information is for educational purposes only and is not intended to diagnose, manage, or treat disease or serious conditions. Always check with your doctor before making any changes. It's important to consult a well-informed health practitioner for personal advice about your situation before relying on general information — we're all wonderfully unique.