Perimenopause 101: What Every Woman Should Know

Perimenopause 101: What Every Woman Should Know

Your 40s are a time of changing hormones, also known as ‘perimenopause’; your body’s slow and gradual transition towards achieving menopause.

Low energy, fatigue, brain fog, lack of focus, mood swings, insomnia, irritability, anxiety, increased belly fat, breast pain, heavy periods, PMS, hot flashes and night sweats are all common peri menopausal symptoms.

What exactly IS perimenopause?

Perimenopause is an inevitable phase of womanhood that marks the start of the body’s slow and gradual transition towards eventually going 12 consecutive months without having a period, which is menopause. The average age for achieving menopause is 51 but your hormones are changing from your mid 30s, bringing you into perimenopause.

The purpose of this blog is to help you understand what happens during peri menopause and what’s ACTUALLY happening with your hormones, so that you can start to make sense of any symptoms you may be experiencing of late that might be confusing and frustrating.

So what’s actually happening?

During your menstruating years, the hypothalamus region in your brain releases hormones that act as chemical messengers, instructing your ovaries to release oestrogen and progesterone at various times to bring about the necessary changes to stimulate ovulation and preparation to hold a pregnancy.

Fertility aside though, this monthly hormonal dance is essential to female health, both now and in the future, and you want this dance to occur month after month (halting if pregnant) until menopause is achieved. This monthly hormone cycle safeguards so many aspects of health, including metabolic, cardiovascular, bone, energy, immune, mental/cognitive health and more.

Understanding progesterone and ovulation

Achieving ovulation mid way through your cycle is the ONLY way you make progesterone. This is a really important concept to understand, especially in perimenopause. Progesterone is a calming, anti-anxiety hormone that supports sleep, cognition and overall sense of wellbeing, plus it prevents menstrual bloating and heavy periods. It works in tandem with oestrogen each month, not just to coordinate your menstrual cycle but to safeguard your health.

If some (or many) months you don’t ovulate, oestrogen is left to run the hormonal dance show by itself (a situation known as ‘unopposed’ oestrogen), which leads to symptoms such as heavy and/or painful periods, breast pain, mood swings, headaches and menstrual bloating.

Oestrogen is a wonderful hormone too, but it must be met with its calming partner progesterone in the second half of the cycle (after ovulation). This picture of an oestrogen-only/non-ovulatory cycle is sometimes referred to as oestrogen ‘dominance’. 

How your hormones change at perimenopause

From age 35, the communication between your brain and ovaries starts to change.

The chemical messenger hormones aren’t released by your brain as efficiently as in your 20s and earlier 30s, resulting in the ovaries not getting the right signals at the right time, and/or your ovaries may get the right messages but not always hear as loud and clear as before because the follicles on your ovaries are dwindling and not as healthy as before, which means they don’t receive and execute on the brain’s signals as well as they used to.

This puts oestrogen on a rollercoaster ride and progesterone on the decline. 

It’s this situation that causes many of the peri menopausal symptoms such as brain fog, low mood, mood swings, anxiety, irritability, sleep issues, heavy periods, breast pain, irregular periods, headaches or migraines, menstrual bloating, weight gain, low libido and even hot flushes and night sweats. 

At times, oestrogen can rise to levels 3 times higher than ever before and then crash down to really low levels, over and over again throughout the month. This is a similar picture to when your periods first started as a teen. Progesterone was also lower at puberty as your body was working its way up to having ovulatory cycles.

Remember as a teen, when your periods were heavy, painful and irregular and PMT through the roof? Well, perimenopause can be likened to your second puberty or ‘puberty in reverse’ because the hormonal picture and symptoms are very similar, as your body starts it’s gradual journey to a complete stopping of your menstrual cycle (menopause). The diagram below shows a more gentle ebb and flow of oestrogen (the red line) during regular cycling years, compared to the more erratic, rollercoaster-like fluctuations during perimenopause.

Why does progesterone decline in your 40s? 

Ovulation starts to become harder and harder to achieve from mid-late 30s, due to the breakdown in brain to ovary communication described above, which means more months without making progesterone. The further you move through your 40s, the more non-ovulatory/progesterone cycles you’ll have and the more erratic the oestrogen roller coaster gets.

The impact of the oestrogen rollercoaster;

The HIGHS = heavy periods, painful periods, breast pain, headaches, bloating, mood swings.

The DROPS = hot flashes, night sweats, headaches, migraines, low mood, flatness in mood, low energy, fatigue and tiredness, low libido + zest for life, joint aches and pains.

The impact of the progesterone decline;

Sleep issues (trouble falling asleep and/or staying asleep), anxiety, irritability, low mood, low energy, fatigue and tiredness, joint aches and pains, breast pain, heavy periods.

So, how can you relieve perimenopause symptoms and have a much easier time?

Leverage nutrition and lifestyle habits that can help to:

  1. Calm the rollercoaster and encourage as healthy a balance of oestrogen as possible in what is naturally a stormy time for this hormone. 
  2. Support the body to ovulate as many months as possible (so that you make progesterone more often and minimise its decline).

I cannot emphasise enough how impactful nutrition and lifestyle habits are on your perimenopause experience. It can improve the severity or intensity of symptoms 10-fold and is a massively underutilised strategy for managing hormone health. Nutrition in perimenopause is so important.

Now that you have more of an understanding about what perimenopause actually IS and what’s happening, read my blog on how to get rid of peri menopausal symptoms here.

Hi, I'm Francesca

I’m a Registered Nutritional Therapist who helps womens in their 40s find vibrant health and vitality, and thrive through perimenopause and beyond.

With nearly 10 years of experience working with hundreds of people, I empower and support women to support their bodies and hormones for a smooth and happy ride in their 4os.

Through our work together, clients have improved their energy, their periods and cycles, their mood, sleep, brain fog and digestion, and learned how to better manage their weight.

I am here to help you get back to YOU so you can have a fantastic time in your 40s.

My signature nutrition and lifestyle coaching approach to supporting women with their health and wellbeing is refreshing, down-to-earth and realistic.

Download the Free Guide

A FREE, no-nonsense PDF guide to Mastering Perimenopause and learn how to master your hormones in your 40s for more energy, better sleep, balanced mood, easier periods and so much more.

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