Everything You Need to Know about Your Hormones During Menopause and Perimenopause

If you understand what happens during menopause and perimenopause with your hormones, you'll understand better how to relieve your symptoms. For example, the menopause symptoms you are experiencing may be caused by a hormone imbalance causing too much estrogen. Here's an overview of what these hormones actually do and how the levels can change during perimenopause and menopause.

This is part of an on-going series on Midlife Rambler, Real Talk about Menopause. Too many of us (including myself) don't fully understand what's happening and don't know where to go to for accurate information. I am not a doctor and this is not medical advice but I'm hoping to provide some of the information I wish I had known when I went through menopause and give you some resources to check out if you want to learn more. 

More Real Talk About Menopause

You might be experiencing some symptoms that you think are related to menopause or perimenopause and you might know that these symptoms are caused by hormone changes, but do you know what hormones are changing and how? I sure didn't and I wish I had because by understanding which hormones are changing and how you can better mitigate any symptoms you might be having.

For example, did you know that during early menopause your progesterone levels drop before your estrogen levels do which can lead to feeling like you're permanently PMS'ing? Ironically, what's happening at that point is that your estrogen levels are too high so the last thing you want to do is add more estrogen to your body at the time. Knowledge is power!

Let's take a moment to review the hormones that are at play during your menstrual cycle so we can understand what each hormone does and what others areas of the body this hormone can affect.

Note: This is an overview of your hormones that will be helpful as you go through your menopause journey. Future posts will discuss menopause symptoms in detail and options for relief from these symptoms so they aren't discussed here.

What Happens During Menopause and Perimenopause with Your Reproductive Hormones

Your menstrual cycle is controlled by several hormones that work together to cause your ovaries to release an egg for fertilization each month and your uterine lining to thicken in preparation for holding a fertilized egg.  The levels of these hormones rise and fall throughout the menstrual cycle as you can see in the chart below.

In addition to controlling the menstrual cycle, these hormones, particularly Estrogen and Progesterone, control other aspects of your health throughout your body via estrogen and progesterone receptors that are found throughout your body.

Just look at all the aspects of your health that Estrogen and Progesterone can affect.

As you enter menopause, your levels of estrogen and progesterone drop, but not at the same rate. What's more, your levels of estrogen and progesterone can begin dropping much sooner than you think.

What Happens to Your Hormones During Each Phase of  Menopause

Perimenopause

Early Perimenopause

At some point during our late 30s - early 40s, many women start having menstrual cycles that don't include ovulation. As our eggs age, they can die before being released and when that happens, ovulation does not occur and progesterone is not released.

Your body continues to make estrogen but when the progesterone is not released, the balance of estrogen and progesterone is upset and your body becomes estrogen dominant.

During this phase, your body might be ovulating or it might not be so your progesterone levels can fluctuate widely. It's often early perimenopause when we start to complain to our friends that we feel like we might be going crazy. Everything can seem normal with your menstrual cycle and yet you may be feeling like you're suffering from a never-ending case of PMS: bloating and weight gain, breast tenderness, mood swings, brain fog and memory problems, anxiety and panic attacks, and problems sleeping.

This phase can last for years as you continue to have normal cycles where you ovulate with the occasional cycle where you don't. It can often be difficult for both you and your doctor to recognize your symptoms as perimenopause.

If you're wondering if you're in early perimenopause, you can ask your doctor to perform a new blood test, MenoCheck. This test can not only tell you if you're if in perimenopause but can even predict when you'll enter full menopause and can be performed on women ages 42 - 62.

Late Perimenopause

By late menopause, you may still be having your period but ovulation is rare and you can begin to miss some periods (or have periods that are heavier than ever. Sigh.) Your progesterone levels stay low and your estrogen levels begin to drop, taking its toll on the many areas of your body affected by these hormones.

This is when you may start having hot flashes and suffering from symptoms relating to low estrogen such as depression, bone loss, loss of skin elasticity, and increased abdominal fat.

What You Should Know During Perimenopause

• The brain fog of perimenopause is a very real thing caused by low progesterone levels. You aren't going crazy and you probably aren't sliding into early dementia.
• Your progesterone levels can fluctuate causing mood swings.
• Early perimenopause is not the time to be trying to increase your estrogen levels as that will only make your symptoms worse. Your doctor may prescribe a low-dose birth control pill with both estrogen and progesterone to try to mitigate your symptoms.
• If your doctor isn't helpful and your symptoms are making your life uncomfortable, find a menopause specialist in your area.
• Consider a test such as MenoCheck to make sure you're in perimenopause and rule out other health issues.
• This is the time for focus on patience and self-care.

Menopause and Post Menopause

Fun fact! You're only in menopause for one day: the one year anniversary of your last period. Before that you're still in perimenopause and after that day, you're postmenopausal. However, as you can see in the chart below, your hormone levels continue to drop even after you're officially menopausal before bottoming out at around age 60.

This means you may still be dealing with the symptoms of menopause for a while after you're officially postmenopausal. In fact, you could be like me and only start having hot flashes well after you are officially menopausal! I thought I had sailed through perimenopause and menopause and then I started having ALL THE SYMPTOMS more than a year after my last period. Isn't that exciting? To say I was confused and distressed would be a massive understatement.

What You Should Know During Menopause and Postmenopause

• Your hormone levels continue to drop so you may continue to have symptoms. Symptoms typically stop about 4.5 years after your last period. (I know. I'm sorry.)
• Because menopause can affect your bone density, you should have a bone density test during this time.
• If you're having trouble managing your symptoms, reach out to your doctor for advice.

I hope you found this overview of what's going on with your hormones in menopause helpful. Future posts will look at menopause symptoms and ways we can mitigate them. Knowledge is power!

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