Menopause is the time after the reproductive years when our menses (period) pauses, permanently.  The time leading up to this stage is referred to as perimenopause.  “Peri,” is a Latin prefix meaning “around,” or “near.”  (You’re familiar with the “peri-bottle” which is used for the “perineum” during bleeding or after childbirth. This word means “around” the open space).  Perimenopause is 1-10 years around menopause, the average length being approximately four years.

You might be at the beginning or middle of your reproductive years, and menopause might feel like a long way off.  But it’s important to remember that these are the years that initiate your experience of perimenopause.  Every phase of reproduction sets us up for the next.  Your years prior to menses, your teen years prior to childbearing, and so on.  Lifestyle during pregnancies, between pregnancies, and simply during your cycling years will suggest what perimenopause might be like for you.  Thankfully, in our cycling years we get a monthly preview of if changes are needed.

Your cycle can help you pay attention a little more now.  Do you have heavy or painful periods now?  Do you have scant or missed periods now?  Do you have low progesterone now?  If you have enhanced mood swings, bloating, or any version of pre-menstrual syndrome, your body is telling you now that you need to make some changes so that perimenopause isn’t too overwhelming.

Perimenopause, like our first pregnancy and the transition before birth, is a transformative time.  We are meant to experience a bit of inward reflection and shed some of our personality that was needed during our reproductive years, but not any longer.  As we move to the next phase of our life, to becoming an elder, we can experience some challenging moments spiritually, emotionally, and physically.  These moments are normal if they aren’t debilitating.  Having moments where we need to say no to a little more, reduce our workload, and rest more is wise.  But being unable to move gracefully through these stages is an indication that our whole body needs a little more help.

As ovarian function reduces, ovulation becomes delayed. This causes, progesterone to decline.  LH and FSH then get a little more excited and your body might start maturing multiple follicles (eggs) during each cycle, making shorter periods or pregnancy with multiple babies more likely.  Though, as estrogen remains proportionately higher to waning progesterone, the uterine lining thickens through a longer cycle which may cause heavier periods when they do come.  Knowing how to track cervical fluid and Basal Body Temperature (BBT) can be especially helpful during this transition of fluctuation and irregularity.

It’s common to experience impatience, hot flashes, intense night sweats, bloating, fatigue, digestive changes, flooding (soaking pads during your period), vaginal dryness, reduced libido, and similar symptoms of hormonal imbalance.  These occasional imbalances can be a normal part of the perimenopausal transition.  Though, it is a reminder to nurture and nourish your body well and notice ongoing or extreme symptoms.  If these imbalance symptoms happen often for you, get help with nutritional and lifestyle changes, supplements, and herbal support.

Nutrient-dense food choices, regular exercise, and adequate sleep can do a lot to help our aging bodies filter toxins and create balance.  Many of the same herbs used during pregnancy, like red raspberry leaf, continue to be beneficial during this time.  Hormonal balancing herbs like Black and Blue Cohosh, Motherwort, and Yarrow are excellent natural options for hot flashes, mood inconsistencies, and fibroids.

If lifestyle changes and natural therapies aren’t helping, testing is ideal. OTC or prescription bio-identical hormone replacement therapy (HRT) helps some women feel more balanced in these years.  Vaginal estrogen may help with incontinence and progesterone cream may help with mood balances and sleep disturbances.

 

LAB TESTS

Day 3/Perimenopause Blood/Serum Values

FSH: Consistently >25 mIU/mL

Estradiol E2: Consistently <20 pg/mL

Menopause: ≥40 y.o., some symptoms,
labs, & no period for ≥1 year

(DUTCH urine/saliva ranges are different)