What happens to hormones during perimenopause?

How do perimenopause hormone levels change?

As you approach menopause, your ovaries respond less predictably to hormone signals. The main changes involve oestrogen, progesterone, and follicle-stimulating hormone (FSH).

• Oestrogen: Levels can swing from high to low during perimenopause, with an overall decline as menopause approaches. They’re not always low, and a normal result on one day doesn’t rule out perimenopause.
• Progesterone: This hormone usually rises after ovulation. As you start having cycles where you don’t release an egg, progesterone levels can be lower, contributing to changes in your bleeding pattern.
• FSH: Produced by the pituitary gland in the brain, FSH helps stimulate egg development in the ovaries. Levels tend to rise as the ovaries become less responsive, but they can fluctuate considerably.

How do hormonal changes affect perimenopause symptoms?

Changing hormone levels can affect how you feel physically and emotionally. Symptoms may come and go, and they aren’t all caused by persistently low oestrogen. Common symptoms include:

• Hot flushes: One of the most commonly reported symptoms, hot flushes involve sudden, intense feelings of heat that typically affect the face, neck, and chest. These sensations can result in sweating and discomfort, disrupting daily activities or quality of life.
• Mood swings: You may feel more irritable, anxious, or low than usual. Poor sleep can make these changes harder to manage.
• Sleep disturbances: Many women in perimenopause report changes in their sleep patterns. This can often be attributed to night sweats or increased anxiety. Disturbed sleep can lead to fatigue and affect overall health and energy levels during the day.

By acknowledging these symptoms and discussing them with a healthcare provider, women can find strategies to manage their symptoms effectively during this transitional period.

What can help with perimenopause symptoms?

Keeping a note of your periods and symptoms can help you spot patterns and prepare for a GP or clinician appointment. Alongside any treatment you choose, the following habits may support your health and wellbeing:

• Diet: Nutrition plays a vital role in how your body copes with the changes during perimenopause. It is essential to focus on balanced meals that are rich in essential nutrients. Increasing your intake of calcium and vitamin D is particularly important as they are vital for bone health, which can be adversely affected during perimenopause. Foods like dairy products, green leafy vegetables, and fish can be excellent sources of these nutrients.
• Exercise: Engaging in regular physical activity is another powerful way to manage perimenopausal symptoms. Exercise not only helps in maintaining a healthy weight but also improves mood and sleep quality, both of which can be negatively impacted during this stage. Activities such as walking, swimming, or cycling for at least 30 minutes a day can offer significant benefits.
• Stress management: Perimenopause can also bring about emotional fluctuations that may enhance stress levels. Adopting stress management techniques such as yoga, meditation, or even deep-breathing exercises can be extremely beneficial. These practices not only help in reducing stress but also contribute to overall emotional well-being and relaxation.

By integrating these lifestyle changes, you can better manage the symptoms of perimenopause and improve your overall health and well-being during this phase of life.

How can HRT help during perimenopause?

Hormone replacement therapy (HRT) can relieve symptoms such as hot flushes, night sweats, and vaginal dryness by replacing oestrogen. If you have a womb, you’ll usually also need a progestogen to protect the womb lining. HRT doesn’t necessarily stop your own hormone fluctuations.

You can discuss HRT while you’re still having periods. Your GP or a menopause specialist can help you weigh up the benefits, risks, and other options.

Can a blood test check perimenopause hormone levels?

Perimenopause hormone levels can change substantially, so a single blood test can’t reliably confirm or rule out perimenopause. If you’re 45 or over and have typical symptoms, such as hot flushes, alongside period changes, diagnosis is usually based on these rather than hormone tests.

A clinician may consider an FSH blood test if you’re aged 40–45 and have symptoms, or if you’re under 40 and menopause is suspected. If symptoms are affecting daily life, speak to your GP or menopause specialist – you don’t need a low hormone result to ask for help.

Read more about oestrogen levels and blood testing.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.