During perimenopause, your body produces less estrogen—which can lead to a slew of different symptoms. Here’s what to expect.
During perimenopause , your body begins experiencing biological changes as you transition to menopause. Over anywhere from a couple of months, to a couple of years, to a decade, your menstrual cycle, period, and ovulation stop, and you reach the end of your reproductive years.
These biological shifts are mainly due to your hormones. Two central reproductive hormones, in particular, experience major changes: estrogen and progesterone.
Here’s what you need to know about estrogen during perimenopause and how its changing levels can affect your body and your life.
What is estrogen? Let’s start with a refresher on estrogen.
There are three types of estrogen: estradiol, estrone, and estriol. Estradiol is the most potent type during your reproductive years, whereas estrone is more prevalent post-menopause. (As for estriol, it’s mostly active during pregnancy.)
Estrogen is mainly produced by the ovaries. The adrenal glands and fat tissue also make small amounts of estrogen.
As a reproductive hormone, estrogen plays a role in functions like:
Estrogen also acts outside of your reproductive system, impacting areas such as:
Bone health Skin health Cognitive function Metabolism of fatty acids (lipids) Because estrogen affects so many bodily functions, when your estrogen levels change during perimenopause, you may experience symptoms all over the place—in your bones, skin, and brain, for example.
Estrogen during perimenopause What happens with estrogen during perimenopause? As you enter perimenopause, estrogen levels begin to decline, hitting their lowest point when you reach menopause.
Your estrogen levels decline because of is your ovaries, which are the main source of estrogen. Getting older means that your ovaries begin releasing less and less estrogen, until eventually, at menopause, your ovaries stop making estrogen altogether. (After menopause, estrone is the only type of estrogen produced by your body ).
With decreased estrogen production, estrogen levels fluctuate significantly, and eventually decline overall.
Not only do your estrogen levels go down during perimenopause, but your progesterone levels , too. Progesterone and estrogen serve as counterbalances to each other. As their levels fluctuate in different proportions, the balance between the two is thrown off.
>>MORE: What is a Hormonal Imbalance?
The trifecta of fluctuation, declining levels, and imbalance with progesterone make it hard for estrogen to go about its business as usual. This can lead to some of the physical and emotional symptoms you may experience during perimenopause.
How can estrogen changes affect you? Fluctuating and declining estrogen levels are a normal and natural part of getting older. Still, for some people, these changes can cause uncomfortable, frustrating, and even horrible perimenopause symptoms . Others may not experience any symptoms, or symptoms may be milder.
Symptoms also vary depending on whether estrogen levels are higher or lower—in other words, depending on how this hormone fluctuates from cycle to cycle.
High estrogen in perimenopause: symptoms While estrogen decreases overall during perimenopause, there will be periods where estrogen fluctuates to higher levels. This may cause symptoms like:
Bloating : Water and fluid retention is increased , potentially resulting in bloating and stomach discomfort. Breast tenderness : The hormonal imbalance of high levels of estrogen coupled with low levels of progesterone can cause breast tenderness, pain, and general discomfort. This may also trigger changes like fibrocystic breasts (noncancerous lumps) and breast hypertrophy (overgrowth of dense, heavy breast tissue).Low estrogen in perimenopause: symptoms As estrogen levels decline during perimenopause, you may experience some of the more common perimenopause symptoms, like:
Hot flashes and night sweats : Drops in estrogen can trigger vasomotor symptoms, also known as hot flashes and night sweats (or hot flashes that happen at night), which can cause overheating, flushing, and sweating.Headaches and migraine: Decreasing estrogen is partly responsible for headache pain. As estrogen levels decline overall, you may experience an increase in frequency or severity of headaches or migraine.Vaginal dryness : Estrogen helps keep your vaginal lining moisturized . When estrogen levels decrease, your vaginal tissue may lose some of its natural lubrication, potentially making penetrative sex uncomfortable or painful. Lower libido: Estrogen (and progesterone) influences your sex drive and arousal. Lower levels of estrogen – estradiol in particular – may impact your libido , making you less interested in sexual activity. Lower bone density: Estrogen helps keep bones strong. When estrogen drops during perimenopause, bone loss can speed up over time, resulting in higher rates of osteoporosis in menopausal and postmenopausal people.>>RELATED: 10 Low Estrogen Symptoms You Need to Look Out For
You may experience other perimenopause symptoms, as well, including symptoms more closely related to changing progesterone levels, such as heavy periods and fatigue.
Estrogen during perimenopause: the bottom line Estrogen is one of the key reproductive hormones. As you approach menopause and your body changes, hormone production declines, making your estrogen levels fluctuate and ultimately decrease significantly during perimenopause.
These changes in estrogen levels can lead to perimenopause symptoms like bloating, hot flashes, headaches, and vaginal dryness. Some people may experience minimal to mild symptoms during perimenopause, while others may be more impacted by their biological changes.
If perimenopausal hormone changes are taking a toll, consider talking with your doctor about symptom management. You may find some relief from lifestyle adjustments, but other treatments aim to supplement your hormone levels for symptom relief. Options for changing estrogen levels include hormone therapies like estrogen therapy or combination hormone therapy. For those interested in other routes, acupuncture and herbal treatments may also offer symptom relief, though make sure to consult with licensed professionals.
While estrogen levels during perimenopause can bring sometimes unwanted changes to your body, understanding what’s happening in your body can help you make the best choices for you and your health.
