Learn About Perimenopause

What is Perimenopause?

Perimenopause marks the interval in which your body begins its transition into menopause. Perimenopause encompasses the years leading up to menopause (anywhere from two to eight years) plus the first year after your final period. It’s a natural part of aging that signals the ending of your reproductive years.

Your estrogen level rises and falls unevenly during perimenopause. Your menstrual cycles may lengthen or shorten, and you begin having menstrual cycles in which you don’t ovulate. It’s only during cycles when you do ovulate that you can become pregnant.

When perimenopause starts and how long it lasts varies. Since women start losing their hormones at a rate of 1%-3% per year in their early 30‘s; you’ll probably notice signs of impending menopause, such as menstrual irregularity, sometime in your 40s. But some women notice changes as early as their mid 30s.

What is Menopause?

The age when a woman has her last menstrual cycle is not known to be related to race, body size or age of first menstruation. Menopause may occur several years earlier or later then the median age of 51.

Symptoms of Perimenopause/Menopause

During perimenopause, estrogen production slows down and the ovaries stop producing eggs. As estrogen levels decline, certain signs (or symptoms) of menopause occur. The first sign is a change in the woman’s menstrual cycle. Periods may skip or occur more often, and the flow may be heavier or lighter than usual.

  • Hot Flashes
  • Vaginal Dryness
  • Increased Urinary Tract and Vaginal Infections
  • Headache/Migraines
  • Mouth Discomfort (pain and burning, altered taste sensations, dry mouth and sensitive gums)
  • Fatigue
  • Heart Palpitations
  • Anxiety
  • Poor Concentration
  • Poor Memory
  • Loss of Sex Drive/Sexual Pleasure
  • Breast Tenderness
  • Insomnia
  • Depression
  • Hopelessness
  • Mood swings
  • Irritability

The most common symptoms are hot flashes or hot flush. The hot flash may begin before a woman has stopped menstruating and may continue for a couple of years after menopause. A hot flash can be defined as a sudden sensation of intense heat in the upper part or all of the body. The face and neck may become flushed with red blotches, appearing on the chest, back and arms. It is usually accompanied by perspiration and may last a few seconds to several minutes. For some women, the feeling of heat is followed by a feeling of chills. The hot flash may be particularly disturbing during sleep.

Vaginal dryness is another common symptom of perimenopause and menopause. With advancing age, the walls of the vagina become thinner, dryer and less elastic. These changes may lead to painful intercourse.
Four or five years after the final menstrual period, there is an increased chance of urinary tract and vaginal infections. The symptoms include having to go to the bathroom often, feeling an urgent need to urinate, not being able to urinate, or having to go often during the night.

Why are Hormones Vital to Our Health and Longevity?

Estrogen: Estrogen effects metabolism, tissue function, sexual function, reproduction, food metabolization, our reaction to stress; regulates bone density and cholesterol levels. Drops in estrogen account for hot flashes, breast tenderness, urinary stress incontinence and mood swings. Lowered estrogen after menopause causes bone resorption and deposition, in which bone is broken down more than its rebuilt (osteoporosis).

Progesterone: Progesterone is responsible for triggering menstruation, improves memory and perceptive ability; acts as an anti-inflammatory agent and corrects the resistant response. Progesterone regulates blood thickening and vascular tone, zinc and copper levels, cell oxygen levels and use of fat stores for energy. It also effects gum health, helps to prevent endometrial cancer (uterine lining) by regulating the effects of estrogen. Progesterone supports the normal development of neurons in the brain, and that it has a protective effect on damaged brain tissue. Progesterone also has a role in skin elasticity and bone strength.
Testosterone: Testosterone replacement therapy in women contributes to bone strength and development of lean muscle mass and strength; reduced body fat percentage, increased sex drive, improved memory and mood, protects against heart disease an overall sense of well-being and hightened energy levels. It is best known for it’s crucial role in a woman’s libido. Testosterone deficiency in women can cause hair loss, hot flashes and amenorrhea, or the absence of menstruation.
Triiodothyronine, T4 – Thyroid: The thyroid plays an important role in regulating the body’s metabolism and calcium balance. The T3 (triiodothyronine) and T4 hormones stimulate every tissue in the body to produce proteins and increase the amount of oxygen used by cells.

Symptoms of an Under-active Thyroid (Hypothyroidism)
  • Fatigue
  • Exhaustion
  • Feeling Run Down and Sluggish
  • Depression
  • Difficulty Concentrating, Brain Fog
  • Unexplained or Excessive Weight Gain
  • Dry, Coarse and/or Itchy Skin
  • Dry, Coarse and/or Thinning Hair
  • Feeling Cold, Especially in the Extremities
  • Constipation
  • Muscle Cramps
  • Increased Menstrual Flow
  • More Frequent Periods
  • Infertility/Miscarriage
Symptoms of an Over-active Thyroid (Hyperthyroidism)
  • Nervousness
  • Irritability
  • Increased Perspiration
  • Thinning of Your Skin
  • Fine Brittle Hair
  • Muscular Weakness Especially Involving the Upper Arms and Thighs
  • Shaky Hands
  • Panic Disorder
  • Insomnia
  • Racing Heart
  • More Frequent Bowel Movements
  • Weight Loss Despite a Good Appetite


Natural Bio-identical Hormone Replacement Therapy

Natural bioidentical hormone replacement therapy for peri/menopausal symptoms refers to custom hormones prepared at compounding pharmacies to match each unique patient. Many doctors claim that compounded natural bioidentical hormones are safer; replacing needed hormones instead of just masking symptoms like their synthetic counterparts.



Of course, any ongoing strategy to reduce the symptoms and risks of andropause should incorporate lifestyle approaches such as optimal diet, regular exercise, stress-management and the reduction of tobacco and alcohol intake.

If you would like relief from the symptoms of andropause please contact our office.