What’s Going on with Perimenopause?

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What's Going on with Perimenopause?

Peri-menopause can be a stressful time of life, but certain practices can help keep symptoms manageable.

Menopause is, in our cultural vocabulary, described as the symptoms of hot flashes and night sweats.  But menopause is actually the cessation of your menstrual cycle. You know it’s ceased when you haven’t had a cycle for a year. Peri-menopause is a period that extends for a long time before menopause.  

Peri-menopause starts at age 35, or starts 10 years before menopause, depending on who you ask.  It is the slow decline (sorry to use that word) of your ovaries as a player in your endocrine system. Accompanying that is a slow decline of fertility, that really speeds up in your 40s.

Now that many women are delaying childbirth, many women are being hit with the double whammy of trying to conceive while dealing with peri-menopause.  Still others are experiencing troubling peri-menopause symptoms while raising young children.

But what is going on in peri-menopause anyway?  Well, as I mentioned, the ovaries are slowly declining in the role and ability.  Estrogen levels fluctuate as the ovaries slack off and the brain then pushes the ovaries to work harder.  Meanwhile missed ovulation or lower egg quality means that less progesterone is made to balance the estrogen.

What might you notice?  Irregular cycles, spotting, decreased sex drive, vaginal dryness, heavy periods, light periods, breast changes, hot flashes, night sweats, insomnia, brain fog or belly fat.

Some women may not notice any overt changes until their 40s, but some will notice signs and symptoms sooner. 

How we feel during perimenopause has to do with a lot more than just age, and that’s good news because it means we can do something about it!

Modern life, with the stressors of money, traffic, social isolation, pollution, processed food, etc can tax the body and, in turn, take your hormones for a nose dive before they should go down that way.

Here are some easy ways to balance your body during this time:


This may be the time to hang up the running shoes and switch to lower impact exercise.  But you can still keep a healthy body weight with moving frequently, sleeping your eight hours, keeping toxins low, and eating a healthy diet.

•   Walk during your lunch break

•   Take weekend bike adventures

•   Join a local hiking club

•   Consider passive movement like Mayan Abdominal Massage or Mercier Therapy

•   Try yoga; it lowers cortisol and raises testosterone (1)


You are sensitive to xeno-estrogens in some meats, plastics and cleaning products and personal care products(2).  Even metals can act as "metallo-estrogens." You are also hit harder with the effects of sugar, alcohol and caffeine(3).  It’s time to find healthier ways to relax and reward yourself!

•   Dry brush the skin to remove toxins and get your skin glowing again

•   Replace coffee with a green smoothie for energy

•   Replace a glass of wine with a hot bath or a walk around the neighborhood to unwind

•   Eat as much organic food as possible, even if it costs a little extra

•   Swap your ‘fragranced’ beauty and cleaning products for un-fragranced or all natural scents

•   Visit the sauna to sweat out toxins (4)


If you are feeling pressure from every angle at this point in your life, you need to advocate for yourself.

•   Ask for help from your partner or kids with chores

•   Consider a house cleaning service; it’s the best!

•   Say no to projects or outings that you just want to do

•   Schedule a monthly acupuncture session

•   Replace Facebook with a girls’ night out (5)

A few other things to know:

You will have changes, at least eventually.  You will ovulate more infrequently, so you may a miss period, and then get a heavy flow. But many of these symptoms can be alleviated with care.

I mentioned many self-care options above, but there are times to see a practitioner too.  Many of us women are working really hard in our careers and families, so peri-menopause comes on early and strong.  We’ve often delayed caring for ourselves, and it’s time to call in the reinforcements. 

If you are having really heavy bleeding, worrisome fatigue or memory loss, or lack of periods before the age of 45, please seek help.  Find a qualified functional medicine practitioner, naturopath, health coach, or medical doctor when needed.

In short, get the support and care you need.  The person who can turn this potentially tumultuous time into a time of growth is you!  You are worth it.  Making new choices can be hard, but it gets easier, and the rewards come to you every day. 

Another resource for your hormone care:

Please join us for Hormones: A Women’s Wellness Summit.  This event is free and online April 11 -18, 2016.  Topics include perimenopause, anxiety, healthy weight management and more.  Our 35 experts include Dr. Tami Meraglia, Sayer Ji, Dr. Mariza Synder and Dr. Kellyann Petrucci.  Just click on this link to join!

Hormones: A Wellness Woman Summit


(1) Yoga and cortisol : http://www.ncbi.nlm.nih.gov/pubmed/26228429

(2) Phthalates and hot flashes:  http://www.ncbi.nlm.nih.gov/pubmed/26867866

(3) Alcohol, PMS:  http://online.liebertpub.com/doi/abs/10.1089/jwh.2006.0202

(4) Sweat for detox:  http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3504417/

(5) Social closeness raises progesterone:  http://www.ncbi.nlm.nih.gov/pubmed/19362559

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