YOUR CYCLES DURING PERIMENOPAUSE

 

Perimenopause is a natural yet often misunderstood phase in a woman’s reproductive journey. It represents the transitional period leading up to menopause, marked by hormonal shifts that can significantly impact both physical and emotional well-being.

Menopause itself is defined as the point at which ovarian function ceases entirely. At this stage, the ovaries no longer produce estrogen, and ovulation stops. However, the period leading up to this transition—known as perimenopause—is more nuanced and often challenging to navigate.

 

What Happens During Perimenopause?

 

Dr Steven R. Goldstein, a Perimenopause Specialist in NYC says that Pre-menopause (not Perimenopause) refers to the time when women are still producing estrogen and may be ovulating regularly. In contrast, perimenopause begins with the first signs of irregularity in the menstrual cycle. While most women associate any vaginal bleeding with menstruation, not all bleeding during this phase is a true menstrual period.

 

Clinically, a menses is defined as bleeding that occurs approximately two weeks after ovulation. During perimenopause, many cycles become anovulatory—meaning ovulation does not occur—even though estrogen is still being produced. In these cases, progesterone, which typically follows ovulation, is absent.

 

This hormonal imbalance—characterized by fluctuating estrogen without the stabilizing presence of progesterone—can lead to irregular bleeding patterns. Beyond physical changes, it can also result in a range of psychosocial symptoms. These may include increased premenstrual syndrome (PMS), anxiety, mood swings, difficulty concentrating, sleep disturbances, and the commonly reported “brain fog.” Unlike menopause, where estrogen is largely absent, perimenopause is dominated by erratic levels of unopposed estrogen.

 

Symptoms and Misunderstandings

Vasomotor symptoms such as hot flashes and night sweats are often thought to occur only in menopause, but they can also emerge during perimenopause. However, during this phase, they are typically caused by a rapid drop in estrogen rather than a complete lack of it.

 

Despite its prevalence, perimenopause remains underrecognized. Many women in their thirties or forties begin experiencing symptoms but are unaware of the hormonal shifts taking place. The irregular cycles and emotional symptoms often lead to confusion, and in some cases, their concerns may be dismissed as psychological rather than physiological. This misunderstanding can delay proper care and support.

 

Advancing Awareness and Education

The topic of perimenopause has gradually gained attention thanks to the contributions of leading gynecologists and menopause specialists like Dr Steven R. Goldstein, co-author of Could it be…Perimenopause?, one of the pioneering books addressing this transitional stage.

 

As a past president of both the International Menopause Society and the North American Menopause Society, and a Certified Menopause Practitioner, his efforts have significantly advanced public and medical understanding of the condition.

Increased awareness, education, and medical recognition are essential to ensure that women receive appropriate guidance and care during this complex stage of life.

 

Perimenopause is not “all in the head.” It is a real, hormonally driven experience that deserves to be addressed with knowledge, compassion, and clinical insight. If you are a woman experiencing these symptoms, then schedule a consultation with Dr Steven R. Goldstein, a Perimenopause Specialist in NYC