Menopause, Nutrition & Lifestyle

Navigating the Change: What to Expect in Perimenopause

by Nikki Warren on Jan 11, 2024

Navigating the Change: What to Expect in Perimenopause

Did you know that hormone changes can start in your late 30s, early 40s?

Perimenopause refers to the lead up to menopause and can last for around 10 years. Everyone experiences it differently, depending on several factors like lifestyle and hormones.


Here's What You Need to Know About Female Hormones in Your Early 40's:

  • Oestrogen has higher fluctuations than usual throughout the cycle.
  • Perimenopause is the transition before menopause, often starting in the late 30s, early 40s. 
  • Women may have many or minimal symptoms.
  • Supporting oestrogen metabolism and progesterone levels is important to manage heavy periods and irregular cycles.


Expected Age of Perimenopause

Perimenopause is the beginning of the transition to menopause, and may begin as early as mid-30s or as late as mid-50s. There are two stages - the early transition and the late transition.

In the early transition stage, women will often have regular menstrual cycles but her periods may be heavier or lighter than usual. 

During the late stage, women may experience longer gaps between periods (at least 60 days). This starts around age 49 years and the average final menstrual period (menopause) is age 51, although there is substantial variability in the age women experience every stage of perimenopause and menopause.


Perimenopause Hormone Changes

There are many changes in hormones during perimenopause. Oestrogen will often be erratic like a ‘rollercoaster’. It can be high, or it can be low at times. It's more likely to be high in the early half of perimenopause. Oestrogen will often be low in the final stage of perimenopause just before periods completely stop.

In perimenopause, progesterone production will slowly but steadily decline, and the ovarian function will continue to decline. Testosterone also begins to decline in perimenopause, usually as a result of age.

The HPA axis which regulates our stress levels can become ‘unstable’ during perimenopause from the hormonal changes. This can make you more vulnerable to stress, tiredness, and feeling like your nerves are more sensitive.


Perimenopause Symptoms to Expect

Oestrogen-related symptoms:

·       High oestrogen may cause – heavy periods, PMSbrain fog, headaches/migraines, breast cysts and may impact thyroid function.

·       Low oestrogen may cause – dry skin, vaginal dryness, hot flushes, night sweats, loss of periods, brain fog, tender breasts, weak bones.

Low progesterone may cause -  low mood, fatigue, anxiety, PMS, irritability, heavy periods, low libido.  Chaste tree is recommend to support healthy hormone balance including progesterone levels.

Low testosterone and DHEA may cause - brain fog, low motivation, loss of libido, weight gain.

Every woman is unique during perimenopause. So consult a healthcare professional for hormone blood tests to better understand your hormones. Some women may not have any symptoms in this period of life.


Heavy Periods in Perimenopause

Heavy periods can be a significant symptom of perimenopause for many women. Experiencing them may increase with age and peak during perimenopause.

Women will often not ovulate in perimenopause. If there is no ovulation, there is no corpus luteum and progesterone levels are low. Meanwhile, your ovaries are still working to produce oestrogen.

This causes continued growth of the endometrium. Which can lead to heavy periods once it sheds.

Heavy periods can be painful for some women and cause stress. They can also increase the risk of developing iron deficiency and anaemia. Being iron deficient can cause symptoms such as fatigue, dizziness, headaches, light headedness, and brain fog.

Supporting oestrogen clearance and metabolism from the body helps ensure oestrogen levels aren’t excessive in perimenopause. You can support oestrogen clearance by supporting liver detoxification, managing constipation, regular exercise and reducing alcohol intake.

Our PMS Support & Antioxidant formula contains herbs traditionally used in Western herbal medicine to maintain healthy reproductive hormones and regular menstrual cycles.


Assessing Your Hormones in Perimenopause

You can ask your healthcare practitioner for a blood test for oestradiol, LH and FSH on day 2 or 3 of your cycle. Other hormones that may be relevant include testosterone, DHEA-S and progesterone.

You could also check your zinc and copper levels. High copper levels are associated with high oestrogen. High dose zinc supplementation is a treatment often used by naturopaths to reduce copper.

In perimenopause oestrogen is often high and that can lead to brain fog.  Testosterone and DHEA can play a big part too, especially for loss of libido. Sometimes high oestrogen levels or "oestrogen dominance" is associated with PMS. 

Usually perimenopause symptoms are irregular periods, brain fog and poor sleep. You may also experience poor memory and irritability.

Low oestrogen symptoms are more likely to start in the late stage of perimenopause just before periods completely stop. Low oestrogen may cause hot flushes, night sweats, poor memory, brain fog and poor sleep.  If a blood test shows low oestrogen levels (less than 150 pmol/L on day 2 or 3 of your cycle), our Menopause Day Formula and Menopause Night Formula may help.

If a blood test shows your oestrogen levels are high, our PMS Support & Antioxidant formula may help. It contains herbs traditionally used in Western herbal medicine to help maintain healthy reproductive hormones and regular menstrual cycles.

Supporting oestrogen metabolism is important in perimenopause, especially for managing heavy periods.

Our PMS Support & Antioxidant contains herbs traditionally used in Western herbal medicine to maintain healthy reproductive hormones and regular menstrual cycles. 

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