TinaThe Main Hormones Involved in Perimenopause: Understanding the Changes and What You Can Do About Them
Perimenopause can feel like a rollercoaster you never signed up for. The mood swings, hot flashes, fatigue, and brain fog seem to come out of nowhere, leaving many women asking, “What is happening to my body?” The answer lies in your hormones. Understanding the key hormones involved in perimenopause can help you manage your symptoms and regain a sense of balance.
In this post, I’m breaking down the major hormones that fluctuate during perimenopause, explaining how they affect your body, and answering the top questions women commonly ask about this transitional phase.
What Is Perimenopause?
Before diving into the hormones, let’s quickly cover what perimenopause actually is. Perimenopause is the period of time before menopause when hormone levels begin to fluctuate, and it can last anywhere from a few months to 10 years. During this time, the production of certain hormones begins to decrease, while others may fluctuate wildly. These hormonal shifts lead to the variety of symptoms many women experience. Perimenopause typically starts in your 40s, but it’s not uncommon for symptoms to begin in your mid-30s.
The Hormones Involved in Perimenopause
Let’s look at the key hormones that play the biggest roles during this stage of life.
1. Estrogen
Estrogen is probably the most well-known hormone related to women’s health, and it plays a major role during perimenopause. It’s produced primarily by your ovaries, and it’s responsible for regulating your menstrual cycle, maintaining bone density, supporting heart health, and keeping your skin and hair healthy.
During perimenopause, estrogen levels become inconsistent. In the early stages, your estrogen levels may spike and dip unpredictably. This fluctuation can cause irregular periods, breast tenderness, and even symptoms like bloating or weight gain. As you get closer to menopause, estrogen production steadily declines, leading to issues like vaginal dryness and hot flashes.
Common symptoms of estrogen fluctuations:
- Irregular periods
- Heavy or light bleeding
- Breast tenderness
- Bloating and water retention
- Mood swings
- Hot flashes and night sweats
- Fatigue
- Vaginal dryness
Top question: Why are my periods so irregular during perimenopause?
Irregular periods are a hallmark of perimenopause, and they’re directly related to fluctuating estrogen levels. As estrogen levels rise and fall unpredictably, your body may ovulate one month and skip it the next. This leads to missed periods, heavier-than-usual periods, or spotting between cycles.
2. Progesterone
Progesterone works hand-in-hand with estrogen to regulate your menstrual cycle. During the first half of your cycle, estrogen builds up the lining of your uterus, and progesterone is responsible for maintaining that lining in the second half. If you don’t conceive, progesterone levels drop, triggering menstruation.
However, as you approach perimenopause, your body doesn’t always ovulate regularly, which means progesterone levels can become erratic or drop significantly. Low progesterone can cause estrogen dominance—a condition where the balance between estrogen and progesterone is disrupted, often causing heightened PMS symptoms, mood swings, and even anxiety or depression.
Common symptoms of low progesterone:
- Anxiety or irritability
- Mood swings
- Difficulty sleeping
- Heavier or longer periods
- Weight gain (especially around the midsection)
- Increased PMS symptoms
- Spotting before periods
Top question: Why am I feeling so anxious or moody lately?
Mood swings, anxiety, and irritability can often be traced back to declining progesterone levels. Progesterone is known for its calming effects on the brain, so when levels drop, you may find yourself more anxious or easily upset. Many women describe this time as feeling like they have “PMS all month long.”
3. Testosterone
Though we often think of testosterone as a male hormone, it plays a crucial role in women’s health as well. Testosterone is responsible for libido, maintaining muscle mass, and supporting energy levels. Like estrogen and progesterone, testosterone levels also start to decline during perimenopause, contributing to some frustrating symptoms.
Low testosterone in women can lead to a decreased sex drive, loss of muscle tone, and even fatigue or lack of motivation. You might notice a drop in energy, weaker muscles, and less interest in physical activity or intimacy.
Common symptoms of low testosterone:
- Low libido or decreased sexual desire
- Fatigue or low energy levels
- Loss of muscle mass or strength
- Mood changes or lack of motivation
Top question: Why has my sex drive disappeared?
A drop in testosterone is often to blame for the sudden decrease in libido many women experience during perimenopause. Testosterone is directly related to sexual desire and arousal, and when levels decline, it can result in a noticeable decrease in your sex drive.
4. Cortisol
Cortisol is known as the “stress hormone” because it’s released in response to stress. While it’s not a reproductive hormone, cortisol plays a significant role during perimenopause. Chronic stress can cause cortisol levels to rise, which can exacerbate perimenopausal symptoms and even impact your other hormones.
High cortisol levels can lead to sleep disturbances, increased anxiety, and weight gain, especially around the midsection. It can also worsen symptoms of estrogen dominance or low progesterone. Learning how to manage stress is critical during perimenopause, as it can help keep cortisol in check and prevent it from further disrupting your hormonal balance.
Common symptoms of high cortisol:
- Difficulty falling asleep or staying asleep
- Weight gain, especially around the abdomen
- Feeling anxious or “on edge”
- Cravings for sugary or fatty foods
- Fatigue or burnout
Top question: Why can’t I sleep even though I’m exhausted?
Cortisol may be the culprit if you’re feeling wired but tired. High cortisol levels can interfere with your body’s natural sleep-wake cycle, making it harder to relax and fall asleep, even when you’re physically tired.
5. Insulin
Insulin is another important hormone that often gets overlooked when discussing perimenopause. It’s responsible for regulating your blood sugar levels by helping your cells absorb glucose for energy. As you age, your body may become more resistant to insulin, meaning your cells don’t respond to it as effectively, which can lead to insulin resistance.
Insulin resistance is linked to weight gain, especially around the midsection, and can increase your risk of developing type 2 diabetes. Many women notice that they gain weight more easily during perimenopause, particularly in their abdominal area, and insulin resistance may play a role in this.
Common symptoms of insulin resistance:
- Increased hunger, especially for carbohydrates or sweets
- Weight gain around the abdomen
- Difficulty losing weight
- Fatigue, especially after meals
- Sugar cravings
Top question: Why am I gaining weight even though my diet hasn’t changed?
Insulin resistance is one of the key factors behind unexplained weight gain during perimenopause. As your cells become less responsive to insulin, your body stores more fat, particularly around the belly area, which can be frustrating to manage.
What Can You Do to Balance Your Hormones?
Now that you know which hormones are involved in perimenopause, the big question is: What can you do to feel better?
Here are a few tips for managing hormone fluctuations during perimenopause:
1. Prioritize Stress Management
Since cortisol plays such a big role in exacerbating perimenopausal symptoms, managing stress is crucial. Incorporate stress-reducing activities into your daily routine, such as yoga, meditation, or even just deep breathing exercises. These practices can help keep your cortisol levels in check and prevent them from further disrupting your hormones.
2. Support Your Progesterone Levels
If you’re dealing with estrogen dominance, supporting your body’s natural production of progesterone can help restore balance. Many women benefit from using bioidentical progesterone cream, which mimics the hormone your body naturally produces. This can alleviate symptoms like mood swings, anxiety, and difficulty sleeping.
3. Focus on a Balanced Diet
Eating a nutrient-dense, hormone-supportive diet is key to managing perimenopausal symptoms. Focus on whole foods, healthy fats, and high-quality protein to stabilize your blood sugar and support healthy hormone production. A low-carb or keto approach can also help manage insulin resistance and support weight loss.
4. Prioritize Sleep
Sleep is vital for hormone regulation, but it’s often one of the first things to go during perimenopause. Create a calming bedtime routine, avoid screens before bed, and make your sleep environment as comfortable as possible. Supplements like magnesium or melatonin can also support better sleep.
5. Exercise for Hormonal Balance
Exercise plays an important role in balancing hormones, but not all exercise is created equal during perimenopause. Focus on strength training and moderate cardio to build muscle, manage weight, and support insulin sensitivity. Be mindful of over-exercising, as too much high-intensity exercise can raise cortisol levels and worsen symptoms.
Conclusion
Understanding how your hormones change during perimenopause can give you insight into the symptoms you’re experiencing. From fluctuating estrogen to declining progesterone and testosterone, hormonal imbalances can lead to a wide range of issues, from mood swings to weight gain and fatigue. But by learning how to manage stress, support hormone production, and make targeted lifestyle changes, you can regain control over your body and navigate perimenopause with confidence.
