Perimenopause - A Guide to Thriving Through The Hormone Changes
- Dr. Jessica
- Apr 23
- 7 min read
Updated: May 8
As women enter their 40s, many begin to notice some significant changes in their bodies. You might start experiencing mood swings, irregular periods, trouble sleeping, or weight gain around your midsection, despite eating and exercising the same way.
You’ve likely seen your doctor and been told that everything looks normal in your blood work, but you still don’t feel quite right.
So, what’s going on? The truth is that these symptoms may be linked to hormone changes, which are a natural part of life for women in their 40s. Let’s break down what’s happening with your hormones during this time, why you might be feeling off, and how you can address these changes with lifestyle changes, proper testing, and natural medicine.
Hormones 101: What Are Hormones and Why Do They Matter?
Hormones are chemical messengers in your body that regulate everything from metabolism to mood, sleep, and even reproductive function. Your endocrine system, made up of various glands like the thyroid, ovaries, and adrenal glands, produces and secretes these hormones.
In your 40s, the balance of hormones such as estrogen, progesterone, and cortisol starts to shift. These changes can cause symptoms that affect your quality of life. Understanding these hormone changes can help you navigate this phase of life with more awareness and better support.
Perimenopause Hormone Shifts in Your 40s
Estrogen
Estrogen is one of the primary female sex hormones and plays a big role in maintaining energy, mood, skin health, and reproductive function. As you approach your 40s, estrogen doesn’t just decline gradually. Instead, it becomes erratic and unreliable. This is why many women in their 40s report having heavier periods, mood swings, and feeling like they’re experiencing premenstrual symptoms (PMS) more intensely.
Research: Studies have shown that during perimenopause (the years leading up to menopause), estrogen levels fluctuate widely. According to a study published in Menopause (2016), women in their 40s can experience estrogen levels that swing from very high to very low, contributing to common symptoms like irregular periods, hot flashes, and sleep disturbances. Estrogen can also influence your metabolism, and fluctuating levels might contribute to weight gain, especially around the midsection. Estrogen’s role in fat distribution is crucial, and changes in its levels can lead to shifts in how your body stores fat.
Progesterone
Progesterone is another important hormone that helps regulate your menstrual cycle, calm anxiety, and support quality sleep. In your 40s, progesterone starts to decline gradually. When progesterone drops, you may experience more anxiety, mood swings, and difficulty sleeping. This hormone is especially important for managing the second half of your menstrual cycle, and low levels can lead to more intense PMS symptoms and heavier periods.
Research: A study published in The Journal of Clinical Endocrinology & Metabolism (2008) found that progesterone levels decline in the 30s and 40s, leading to an imbalance with estrogen. This imbalance, known as estrogen dominance, can result in symptoms such as irritability, heavy periods, and sleep disturbances, which are commonly reported by women in their 40s.
Cortisol
Cortisol is your body’s main stress hormone. When you experience stress, whether physical or emotional, cortisol levels rise to help you cope. In your 40s, chronic stress or the pressures of balancing work, family, and personal life can cause cortisol levels to stay elevated. This can negatively affect your other hormones, including progesterone, and may lead to fatigue, anxiety, weight gain, and disrupted sleep patterns.
Research: A review in Psychoneuroendocrinology (2012) found that chronic stress and elevated cortisol levels are linked to hormonal imbalances, including the suppression of progesterone and the promotion of estrogen dominance. High cortisol can also interfere with thyroid function and lead to weight gain around the abdominal area.
Thyroid Hormones
Your thyroid, located in your neck, produces hormones that regulate metabolism. In your 40s, thyroid dysfunction can mimic perimenopausal symptoms. Low thyroid function (hypothyroidism) can lead to fatigue, weight gain, dry skin, and even depression. It’s important to test your thyroid hormones thoroughly, not just the basic thyroid-stimulating hormone (TSH), but also your T3 and T4 levels, to get a clearer picture of your thyroid health.
Research: According to a study in The Journal of Clinical Endocrinology & Metabolism (2013), thyroid disorders are more common in women in their 40s, with symptoms often overlapping with perimenopause. This is why comprehensive thyroid testing is crucial for accurately diagnosing and addressing hormone imbalances during this time of life.
Why Standard Blood Tests Aren’t Enough
You might have had blood tests at your doctor’s office, only to be told that everything is “normal.” The problem is that hormone levels fluctuate throughout the day and month. Estrogen, for example, can vary significantly based on the phase of your menstrual cycle. Progesterone is known to fluctuate up to 11 times in an hour. So, a single blood test may not give you a full picture of what’s really going on with your hormones.
Instead of relying on a one-time blood test, it’s essential to track your symptoms over time. A thorough hormone assessment considers not just your blood work but also your symptoms, lifestyle, and overall health. A personalized approach is crucial to understanding what’s happening with your hormones in your 40s.
Perimenopause Signs You Might Be Experiencing
Some of the common signs that you may be entering perimenopause or dealing with hormone imbalances in your 40s include:
Irregular periods: Your cycle might get shorter or longer, or your flow may become heavier or lighter.
Sleep disturbances: Trouble falling asleep or waking up in the middle of the night, even if you were a good sleeper in the past.
Mood swings: Feeling more irritable, anxious, or depressed without clear reasons.
Fatigue: Feeling exhausted all the time, even after a full night’s sleep.
Weight gain: Especially around the midsection, despite maintaining the same diet and exercise routine.
Hot flashes or night sweats: These can begin in perimenopause but aren’t always present.
Breast tenderness or swelling: Hormonal fluctuations can cause changes in your breasts.
Memory or concentration issues: Brain fog can sometimes accompany hormone changes.
If you're experiencing several of these symptoms, it could be time to dive deeper into your hormone health with the help of a healthcare provider who specializes in women’s health.
How to Address Hormone Imbalances Naturally
While hormone shifts are a natural part of aging, there are several ways to support your body through these changes and improve your symptoms.
1. Manage Stress
Chronic stress can make hormone imbalances worse. Elevated cortisol levels can interfere with progesterone and cause sleep disruptions, weight gain, and irritability. To manage stress, consider practices such as yoga, meditation, or deep breathing exercises. Prioritize self-care and ensure you’re getting regular downtime.
Research: A study in Psychology and Health (2013) showed that mindfulness-based stress reduction techniques can significantly reduce cortisol levels and improve hormonal balance, particularly in women experiencing perimenopausal symptoms.
2. Improve Your Diet
What you eat has a direct impact on your hormone health. Focus on a balanced diet rich in whole foods, such as vegetables, fruits, lean proteins, and healthy fats. Avoid processed foods, refined sugars, and excessive caffeine, which can contribute to blood sugar imbalances and cortisol spikes.
Research: A study published in The Journal of Clinical Endocrinology & Metabolism (2009) found that a diet high in refined carbohydrates and sugar can increase insulin resistance and exacerbate hormone imbalances in women.
Foods that support hormone health include:
Cruciferous vegetables: Broccoli, cauliflower, and kale help detoxify estrogen and support liver function.
Flaxseeds: Rich in lignans, which support estrogen metabolism in the gut.
Healthy fats: Avocados, olive oil, and fatty fish provide essential fats for hormone production.
3. Get Active
Regular exercise is essential for balancing hormones. Aim for a mix of aerobic, strength, and flexibility training. Exercise helps regulate insulin levels, improve mood, and reduce cortisol. However, be careful not to overdo it, as excessive exercise can lead to higher cortisol levels.
Research: According to a study in Menopause (2017), moderate physical activity can improve perimenopausal symptoms like weight gain, fatigue, and mood swings by balancing estrogen and progesterone.
4. Consider Supplements
Certain supplements can support hormone balance during perimenopause and beyond. Some helpful options include:
Magnesium: This calming mineral helps with anxiety, sleep, and PMS symptoms.
B Vitamins: Important for energy production, metabolism, and hormone detoxification.
Ashwagandha: An adaptogenic herb that helps your body manage stress and reduce cortisol levels.
Research: A study published in The Journal of Clinical Psychopharmacology (2012) showed that ashwagandha supplementation reduced cortisol levels and helped manage stress in women, making it a useful tool in balancing hormones.
5. Get Enough Sleep
Sleep is crucial for hormone health, particularly for managing cortisol and balancing estrogen and progesterone. Aim for 7-9 hours of quality sleep each night. Create a calming bedtime routine, avoid caffeine and screens before bed, and keep your bedroom dark and cool.
Research: A study in Sleep Medicine Reviews (2016) found that poor sleep quality negatively affects hormone production, including cortisol, which can lead to further hormonal imbalances.
When to Seek Help
If you’re struggling with hormone-related symptoms that are affecting your quality of life, it’s important to seek help from a healthcare provider who understands the complexity of hormone health. A comprehensive assessment, including detailed hormone testing, can help identify imbalances and guide you toward effective treatments.
Don’t settle for a “normal” diagnosis when you don’t feel normal. A deeper understanding of your hormonal changes can lead to better solutions and a smoother transition through your 40s and beyond.
Conclusion
Hormone changes in your 40s are a natural part of life, but they don’t have to mean the end of feeling your best. By understanding what’s happening with your hormones and how to support your body through diet, stress management, and targeted supplements, you can feel more in control and empowered during this transformative time.
If you're ready to take charge of your hormone health, I invite you to book a complimentary phone consultation to start your path toward hormone harmony!
Next Steps
I invite you to have a complimentary health discovery phone call with me if;
If you are in your late 30s to early 40s and noticing changes in your period
You suspect you are in Perimenopause, but your medical doctor isn't testing your hormones
During this call, I will explain how I would approach your particular concerns and outline the process of what it looks like to work with me over the first few appointments.
My goal is provide you with the information to help you feel empowered in your health journey.
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