As we age women like to discuss “menopause”. However….menopause is actually one day in your life. The day you have gone a whole year without your period. That’s all that word means…everything going on before, from as early as 30, until that day is perimenopause.

What is perimenopause?

Perimenopause, also called menopausal transition means “around menopause” and refers to the time during which your body makes the natural transition to menopause, marking the end of the reproductive years. While this transition is different for every woman, the transition can take a few years or a few decades. As you go through the menopausal transition, your body’s production of estrogen and progesterone rises and falls. Many of the changes you experience during perimenopause are a result of decreasing estrogen.

Perimenopause and menopause are normal phases in life and are different for each woman. There are risk factors associated with early perimenopause:

Smoking: Menopause occurs one to two years earlier in women who smoke than in women who don’t smoke.

Family history: If the women in your family have experienced early menopause you may also experience early menopause.

Cancer treatment: Treatment for cancer with chemotherapy or pelvic radiation therapy has been linked to early menopause.

Hysterectomy. A partial hysterectomy that removes your uterus, but not your ovaries, usually doesn’t cause menopause. While you no longer have periods, your ovaries still produce estrogen. But a hysterectomy may cause menopause to occur earlier than average.

Estrogen, the main female hormone, and progesterone rise and fall unevenly during perimenopause. These two key hormones also contribute interfere with other hormones, most notably cortisol, which we’ll cover next. When estrogen and progesterone levels fluctuate you can experience:

Decreased Fertility: Fluctuating estrogen leads to ovulation becomes irregular, and your ability to conceive decreases. Pregnancy, however, is still possible, as long as you’re having periods. To avoid pregnancy, use birth control until you’ve had no periods for 12 months.

Irregular Periods: As ovulation becomes more unpredictable, the length of time between periods may be longer or shorter, your flow may be light to heavy, and you may skip some periods. If you have a persistent change of seven days or more in the length of your menstrual cycle, you may be in early perimenopause. If you have a space of 60 days or more between periods, you’re likely in late perimenopause.

Sleep Problems & Hot Flashes: Hot flashes are common during perimenopause. The intensity, length and frequency vary. Sleep problems are often due to hot flashes or night sweats.

Mood Changes: Mood swings, irritability or increased risk of depression may happen during perimenopause. The cause of these symptoms may be sleep disruption associated with hot flashes.

Bladder & Vaginal Problems: Vaginal tissues may lose lubrication and elasticity, making intercourse painful when estrogen levels diminish. Low estrogen may also leave you more vulnerable to urinary or vaginal infections, while loss of tissue tone may contribute to urinary incontinence.

Changes in sexual function. Sexual arousal and desire may change during perimenopause. Decreased sexual arousal is often experienced when you are also experiencing bladder and vaginal problems.

Loss of bone. Osteoporosis — a disease that causes fragile bones, is related to declining estrogen levels, and you start to lose bone more quickly than you replace it, increasing your risk of

Erratic Cholesterol Levels: An increase in low-density lipoprotein (LDL) cholesterol — the “bad” cholesterol — which contributes to an increased risk of heart disease combined with a decrease in high-density lipoprotein (HDL) cholesterol — the “good” cholesterol —also increases the risk of heart disease.

Cortisol & Perimenopause

Reasearch shows that cortisol (the stress hormone) levels begin to increase during the third decade of life. Anecdotally we can attribute this increase to external life factors: everyday stresses from balancing being in a relationship, having children, a career, a mortgage etc…Made in the adrenal glands, cortisol controls your mood, fear and motivation. Best known as the fight or flight hormone, cortisol also plays a key role in regulating:

Metabolism & Use of Carbohydrates, Fats, and Proteins


Blood Pressure

Sleep/Wake Cycle

Energy Levels Under Stress

When your body is under constant stress and stimulation, combined with fluctuating estrogen and progesterone, your body will not be able to regulate cortisol.

Because you can experience symptoms gradually, you may not realize at first that they’re all connected to the same thing — rising and falling levels of estrogen and progesterone.

But these symptoms can interfere with your life and well-being, particularly hot flashes, mood swings or changes in sexual function. But the good news is that you don’t have to be hi-jacked my perimenopause, there are many things that you can do, to reduce and eliminate the symptoms of peri-menopause.

You will see in the next article in this series how to survive and thrive during perimenopause and beyond!


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