Perimenopause: The Hormonal Roller Coaster

Feeling like you are on a hormonal roller coaster at midlife?    Symptoms of erratic periods, foggy thinking, hot flashes, night sweats, mood swings, palpitations, insomnia, thinning hair and weight gain may occur as your ovaries begin to produce less estrogen and progesterone.

Other metabolic imbalances such as thyroid or anemia (a low blood count) can cause some of the same symptoms.  Investigating with baseline lab testing can be helpful to determine if treatment is needed.  In most cases, a woman's symptoms are hormonal as she is beginning her menopause journey.

Symptoms of hormonal changes can continue well into a woman’s 50’s, as the average age of menopause in the United States is 51.  Early menopause is  when the final menstrual period is before age 45 and late menopause when the final menstrual period is after age 54.

Most women think of the menopause journey in 3 phases: perimenopause, menopause and post menopause. Perimenopause begins for most women in their 40’s.  Menopause is officially declared one year after a woman’s final menstrual period. Hormone levels of FSH and Estradiol can be tested to confirm.  

Post Menopause is the period of time in a woman’s life after her final menstrual period.  During this time, the loss of estrogen and progesterone production can begin to negatively impact a woman’s health.  The risk of osteoporosis (thinning bones) and cardiovascular disease increases. Menopause symptoms such as hot flashes and night sweats may improve but thinning hair and skin, decreased memory, vaginal dryness, painful intercourse and increased urinary tract infections may become more bothersome.

No woman's menopause journey is alike.  Some women have no symptoms. Others are miserable. Sadly, many women suffer in silence.  Safe, effective prescription treatments are available. If a woman's local healthcare provider can not offer the care she needs, help is available from a menopause specialist.


Barbra Hanna, DO, FACOG, MSCP

Barbra Hanna, DO, FACOG, MSCP

Dr Barbra Hanna, a board-certified OB/GYN and Menopause Society Certified Practitioner has 25+ years experience in women's health. She founded MyMenopauseRx to fill the void in menopause healthcare.