Perimenopause signals the waning of a woman’s fertility cycle. Often mistaken for menopause – which isn’t official until you’ve missed your period for 12 consecutive months – perimenopause typically unfolds over multiple years.
This process includes changes in hormone balance that affect ovulation and the development and shedding of the endometrium (uterine lining).
Age-related physiological changes lead women through a journey of puberty, fertility, and then perimenopause – culminating in menopause and the post-menopausal years. This is why age matters when trying to conceive.
The average age of menopause for women in the United States is 51, and the preceding perimenopause leading up to menopause takes about 10 years from start to finish. So, while some women begin experiencing symptoms of perimenopause in their late 30s, most notice subtle or apparent signals in their early- to mid-40s.
During the stages of perimenopause, there are three notable and measurable changes.
Estrogen levels begin to decrease, changing the quality and quantity of the endometrial lining and the frequency at which you ovulate. Estrogen is also responsible for things like collagen production and bone density, which is why you may begin to notice changes in skin texture, thinning hair, or your doctor may start talking to you about calcium intake and how to keep bones strong.
Your body also begins producing less progesterone. One of progesterone’s main roles is to prepare the body for pregnancy if a fertilized egg implants into the uterus.
Once progesterone levels begin to dip, it can make it harder or impossible for a woman to remain pregnant – even if her egg is fertilized. This is the reason why progesterone supplements are almost always a part of fertility treatments – especially for women 35 years old or older. You may also receive a progesterone prescription if you’ve experienced unexplained and recurrent pregnancy loss since low progesterone can contribute to miscarriages.
3. Recalibrated androgens (male hormones)
Most healthy women do not experience a true increase in androgen levels during perimenopause unless they have PCOS or other existing health issues that increase testosterone. However, because testosterone levels may not decrease as fast as – or in balance with – declining estrogen and progesterone levels, women may notice increased facial hair growth or hair thinning they didn’t experience before.
Hormones do not decline in a nice, balanced, steady fashion. It’s more like a roller coaster ride with some ups and some downs in varying degrees until things level out again after menopause.
Symptoms of perimenopause include:
- Sporadic, skipped, or irregular periods
- Mood swings
- Night sweats
- Hot flashes
- Insomnia or sleep disruptions
- Gaining weight more easily (having a harder time losing weight)
- Increased hair growth on the face or neck
If you experience any of these symptoms, check in with your OB/GYN at your next appointment. If you’re experiencing perimenopause symptoms and you still want to get pregnant, schedule an appointment ASAP to schedule hormone testing and begin looking into first-stage fertility options like Clomid.
Perimenopause is a natural part of aging and the female fertility cycle. It is completely normal and is not the same thing as early menopause.
Early menopause – also called ovarian failure – occurs when a woman begins perimenopause and menopause far earlier than she should. It is diagnosed in women who experience menopause before age 45. Sometimes, early or premature menopause is the result of genetics, but it can also be the result of certain health conditions, illnesses, or medical treatments.
Fertility Support for Perimenopause
Women can absolutely get pregnant during perimenopause. However, it can be more difficult. If you know you’re in perimenopause and you want to get pregnant, we recommend scheduling an appointment with a fertility specialist. This gives you the chance to learn about all of your options, which may be as simple as timing intercourse at home for a few months or using an oral fertility medicine for your next cycle or two.
If that doesn’t work, we can discuss the next steps. The great news is that perimenopause means you’re still ovulating, giving us the chance to leverage that with the least invasive course of action. Contact Fertility Solutions to schedule an appointment and feel more secure about your future fertility during this fleeting window.