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Perimenopause: What to Expect as Estrogen Levels Drop

Updated: Sep 23

“I wish I would have known!” 

I hear this frequently from women who have gone through the change or are experiencing symptoms and struggling to understand them.  The gradual drop in estrogen can affect so many aspects of how we feel every day, it's hard to know when it's estrogen and when it's something else. While this change doesn’t happen overnight—it can start in your mid-30s and continue until menopause– it can often feel like the symptoms came out of nowhere.  


Below are a few examples of the role estrogen plays in the body, and the effects the decline can have. 🌸


The Impact of Estrogen on Your Body: What to Expect as Levels Drop


Reproductive Health: Estrogen keeps our menstrual cycle on track and supports fertility.   When estrogen starts dropping, you might notice your periods becoming unpredictable—heavier, lighter, or skipping altogether. It’s one of the first signs that your hormones are changing.


Bone Health: We don’t often think about our bones until something goes wrong, but estrogen helps keep our bones strong by maintaining bone density. When it starts to decline, your bones can lose some of that strength, putting you at higher risk for osteoporosis or fractures. 


Heart Health: Estrogen helps keep our hearts healthy by balancing cholesterol and keeping blood vessels flexible. As levels drop, many women notice their cholesterol creeping up and may face a higher risk of heart disease.


Brain and Mood Regulation: Ever feel like your brain is in a fog? Or notice that your moods seem all over the place? Estrogen helps regulate chemicals like serotonin that keep our emotions stable and our brain sharp. So when estrogen levels drop, those mood swings, anxiety, and "where did I put my keys?" moments can start showing up more often.


Skin and Hair: Estrogen helps keep our skin plump, elastic, and hydrated. It also supports vaginal and urinary tissue health. When estrogen declines, skin can get drier, hair may thin, and things like itchy ears, irritated skin, and vaginal dryness (which can make sex uncomfortable) become more noticeable.  These are all common but often surprising symptoms.


Sleep Patterns: Estrogen also plays a role in regulating our sleep, which is why you might find yourself waking up at 3 a.m. and struggling to fall back asleep. It's a frustrating and all too common side effect of estrogen's influence on your circadian rhythms.


Weight Management: Here’s a fun one (not really): Estrogen also helps regulate your hunger signals and promotes muscle mass. As it drops, along with other fluctuating hormones, your body composition may shift, especially around your midsection, leading to that infamous belly fat that’s suddenly harder to shake.


Pain and Inflammation: Estrogen has anti-inflammatory properties, this explains so much!  When it dips, women often experience aches and pains they can’t explain—like frozen shoulder or painful hips.  This is a very common and misunderstood symptom of perimenopause.


Hot Flashes and Night Sweats: The infamous hot flashes! Estrogen receptors are all over our bodies, including in the hypothalamus, the part of the brain that regulates temperature. When estrogen drops, the hypothalamus gets a little too sensitive, which is why you suddenly feel like you're overheating, even when it's cool out. (which also doesn't help with sleep).


Be Proactive and Advocate for Yourself 🔑 

Phew, that was a lot, and unfortunately not every symptom that you might experience. While everyone's journey is different, I can’t stress enough how important it is to be proactive about your health, even before symptoms hit. The hormonal changes that come with perimenopause are completely natural, but they can still catch you off guard. Whether you’re just starting to notice the signs or you're already dealing with the ups and downs, there are plenty of ways you can make the transition smoother.  While each symptom may need its own approach, the following strategies are generally effective for easing the impact of perimenopause:

  • Acceptance: The first step to feeling better is accepting where you are. Many women feel embarrassed or hesitant to admit they’re entering this stage of life, but it’s something to celebrate! Be grateful for how far you’ve come and commit to making this chapter the best it can be.

  • Lifestyle Adjustments: Eating a balanced anti-inflammatory diet full of whole food, staying active, and managing stress can help smooth out the rollercoaster of hormonal changes. Small, consistent changes can go a long way.

  • Prioritize Sleep: Sleep is the foundation of your health and well-being. If perimenopause is messing with your rest, focus on improving your sleep habits—even small changes can lead to big improvements.

  • Try Holistic Approaches: Mindfulness, acupuncture, and herbal supplements can offer relief for some women.  Find a trusted nutrition store or healthcare provider who can guide you in exploring these options.

  • Advocate for yourself:  Under no circumstances should, “it's just part of life, you have to deal with it” be accepted.  If you aren’t getting the support you need, seek it elsewhere. 💪 

  • Menopausal Hormone Therapy (MHT): If symptoms are really affecting your life, hormone therapy is an option for some. Talk to your healthcare provider to see if it's the right fit for you.  


Conclusion

The changes that come with declining estrogen can feel overwhelming, but understanding what’s happening in your body gives you agency. With the right strategies and support, you can take charge of your health and navigate perimenopause with confidence.


If you’re feeling lost in the process, dealing with symptoms or unsure how to move forward, I’m here to help with personalized support for your unique journey.  You don’t have to go through this transition alone – taking action now can make all the difference in how you feel!



Follow me on Instagram or Facebook to learn more about Perimenopause , the different symptoms and strategies to get relief.  Have a specific symptom you'd like to know more about? Comment 💬 below, reach out on social media, or send me a direct message. The more we share, the more we can help ourselves and each other. ❤️




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