Perimenopause

The transition beyond menstrual life

Perimenopause is a critical window for health

This part of menstrual life is an unfolding of events, a transition between your menstrual years into the graduated phase of life that is menopause.

Perimenopause is hormonally related to puberty

the menstrual life cycle graphic shows that both puberty and perimenopause have a destabilization and fluctation of estrogen with relatively low progesterone

Stages of Perimenopause

very early menopause

Very Early Perimenopause

  • cycles are still regular, or you have slightly shorter luteal phases

  • less progesterone

  • higher, fluctuating estrogen (up to 3x higher than the menstrual years)

  • the onset of low progesterone symptoms (migraines, heavy menses and more pain, sleep changes)

  • this phase lasts 2-5 years

  • heavier menses, increased menstrual pain, migraines, and sleep disturbance.

estrogen is high and irregular while progesterone goes down

Early Transition

  • cycle becomes more irregular by varying in length more than 7 days

  • estrogen fluctuates more wildly

  • sharp drops in estrogen from their high peaks can trigger hot flashes and night sweats

  • this phase lasts 2-3 years

estrogen is fluctuating but headed lower and progesterone is down

Late Transition

  • This is when you have the first cycle longer than 60 days or a “missed menses”

  • hot flashes and night sweats intensify as estrogen continues to fluctuate before it makes its descent to a menopausal baseline

  • heavy menses are common at this stage

  • breast pain should start to subside

  • this phase lasts 4 years

estrogen and progesterone are low in late perimenopause

Late Perimenopause

  • The 12 months after your final menstruation

  • low estrogen, low progesterone

  • hot flashes may continue for 1-2 years or longer

perimenopause stages can take several years to transition from regular cycles to the final cycle

It’s important to ovulate for as long as possible.

Preventative health

Protect against

  • heart disease

  • breast cancer

  • osteoporosis

  • diabetes

  • neurological degeneration

Reflect On Menstrual Years

If you had easy menstrual years, perimenopause will be less likely to cause disturbance

If you had difficult menstrual years, perimenopause may cause more extreme symptoms

It’s Not Just Perimenopause

Symptoms can be a sign of an underlying health problem like thyroid disease

Perimenopause may make these health problems more apparent because of the deep connection between hormones and other parts of the body

Use Body Literacy As A Tool

FAM can help you track

  • progesterone levels

  • fluctuating estrogen

  • your symptoms

  • knowing which stage you’re in


<< Return to pregnancy & postpartum

Next to menopause >>