Understanding the Changes In Hormone Levels During Perimenopause

Understanding the Changes In Hormone Levels During Perimenopause

Perimenopause is the period of time before menopause starts. The word “perimenopause” literally means “around menopause,” and it signifies the point in time when your hormones change, your periods begin to stop, and your body prepares to eventually go through 12 consecutive months without a menstrual cycle which is when you are officially in menopause.  

Perimenopause Hormone Basics 

During perimenopause, symptoms are brought on by a change in the hormone estrogen, which is mainly produced by the ovaries. This hormone is responsible for the maintenance and upkeep of many traits unique to female bodies. Changes in levels of the hormone estrogen can affect many ways that your body functions, from your energy to your bone density. 

For example, estrogen is the main contributor to a consistent and typical menstrual cycle. When estrogen levels fall, menstruation might stop altogether or become spotty and irregular, which is what happens with women experiencing menopause. 

During perimenopause, your estrogen levels will typically become irregular, but overall, you will see a decline in estrogen levels until they reach a more consistent low level during menopause. 

Estrogen Levels in Perimenopause  

Estrogen levels are not at an all-time low during perimenopause. Menopause itself is when estrogen levels hit a low, but perimenopause begins to slowly ease an individual into the experiences that they can expect when menopause begins in earnest. That means that during perimenopause, your estrogen levels will fluctuate with an overall tendency downward. 

During perimenopause, the body will begin to sporadically experience symptoms associated with menopause. 

List of symptoms of menopause: 

  • Hot flashes 
  • Spotty or irregular menstrual cycles 
  • Weight gain 
  • Mood fluctuations 
  • Sleep complications 
  • Vaginal dryness 

Perimenopause is indicated by a combination of these symptoms. However, menopause itself begins when an individual goes 12 months in a row without experiencing a menstrual cycle. Before then, they’re experiencing perimenopause. 

Normal Hormone Levels During Perimenopause 

Your estrogen and progesterone hormone levels (both hormones primarily produced by the ovaries) begin to fluctuate during perimenopause. Although these hormones may remain at their typical levels most of the time during the beginning of perimenopause, the body’s systems will begin to produce less and less as time goes on until, eventually, not enough is produced at any one time to cause certain bodily functions to occur such as menstruation and ovulation. 

Your body will never be completely without estrogen or progesterone, but it will have significantly less. There will be enough to upkeep important and vital functions, but ovulation and other cycles associated with the reproductive system in female bodies will cease. 

Common symptoms due to fluctuating and declining hormone levels during perimenopause can also include: 

  • Lightheadedness 
  • Clammy skin 
  • Brain fog 
  • Decrease in sex drive 
  • Urinary leakage 
  • Headaches 

What Level of FSH Indicates Perimenopause? 

Ovulation, in addition to being managed by estrogen, is also managed by a hormone called follicular stimulating hormone (FSH).1 The two hormones work in tandem in order to manage the menstrual and ovulation cycles. FSH “activates” the follicles in the ovaries, which then begin to produce estrogen to promote the typical menstruation cycle.  

As female bodies age, however, fewer and fewer ovarian follicles remain able to be stimulated, so there are not as many locations for estrogen to be produced. As such, the body’s levels of FSH continue to increase, but estrogen levels decline. At that point, the body will have an excess of FSH without the high estrogen levels to match. 

The level of FSH in the body that is typical for perimenopause and can help healthcare providers determine whether or not an individual is experiencing perimenopause symptoms is >30 International Units per Liter (IU/L). Women experiencing post-menopause, however, also sometimes exhibit FSH levels greater than 30 IU/L. 

Balancing Hormones During Perimenopause 

There are many natural ways to attempt to balance the effects of hormones during perimenopause that also work for balancing hormones during menopause and post-menopause. 

Incorporate Phytoestrogens Into Your Diet 

Phytoestrogens are estrogen-like compounds naturally found in  plants, so eating foods that contain phytoestrogens can assist in mitigating the severity of your body’s natural estrogen levels dropping. Foods that are rich in phytoestrogens include: 

  • Soy 
  • Carrots 
  • Tea  
  • Broccoli 
  • Nuts 
  • Legumes 

Consider Plant-Based Supplements 

Equelle is a hormone-free *, vegetarian supplement. Its active ingredient, S-equol, mimics estrogen in the body, thus decreasing perimenopausal and menopausal symptoms without affecting the natural levels of hormones in your body. Equelle is a safe and effective menopause relief supplement that has been extensively researched1.   

Implement Stress Management Techniques In Your Daily Life 

Fluctuating hormone levels mean your mood will likely be affected dramatically depending on what your body’s hormone levels look like at a given moment. The stress of everyday life can also have an effect on your body’s hormone levels, however, which can combine with the hormone fluctuations that will already be caused by perimenopause symptoms. 

It’s been found that individuals who practice techniques to manage stress such as mindfulness activities and meditation, can prevent outside stress levels from affecting their body’s hormones to a noticeable degree.2  

Exercise Regularly 

Along with a healthy diet, regular exercise can also help improve many health conditions, including the symptoms of perimenopause. By exercising regularly, you promote the dispersion of hormones produced by physical activity within your body, and it can make those symptoms caused by other hormone shortages less prominent. 

Speak With a Healthcare Provider 

There are supplements like Equelle that are trusted by doctors, as well as other methods of treatment that can help individuals reduce menopause symptoms during perimenopause, menopause, and post-menopause. By having an open and honest conversation with your healthcare provider, you can be pointed in the right direction about what treatment options may be right for you.


1 “Menopause.” Menopause | Penn Center for Women's Behavioral Wellness |      Perelman School of Medicine at the University of Pennsylvania. Accessed October 27, 2022. https://www.med.upenn.edu/womenswellness/menopause.html.

Pal, Parneet. “5 Simple Mindfulness Practices for Daily Life.” Mindful, October 3, 2022. https://www.mindful.org/take-a-mindful-moment-5-simple-practices-for-daily-life/.

*Free from human or animal hormones. Contains trace amounts of plant isoflavones.