What Perimenopause Means For Your Period

You’re in your 40s, or even 30s. You’ve had your period for decades now and you basically know your flow better than the back of your hand. Things are going to stay pretty much the same...until menopause, right?

Read more: Beat The Bloat: 4 Remedies for Menstrual Bloating

Actually, that’s not the case for most women. See, somewhere in your mid-to-late 40s, your entire menstrual cycle is subject to change. This is rooted in upcoming fluctuations in hormones that can alter your period and its symptoms dramatically. So, what exactly happens to your hormones? 

According to Dr. Judith Reichman, the TODAY show's medical contributor on women's health, when we’re born, we start out with one million to two million pre-eggs (called oocytes). Before we even reach puberty most of our oocytes die, leaving us with only 400,000 oocytes. During the next 25 years, unless we get pregnant or go on birth control, one of our oocytes develops within a mature follicle. It initially produces estrogen and, after two weeks, releases an egg (aka ovulation) and produces more estrogen and progesterone.

Since only one oocyte matures each month, thousands end up dying. This consistent pattern of death and demolition leaves us with fewer and “less youthful” oocytes in our 40s. The oocytes we’re left with are less likely to fully develop into hormonally competent follicles that can secrete the full amount of estrogen and progesterone like we had in our 20s and 30s. 

This experience is better known as perimenopause: a time of irregular periods and symptoms due to hormone fluctuations. It can begin up to 10 years prior to menopause (for which the average age is 51) and the usual duration is three or four years. 

So, what does this mean for our cycles? You may experience...

Shorter or More Spaced Out Cycles

When a follicle doesn’t develop well, it usually produces fewer hormones. This means it may die before its time. This causes your period to come sooner than usual. For example, a 28-day cycle may become 24 days or less. This is all thanks to perimenopause. “Perimenopause is a time that’s characterized by irregular menses, which are usually more spaced out.” As your hormones begin to fluctuate, “it can lead to scanter, lighter periods,” says Adeeti Gupta, an OB/GYN and founder of Walk In GYN Care in New York City.

Missing Periods

Miss a period? It’s not time to freak out (or celebrate) just yet. “A skipped period is the first sign of deteriorating egg quality,” says Rebecca Dunsmoor-Su, MD, an OB/GYN in Seattle. “Some months, the eggs just don't reach a point where they release, and so a period gets missed.” Don’t forget - to be in menopause requires you to go a full year without your period. So skipping one month doesn’t mean it's time to toss out the tampons just yet.

Heavier Flow

“Some months, the egg makes it to release on time and everything’s fine,” says Dr. Dunsmoor-Su. “Some months, it’s a bit behind, and your period will be late; and some months, it doesn't make it at all and you skip a month or two. When you miss an ovulation, the lining of the uterus continues to grow, so that when you finally bleed it tends to be heavier.” 

Elevated Symptoms

If the ovaries make too little estrogen, menopausal-type symptoms can occur even though you still have your period. Worst of both worlds, right? Additionally, scientists know estrogen and progesterone affect the brain by changing levels of neurotransmitting substances. This can affect your mood.

“As the hormones fluctuate more dramatically, those women who have mood symptoms with their periods tend to see more fluctuations in those moods,” says Dr. Dunsmoor-Su. “Some women get very depressed as the hormonal fluctuations become more significant.” As estrogen and progesterone levels fall prior to and during your period, you can feel depressed, experience hot flashes, night sweats, or develop insomnia. Not fun.

Whatever your age, your period offers a lot of insight into overall health. So if you experience any unusual symptoms, it's a good idea to check in with your doctor. Highly drastic changes to your flow may be a sign of thyroid issues, polycystic ovarian syndrome (PCOS), or a number of other health concerns.

Elix is here to help.

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