Perimenopause 101: How to Create Hormonal Harmony

Published August 27th, 2020 by Dr. Betsy Hoida, PharmD, BCPS
Fact Checked by
Chris Riley

Charlotte, 39, describes her life as relatively drama-free. Well, maybe there was a little bit of drama. She did have two teenage daughters, and her youngest daughter would make that “three teenage daughters” when she turned 13 this fall.  

This fall, when she sent them back to school. During a pandemic. Ok, it was dramatic. And she was in denial.

With her 40th birthday on the near horizon, she thought life should be easier right now. She thought with age came wisdom, right? Her emotions are a roller coaster. Her husband accuses her of acting like their teenage daughters, laughing one minute and crying the next. Something is off with her body too. For the past year, her periods have been more and more irregular. When discussing this with her friends, one of them mentioned something about “perimenopause.” 

Perimenopause? Like menopause? Wasn’t she too young for that?

What is Perimenopause?

For most women, the forties signify a time of hormonal transition. It is a time when their bodies move from a childbearing state to menopause. Menopause is a fixed point in time. It is defined clinically as the date twelve months after your last period.

The symptoms leading up that date are labeled as “perimenopause.” Peri, a Greek word for “around” or “near” menopause, refers to this hormonal transitional state. The average age menopause occurs is 51 years, but there is a wide range of what is considered normal. Lifestyle factors, such as smoking, can cause a women’s body to enter menopause earlier than expected.

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Perimenopause Can Equal Hormonal Havoc

Some women describe perimenopause as a “second wave puberty”. Symptoms of perimenopause fall on a spectrum. Some women report minimal symptoms; some suffer through the transition with no relief, while most fall someplace between the two.

Hormones, namely, progesterone and estrogen are responsible for the changes you experience during perimenopause. The menstrual cycle itself is controlled mainly through these two hormones. The first reproductive hormone to decline is progesterone, followed by estrogen. The decline in progesterone is what contributes to cycle irregularity, which is the hallmark sign of perimenopause. Also, at first, estrogen levels remain stable or even increase. This is what is known as “estrogen dominance.” Women report symptoms such as mood swings, irritability, water retention, and trouble sleeping.

Estrogen is the last hormone to decline in the perimenopausal transition. As you go through the final stages of perimenopause, your body will produce less and less estrogen. Symptoms of estrogen decline are hot flashes, night sweats, mental confusion, vaginal dryness, and urinary incontinence. 

After reading all of this, you may be dreading this change in your life. The beautiful thing is there are things you can do now to prevent this from being a negative experience in your life. Hormones are a part of life, and when balanced help your body to achieve optimal functioning. Working to achieve balance, both externally and internally, is the key to a fulfilling perimenopausal transition.

5 Ways to Create Hormonal Harmony in Perimenopause

1) Optimize hormonal balance - find a healthcare professional trained in women’s health, specifically hormone replacement therapy, who can help achieve this balance. While hormone replacement therapy (HRT) is not always the right choice for every woman, clinicians with expertise in this area can help in other ways as well. 

2) Clean up your diet - add cruciferous vegetables, such as broccoli or cabbage, to support healthy estrogen metabolism.

3) Make bedtime a priority - sleep in a cool, dark room, and avoid electronics one hour before bed.

4) Seek out social connections - women were not meant to handle life alone. Plus, spending time with those you love increases levels of oxytocin (the “bonding” or “love” hormone).

5) Get outside - spending time outside, even just for a 15- minute walk, can improve your mental mindset. 

The Bottom Line

Perimenopause is a transitional time that signifies the end of your reproductive years. Taking care of yourself, changing your mindset, and reaching out for help when needed are ways you can make the experience positive rather than negative. 

Reference List

Menopause 101: A primer for the perimenopausal. NAMS: The North American Menopause Society. Accessed August 6, 2020.

Northrup C. Is This Your Perimenopause Transition? January 14, 2014. Accessed August 6, 2020.

Cabeca A. The Hormone Fix: burn fat naturally, boost energy, sleep better, and stop hot flashes, The Keto-Green™ Way. Ballantine Books;2019. 

Published August 27th, 2020 by Dr. Betsy Hoida, PharmD, BCPS
Fact Checked by
Chris Riley

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