What happens to hormones during perimenopause?
During perimenopause, which often starts 5 to 10 years before menopause, your ovaries stop making hormones in a steady, predictable pattern. Estrogen usually swings up and down first, then gradually trends lower. Ovulation also becomes less reliable, and in cycles where you don’t ovulate, progesterone drops too. That’s why your cycle can suddenly get heavier, lighter, shorter, longer, or skip months.
Those hormone swings can affect a lot more than periods. Estrogen has effects throughout the body, including the brain, joints, hair, heart, and vaginal tissue, so changing levels can show up as hot flashes, night sweats, mood changes, sleep problems, brain fog, headaches, palpitations, vaginal dryness, and lower libido. Menopause is official once you’ve gone 12 straight months without a period, and by then estrogen and progesterone have usually settled into a lower baseline. One frustrating part is that hormone testing often isn’t very helpful during perimenopause, because levels can be high one day and low the next.
Here at Alloy, we break this down in more detail in our guide to what perimenopause is and our article on low estrogen symptoms and treatment. If you want a quick video explanation, this chapter on decline in perimenopause is helpful. If symptoms are getting in the way, our perimenopause care page walks through treatment options.
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