One of the very first symptoms of perimenopause is that your period starts to show up differently than you might usually be used to.

You may notice that your period cycle is longer, shorter, that your bleeding could is heavier or lighter than normal.  You may even begin having menstrual cycles in which your ovaries don't release an egg at all (ovulation).

If you've experienced premenstrual syndrome (PMS) symptoms in the past you may notice that they're getting worse after you moved past 40 (sometimes late 30s).

All of these changes are thanks to the female hormone, estrogen, rising and falling like a wild horse, as your body transits out of your fertile years and heads towards menopause (a point in time when you haven't had a period for 12 months).

Why Does PMS Change in Perimenopause?

Just when you thought PMS was quite enough thankyouverymuch for the past 30 years, no, the Goddess of All Women says "Let's crank this misery up a notch of 80000 to Level: Female Apocalypse".

We joke but really, this is one of the most distressing experiences of perimenopause for so many women.

We can find that we may experience more anxiety, more irritability, greater mood swings than before.  If you're reading this and sounds like you, please know you are far from alone.  Many women experience increased PMS symptoms, some reporting they just don't even know who they are anymore.   

We find that regular and consistent taking of Magnesium can drastically reduce such symptomsThis drink is helping many peri women.

The increase in PMS symptoms is, you guessed it, due to wild and fluctuating estrogen along with a decrease of the calming hormone progesterone (not being released because we may not be ovulating every cycle). With these hormone changes can come a marked increase in our PMS symptoms. 

Oddly enough, you may expect perimenopause means less frequent periods however they can actually get more frequent which means more PMS symptoms with it. 

As well, you might skip a period and then have a heavier period. You might not have a period for 3 months and then slot back into a regular cycle again.

All these different scenarios can exacerbate how you experience PMS.

Why Are My Periods Heavier in Perimenopause?

Women can experience heavier flows during perimenopause due to the ovaries releasing fewer eggs called anovulatory cycles.

These types of cycles causes estrogen dominance as no progesterone is being released after ovulation. This means that progesterone can’t thin your uterine lining and the build of the lining can cause heavy and irregular bleeding that can go on for days and weeks.

Bleeds like this can cause iron deficiency which can have serious knock-effects to your quality of life.  Please check in with your doctor if you have prolonged heavy bleeding and feel concerned. 

The way your periods show up can give you some serious clues about where you are in the journey of Perimenopause.

Did you know there are four stages of perimenopause?

The Four Stages of Perimenopause

  1. Very Early Perimenopause
  2. Early Menopause Transition
  3. Late Menopause Transition
  4. Late Perimenopause.

This diagram shows the absolute hormonal rollercoaster we're on (that we did NOT ask to get aboard!) *note estradiol is a type of oestrogen.

In the diagram above it shows you what oestrogen and progesterone are up to (dizzying, we know!) and see below for a list of perimenopause symptoms they cause.

Symptoms of High and Fluctuating Estrogen

Symptoms of Low Progesterone

  • Mood changes - less able to cope with stress, increased risk of depression, anxiety and memory loss
  • Sleep disturbances
  • Hot flashes and night sweats 
  • Heart palpitations
  • Migraines
  • Heavy periods
  • Painful periods.

Note that some of the symptoms are the same for low progesterone and fluctuating and high oestrogen as they are caused by the combination of the low progesterone and high and fluctuating oestrogen.

Read about the different stages below and what symptoms to expect and what your period might be doing in the four difference stages.

STAGE 1: Very Early Perimenopause (lasts 2 - 5 years on average)

  • Cycles are still regular but could be shorter in length, maybe between 21-26 days. 
  • Likely to have less progesterone and more oestrogen.
  • Symptoms might be heavier periods, increased period pain, migraines, sleep disturbances.

STAGE 2: Early Menopause Transition (2 - 3 years on average)

  • Cycles are starting to be irregular and vary in length up to seven days
  • Likely to have less progesterone and more oestrogen. Oestrogen is starting to fluctuate and when it drops it goes lower than you are used to.
  • Symptoms might be more hot flashes and night sweats.

STAGE 3: Late Menopause Transition (you might be 4 years away from menopause)

  • You start to miss cycles or have your first cycle that is longer than 60 days.
  • Symptoms could increase: hot flashes/night sweats and heavier periods. Breast pain should ease if you have any.

STAGE 4: Late Perimenopause (the twelve months from your final period)

This is the start of your body getting used to low oestrogen and you should start to feel less of the symptoms associated with the wild fluctuating oestrogen levels like migraines and mood symptoms. 

While you are transitioning from late menopause transition to late perimenopause you will float between the two stages until you don’t have a period for 12 months (at that point you have reached Menopause).

For example you might not have a period for 8 months and feel less of the wild fluctuating oestrogen symptoms. Then you might get another period and experience symptoms and then the countdown starts again until you reach 12 months with no period.  Drives you nuts!

Bleeding after Menopause

If you have any bleeding after you have reached menopause you should check in with your doctor immediately. As any amount of bleeding after menopause isn’t normal and could me an indication of something else that needs addressing like endometrial hyperplasia which can progress into cancer.

A Quick Look at Hormone Roles In our Menstrual Cycles

The Role of Estrogen in Menstrual Cycle

Estrogen rises in the days leading up to ovulation. This is your most fertile period. At the same time, estrogen thins your cervical mucus, a fluid sperm has to swim through to reach and fertilize an egg. These estrogen-induced changes make it easier for you to become pregnant if you have sex.

The Role of Progesterone in Menstrual Cycle

The job of progesterone in overall fertility health is that it helps prepare the uterus for pregnancy. After ovulation occurs, the ovaries start to produce progesterone needed by the uterus. Progesterone prepares the wall of the uterus so that the lining is able to accept a fertilized egg and so that the egg can be implanted and develop


Need help with your perimenopause symptoms? Click here

November 28, 2022 — Angela Greely

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