Being a woman is a wild ride, am I right? Just when you think you’ve got the hang of this whole monthly cycle thing, life throws you a curve. That curve is commonly referred to as perimenopause, or the beginning of your journey to menopause. Many people think that menopause is like a flip that is switched, but it doesn’t happen overnight. The journey into menopause is a process that happens over time, commonly called perimenopause or the menopausal transition. You can think of perimenopause as an in-between phase. You’re winding down the premenopause phase of your life, but you’re not quite ready for menopause. It’s a time of transition, where your body is getting ready to say goodbye to the reproductive phase (and monthly periods!). It’s a preparation to enter a new phase of being.
While not clearly defined, professionals agree that perimenopause is a time full of profound shifts in your hormones and reproductive system. On average, a woman enters perimenopause in her late 40s or early 50s. Perimenopause lasts two to eight years preceding a woman’s final period and a year after the final period (15).
Perimenopause occurs in two phases:
1. Early transition– which is when your monthly period is mostly regular with a few irregular months.
2. Late transition– when you have a space of at least 60 days between periods.
The late transition comes to an end with what will be your final menstrual period.
The Mystery of Menopause
It’s still unclear what really causes menopause. However, a theory exists that a woman is born with all of her follicles (sacs in the ovaries that store immature eggs) and that over time as a woman loses some with each menstrual cycle, she becomes less fertile and her ovaries stop responding to her brain’s signal to produce more hormones to keep going as an attempt to reproduce. Because the ovaries aren’t responding, the brain keeps surging out a signal to them to try to get them to make more hormones, and that’s when hot flashes are most likely to occur. Periods can become irregular or just stop altogether. Postmenopause is defined as when a woman has not had a period for at least 12 months.
Poor nutrition and stress have traditionally been blamed for triggering early menopause. In part, that may be true. Think about it this way: Your female body was engineered to produce children. Mother Nature insists that your body be healthy enough to do that. If you don’t have proper nutrition even just for yourself, you won’t have proper nutrition for another human growing inside of you. Similarly, a state of constant stress is also not a good environment for a baby. Chronic stress can cause inflammation, which isn’t good for a growing baby. So, if you have been dealing with stress for a long period of time, your body knows it’s not an optimal time to become pregnant so it shuts down your ability to be able to do so. Regardless if you still want to be fertile or not, aiming for optimal nutrition, exercise, and stress management is ideal if you want to keep your hormones in balance in order to feel good.
The changes experienced in perimenopause are directly connected to hormonal shifts. Most people think that falling levels of estrogen are the main blame for why women feel so crummy during perimenopause. Here’s a shocker: Menopause is not an estrogen deficiency disease. Estrogen levels only drop between 40 to 60% at menopause, while progesterone drops to nearly zero. Most women start having anovulatory cycles in their mid-30’s, which means their ovaries are not releasing mature eggs even though they are still having periods. Progesterone levels drop below normal while estrogen goes unbalanced. While estrogen levels will decrease during menopause, the truth is, estrogen levels do not fall appreciably until after a woman’s last period.
Perimenopause and Menopause: What’s the Difference?
The difference between perimenopause and menopause is very simple. Being in menopause means that it has been at least 12 months since you had a menstrual period. When I say 12 months, I mean 12 straight months in a row. If your period is still popping up every now and then, that means your ovaries are still producing hormones and you are still in perimenopause. When your period stops completely and doesn’t return, your ovaries are no longer producing enough estrogen, progesterone, or testosterone.