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What's going on with my hormones during Perimenopause?

Updated: Mar 5

Black woman in yellow sweater looking confused, shrugging her shoulders

Perimenopause is a transitional phase that typically begins in a woman's 40s but can start in her 30s. During perimenopause, the ovaries gradually produce less estrogen, marking the approach toward menopause. This hormone, crucial for various bodily functions, experiences fluctuations, leading to several hormonal changes.

Here's a breakdown:

Estrogen Variations:

  • Decline: Estrogen levels begin to decrease, but this process is not linear. Instead, there can be erratic fluctuations.

  • Impact: Reduced estrogen levels contribute to changes in the menstrual cycle, including irregular periods and eventual cessation.

Progesterone Decline:

  • Decrease: Progesterone, which prepares the uterus for a potential pregnancy, also declines.

  • Impact: Lower progesterone levels can lead to changes in sleep patterns, mood swings, and, over time, contribute to the end of menstruation.

Follicle-Stimulating Hormone (FSH) Surge:

  • Increase: As the ovaries produce less estrogen, the pituitary gland releases more FSH in an attempt to stimulate the ovaries.

  • Impact: Elevated FSH levels are often a key marker of perimenopause and can contribute to symptoms like hot flashes and night sweats.

Testosterone Fluctuations:

  • Variability: Testosterone, typically associated with male reproductive health, also decreases during perimenopause.

  • Impact: This hormonal shift can contribute to changes in libido and energy levels.

Cortisol and Stress Hormones:

  • Sensitivity: Hormones related to stress, like cortisol, can become more impactful during perimenopause.

  • Impact: Increased stress sensitivity may contribute to mood swings, anxiety, or disruptions in sleep.

Understanding these hormonal changes provides insight into the diverse symptoms experienced during perimenopause, including irregular periods, hot flashes, mood swings, sleep disturbances, and changes in sexual function. It's important to note that the experience varies among individuals, and some may navigate perimenopause with minimal disruption, while others may find it more challenging.



About Michelle

Michelle is a Doctor of Physical Therapy at Webb Physical Therapy, located in Lawrence, Kansas.  She's worked in PT for close to 10 years, and believes each patient should be treated with a holistic, whole person approach to healing.

She is devoted to helping her patients develop individualized treatment plans to help them achieve their specific goals.

Call (785) 813-1338 for a free 15 minute phone consultation, or email

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