Perimenopause: The Shift into Menopause

Menopause Winnipeg - Hormones Winnipeg

Perimenopause: the hormonal shift, occurring over months-years, which transitions you into menopause.  ‘Peri’ means “around” or “near”, so - you get the point.


For some, perimenopause starts in their 40s. And for others, it only starts in their 50s.  And interestingly enough, cigarette smoking has been associated with earlier menopause, by 1.5-2 years. (1) And significant alcohol consumption is associated with a delay in menopause onset. (2)


Premenopausally, your ovaries are responsible for producing a significant amount of estradiol (a potent form of natural estrogen). And approximately one year prior to menopause, your ovaries start producing less and less estrogen. (3)


The hallmark feature of declining estrogen is the hot flash. Hot flashes usually occur for 2 years after estrogen becomes deficient/low, but can persist for 10 or more years. The average time for persistence of bothersome hot flashes is 7.4 years. (4) I’m sorry, but that’s way too long.


And one of the most disruptive things about hot flashes is their profound effect on sleep. Sleep efficiency lowers, and for women who have hot flashes, they tend to take longer to enter into REM sleep than a woman who doesn’t deal with hot flashes. So the sleep is compromised, and then so is your energy and mood.


Seeing so much of this in my own practice, I love providing women with tools to balance out their hormones. And I love when these same women realize that they have way more control than they ever thought. 

Reference(s): (1) PMID: 24672198, (2) PMID: 4026083, (3) PMID: 21159842, (4) PMID: 30401547

Interested in reading more?