Perimenopause - the transition leading to menopause - can begin as early as your mid-30s and last for years. Yet many women are caught off guard by symptoms their doctors dismiss as "just stress."
What Is Perimenopause?
Perimenopause is the gradual transition when your ovaries begin producing less estrogen. It typically starts in your 40s but can begin earlier. During this time, hormone levels can fluctuate unpredictably, which can cause a wide range of symptoms.
Common Perimenopause Symptoms
- Irregular periods: Cycles may become shorter, longer, heavier, or lighter
- Hot flashes and night sweats: Sudden waves of heat, often at night
- Sleep disturbances: Difficulty falling or staying asleep
- Mood changes: Anxiety, irritability, depression
- Brain fog: Difficulty concentrating or remembering
- Vaginal dryness: Changes in vaginal health
- Weight gain: Especially around the midsection
- Hair and skin changes: Thinning hair, drier skin
Hormone Tests for Perimenopause
FSH (Follicle Stimulating Hormone)
Can rise as ovarian function declines. Levels above 25 mIU/mL may suggest perimenopause.
Estradiol
The primary estrogen. Levels can fluctuate widely during perimenopause.
Progesterone
Can be the first hormone to decline, which can cause cycle changes and sleep issues.
LH (Luteinizing Hormone)
Works with FSH to regulate ovulation. The FSH/LH ratio may point to perimenopause.
When to Test
For the most accurate results, test on day 3 of your cycle (if still menstruating). Since hormones can fluctuate, testing multiple times may be helpful.
References
- Harlow, S. D., et al. (2012). Executive summary of the Stages of Reproductive Aging Workshop + 10: addressing the unfinished agenda of staging reproductive aging. Journal of Clinical Endocrinology & Metabolism, 97(4), 1159-1168. PMID 22344196
- Freeman, E. W., et al. (2006). Associations of hormones and menopausal status with depressed mood in women with no history of depression. Archives of General Psychiatry, 63(4), 375-382. PMID 16585466
- Santoro, N., et al. (2015). Menopausal symptoms and their management. Endocrinology and Metabolism Clinics of North America, 44(3), 497-515. PMID 26316239
