Hormonal changes in perimenopause and menopause: What you need to know

Today's Topic

Today on A.Vogel Talks Menopause, we're going to be talking about how your hormones change in perimenopause and menopause, and what you need to know.

It's such a confusing time as you approach perimenopause and menopause, as most of us have no idea what's happening to our hormones. So, understanding what goes on with them before, during, and after menopause can make a huge difference to how we manage to cope with everything.

Do you know which hormones could be causing your symptoms? Do you know what happens to your hormones during each stage of menopause and how they change? These are really big questions, and knowing the answers can really help you.

So, this week, my lovely colleague, Sarah, and I are going to delve a little bit deeper into this subject to help you understand your hormones better.

We're going to explain what happens to them at each stage of menopause because they're completely different, and why they can bring on specific symptoms.

The two main hormones which we are going to focus on are oestrogen and progesterone:

Oestrogen

Eileen: Most of us think of oestrogen as just being associated with our monthly cycle. It's there to trigger ovulation. It helps with fertility. It helps with our libido. But oestrogen is needed for so many other different processes in the body that are really important for our general health.

Oestrogen is needed to maintain water balance in the body. It's needed for heart health. It's needed to keep our bones strong. It's needed to keep our moods up. It's really good for the libido, and it's important for our skin to look good. So, you can see already that oestrogen is associated with a lot more than just our monthly cycle.

Progesterone

Sarah: Progesterone is our calming hormone. It starts to dip sometime in your early 30s but we're not going to feel that until we're probably in our mid-40s.

The first little clue that your progesterone levels have dipped, is your sleep will be affected. You might start waking up in the middle of the night when you did not do that before or you might just find that your sleep gets a bit scrappy. It might be harder to fall asleep.

When your progesterone levels dip and become out of balance with oestrogen, you can get quite heavy periods and PMS, maybe for the first time ever. And usually, when you suffer from PMS, you're said to be oestrogen dominant, your progesterone levels are just lagging a little bit behind. The symptoms of that are irritability, a bit of breast tenderness, and sometimes, there can be a little bit of inflammation and joint pain before the period as well. They're very common symptoms of early perimenopause.

How your hormones change throughout perimenopause, menopause, and post-menopause

Sarah: As you get into the later stages of perimenopause, that's when you're going to start feeling a dip in oestrogen as well. The periods can get lighter. They can become irregular, and they can get further apart. And that's how you know your oestrogen levels are dipping a little bit. And that's when you may get all the symptoms like hot flushes, and all the things that Eileen normally talks about.

Eileen: Yes. One of the really interesting things that is not always picked up on, is that in the second phase of perimenopause when you're still getting periods, you can start to get the menopause symptoms as well. And very often, everybody gets really worried about this because they think other things are going on, but this is a phase just before periods stop for good, when your body can be in complete hormonal chaos.

So once your periods stop for good, all that basically means is there aren't enough hormones produced to give you that monthly cycle. But your hormones can still continue to decrease for a number of years afterward. And this is why a lot of you come to me worried because periods have stopped but they're still getting menopause symptoms. So, you need to be aware that this hormonal flux can continue for a little bit longer after your periods have stopped.

We normally say that after two years without any period, you're through to post-menopause. But symptoms can still continue after that point. Although if it's for years and years, very often, other health issues are incorporated and may be factors as well, so just be aware of that.

Once your periods have stopped for quite a while, your hormones do come to their own natural levels. They won't disappear completely. You're not ever 'hormone-less', but your hormones will reach a much lower level, and your body, basically, learns to adjust and be comfortable at that lower level.

What you can do to help support your hormones

Eileen: But there are many things that you can do to help support the hormones that you have left:

The main things here are to eat plenty of phytoestrogen-rich foods. Phytoestrogen-rich foods are natural foods. They are your fresh foods, vegetables, nuts, and seeds; so, try to incorporate these into your daily diet.

In order to extract oestrogen from the foods that you are eating, in the form of phytoestrogens, you need good, robust, strong digestion and elimination. So, if you have digestive problems, that's going to hinder this as well.

And the other really important thing is your liver. Liver health is paramount in perimenopause and menopause, because it helps to eliminate excess hormones or hormones that may be causing a few problems and unsettling everything. So, taking care and giving your liver a little bit of TLC is really important for your postmenopausal health and happiness.

You can look at soy isoflavones. These are natural oestrogen compounds that are extracted from soya and taken in a supplement form. They can help to just very gently balance out that oestrogen imbalance, maybe raise your oestrogen levels just very slightly. And that can go a long way to helping ease a number of low oestrogen symptoms.

Sarah: The other thing to know is that once you're into late perimenopause, and the ovaries wind down, your oestrogen is going to be produced in different parts of the body; and where most of the oestrogen after perimenopause is produced is in your adrenal glands.

The adrenal glands are where some of the stress hormones are coming from. So, if you go into perimenopause stressed off your head, basically, your body is going to struggle to produce its own oestrogen naturally. Going into transition with a handle on stress is going to be a fantastic way of managing things.

Also, when your progesterone levels dip, it does affect your ability to sleep well or sleep throughout the night. So, anything you can do to improve sleep quality, whether that's going to bed a little bit earlier or managing your stress, whether you do that by balancing your blood sugar levels or tweaking your lifestyle, will really stand you and your feelings of well-being in good stead when you're dealing with this menopause transition.

A lot of my friends are on HRT as well, and they're finding it supportive. But it's not necessarily dealing with all of their issues, particularly when it comes to stress and sleep. So, anything you can do yourself with regards to diet and lifestyle changes, and just small, easy-to-remember measures, and easy-to-do little tips are going to make a massive difference.

Eileen: Absolutely. So, I hope you enjoyed this. It's a very complex subject. We tried to make things as simple as possible. If any of you have any other questions out there, please send them in and we will be happy to help you.

So, until then, I'll see you next week for another edition of A.Vogel Talks Menopause.

You may also find these topics helpful:

10 self-care tips for perimenopause, menopause & postmenopause

The three stages of menopause