Perimenopause is a transition into menopause that is often thought of by women to either be a slow decline of female hormones into the fifth decade of life or else it is a dramatic drop of hormones that occurs in one day, neither of these assumptions are correct.
It is neither a slow decline or a sudden loss of hormones in the perimenopausal stage, it is a lot more disorganised with fluctuations and deficiencies of hormones.
Because hormones are produced more erratically during this stage of a woman’s life the production of an egg each month is less consistent. It is ovulation that is the major trigger for hormone production and as ovulation becomes less consistent there are also fluctuations and deficiencies of oestrogen and progesterone production . In the perimenopausal stage a woman may feel no different, she may even feel better not having a monthly ovulation as she is no longer experiencing the hormonal shift that comes with ovulation such as PMS, bloating, and breast tenderness, no longer experience these monthly symptoms can feel like a gift. However, when these anovulatory (lack of egg) cycles become a regular occurrence women start to experience symptoms of hormone deficiency and may have waves of being menopausal with increases in hot flushes, depression or vaginal dryness.
Understanding the hormonal shift
While women are having these underlying hormonal fluctuations and deficiencies, they can still get a monthly bleed.
Understanding a woman’s perimenopausal experience is often misleading because of the period. Women are guided to think their period is the major indicator into the state of their hormones. A period does not mean you have made your hormones the way you should have or that you have ovulated.
In the perimenopause stage a woman may have a bleed twice in 4 weeks and then skip a month and then it may come back again a month later. It is often the case that in the peri menopausal stage of a woman’s life the cause of erratic and heavy menstruation is due to anovulatory (no egg) cycles.
When discussing perimenopause with a women, she may notice that over a 3 month cycle hormonally things are fine and she might experience symptoms of PMS, bloating, breast tenderness, and fatigue, If she has a 3 month cycle where she does not ovulate, she might discuss symptoms of hot flushes, dry vagina, low mood, insomnia and joint pain.
A naturopath can spend the time understanding how a women is feeling so a hormonal blood test can be recorded on the correct day.
Often during this time of a woman’s life hormonal lab work can be misleading as it may overestimate or underestimate her total monthly hormone production depending at what time of the month the blood test was done.
Women will often approach their family doctor wanting hormonal labs done at this stage. But testing hormones in perimenopause should be paired with a long discussion about how a woman is feeling so that a hormonal blood test can be recorded on the correct day and interpret those numbers in the context of how the woman feels.
Working with Women in perimenopause
As a naturopath practitioner my goal when working with women in perimenopause is to help them understand their hormone fluctuations and coach them towards a healthier lifestyle using diet, exercise, stress relief and including nutrient or herbal support to help smooth out the hormonal symptoms women experience at this time. At this time all women benefit from feeling more in control of their symptoms and getting back to feeling more like themselves. If you are curious about your hormones and perimenopause call the office to book your time with Autumn the Naturopath.