Perimenopause: Not for the Weak

by | | Female Hormones

Perimenopause is a reverse puberty that occurs as women approach menopause in our forties and fifties.  Changes occur for every gender and we need to be kind to one another.  The definition of menopause is twelve consecutive months without a menstrual cycle.  In perimenopause, the follicles on your ovaries decline and the cells produce less estrogen, progesterone and testosterone.  As progesterone slows down, ovulation stops occurring regularly.  Brain fog, weight gain and insomnia can occur. Skin can become dry.

Let’s go through some more of symptoms to understand why they happen and what you can do.  It’s never too early to take care of your hormone balance.  Some women breeze through without any trouble. It is possible to feel at your best.  We are great at adapting to change!

Sleep, Hot Flashes & Night Sweats

Blood sugar can be a contributing factor to insomnia and hormone imbalance.  In perimenopause, we can become more sensitive to alcohol and sugar so stick to a dry drink earlier in the day when you indulge.  Myo-inositol is great for regulating blood sugar.  Diet helps a lot too so check my other posts on this topic.

Melatonin goes down as we age.  Pain killers (NSAIDS) worsen this.  If you are experiencing joint pain use other anti-inflammatories like boswellia, curcumin and CBD instead.  High stress, high estrogen and inflammation also reduce melatonin.  Get tested so you can find your sweet spot.  Hormone changes affect neurotransmitters like GABA and serotonin.  Remember progesterone and GABA works closely together.

Anxiety anyone? Hormone changes affect neurotransmitters like GABA and serotonin.  Remember progesterone and GABA works closely together. Passion flower is as effective as xanax but doesn’t have the side-effects.  California poppy helps with sleep, pain and anxiety.  Keep these on hand and find your go-to for stress management.  This can be adaptogens, nervines or nutraceuticals that regulate cortisol but lifestyle modifications are key.  Progesterone is the queen of temperature regulation for sleep and a good rest helps everything!

For hot flashes, rhodiola can be drying while supporting the stress response.  Estrogen falling is a big reason why night sweats happen.  Red clover, black cohosh, motherwort and dong quai are some of my favourite herbs depending on what is presenting.  A sleep mat is a brilliant solutions for night sweats.  I also love the Oura ring for getting to know what lifestyle habits support better sleep.  i can get you a discount so reach out!  Sleep tracking is a game changer.

Brain Fog

Brain fog or memory loss happens in perimenopause because of lower estrogen levels. The hippocampus in the brain is the area that deals with complex thinking and planning.  It has a lot of estrogen receptors.  High stress makes it much harder to think.  So can dehydration, poor sleep and blood sugar spikes so please don’t skip meals.  None of this is fair and in fact it’s down right mean.  Allow your symptoms to motivate you.  You come first!!  Gather the right support around you and  transform this into something good.

One excellent nutrient is choline.  Make sure you are getting enough. The enzyme PEMT converts phosphatidylcholine into choline but this is initiated by estrogen.  So as estrogen drops increase choline in your diet.  Egg yolks are an excellent source.  Your brain loves phosphocholine.  You reduce your chance of fatty liver by having enough and it reduces homocysteine levels by supporting methylation.  Super nerdy right?  Basically make sure you are nourished.  Protein, choline and lots of veggies.  Cut out refined foods including anything that hurts your gut.


Migraines are related with hormones about 50% of the time.  Usually they occur before or during the menstrual cycle.  If you get a migraine near ovulation it’s because your estrogen is dropping too quickly and this can happen in perimenopause.  Low estrogen can also trigger low serotonin and increase your sensitivity to pain.

Contraction and expansion of blood vessels can occur when estrogen declines leading to a throbbing feeling.  High estrogen in the luteal phase can cause migraines for two reasons: one involves tryptophan (and the production of serotonin) and the other involves histamine.  Proper testing can show you exactly what is happening to cause your migraines.  Again, getting tested is one way to take care of yourself!

Heavy or Irregular Cycles

Progesterone spikes after we ovulate but in perimenopause you may not be ovulating.  With less progesterone there is nothing counterbalancing estrogen.  Estrogen makes the uterine lining grow and you are more likely to have heavy and/or clotted menstrual cycles. Excess estrogen is the cause of fibroids or polyps which also can cause bleeding.  Low iron, low thyroid and the copper IUD can also cause heavy cycles.

Irregular cycles can also happen.  The cells on your ovaries are not responding so hormones don’t get released or ovulation isn’t happening.  This could mean two cycles in one month or a missed period.  Missed periods can also be caused by over-exercising, being under weight, PCOS or pregnancy.  Some medications or birth control can also be the cause.  Good to rule out pregnancy too!

Fun Factor

During perimenopause you have to increase your fun.  This is physiological.  There is a brain derived neurotrophic factor (BDNF) that regulates your brain and keeps your neurons happy.  As estrogen falls you so does this factor but fun social time, enjoyable exercise, deep sleep and good sex all help keep BDNF up.  Schedule in your next dance party, date night or pleasure-filled vacation.





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