How does perimenopause cause cycle changes

One of the most common early signs of perimenopause is a change to your menstrual cycle. Menopause officially begins one year after your last period, but you might notice during perimenopause (the stage before menopause) that your periods are becoming irregular as your ovaries slow down. This transitional period typically starts from age 40-44 and can last from two to 10 years. 

If you notice your cycle start to change in your 30s, you may be experiencing early perimenopause. 

Physical changes during perimenopause 

During perimenopause, your menstrual cycle will change, but exactly how it changes varies from person to person. You may experience lighter, heavier or longer periods, or even no periods at all. Most people experience much heavier periods, including some people with periods so heavy urgent care is needed.

And your body functions will begin to shift as well. As estrogen rises and falls unevenly, you may notice hot flashes, moodiness and dry skin, in addition to irregular periods. Additionally, because fewer eggs are being released during this phase, your chances of getting pregnant decline. 

For some this last aspect of perimenopause is a relief, but for those still hoping to grow their families, it can be emotionally challenging. Take time to notice how you’re feeling, and if you think you would benefit from some professional support, ask your provider for a therapist recommendation. 

How hormones fit into the picture 

As your ovaries produce less estrogen over time to prepare your body to stop releasing eggs completely, your periods will become irregular. During a typical period, estrogen levels rise during the follicular phase to prepare for an egg, and drop after ovulation (unless you become pregnant). 

If estrogen doesn’t rise and fall when it typically does, you might notice irregular periods. Low estrogen levels during perimenopause will cause progesterone to be off balance too. And, since both estrogen and progesterone are responsible for ovulation and menstruation, when they’re out of sync, it will impact your cycle. 

Managing irregular periods

Medications like birth control or hormone therapy (cream or pill form) can help balance out estrogen and progesterone levels and certain kinds of birth control can prevent menstruation completely. These methods can also relieve symptoms like hot flashes, night sweats, and mood swings. There are side effects associated with both, so if you’re interested in this route, talk to your provider about finding a safe plan based on your needs, unique health history and risk factors.

Eventually the irregularity will stop and your periods will stop appearing entirely. But for now, you’ll want to make yourself as comfortable as possible. Changes in your cycle can be frustrating, but it helps to be prepared in advance and knowledgeable about your treatment options. 

Reviewed by the Ovia Health Clinical Team


“Perimenopause” John Hopkins Medicine. John Hopkins Medicine

“Menopause” Mount Sinai. Mount Sinai

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