November 28, 2023 8 min read

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    While menopause is a more talked about, prominent topic when it comes to female health issues, that is not the case with perimenopause. An initial stage in the (often rocky) menopausal transition, the perimenopause experience is just as unique as any other bodily process. For some women, it can be pretty much non-existent, while for others, it might be quite intense and challenging. 

    Contrary to popular belief, perimenopause isn’t always a short stage leading up to menopause. In fact, onset can begin as early as the mid-thirties, and it can last for years, triggering unpleasant, sometimes even debilitating symptoms - both physical and psychological.

    In an attempt to lift the veil off this critical healthcare issue and raise greater awareness around early perimenopause, we will dive into its early symptoms, the hormonal changes that accompany it, and potential treatments that could help. Keep reading to learn more!

    First Things First: The Menopausal Stages

    Before we can fully understand perimenopause, we must dive into the complexity of the menopausal transition and all menopausal stages. Menopause is, by definition, a process that begins with a 12-month absence of the menstrual period. While it usually occurs when a woman enters her 50s, it can also begin in their 40s for some women.[1

    However, the menopausal transition is not necessarily a linear process. It is preceded by perimenopause, which is characterized by irregular periods, hot flashes, sudden mood swings, a slower metabolism, and night sweats.[1] Sounds familiar? That’s right -  it is perfectly normal for women to experience menopausal symptoms before menopause itself even starts.

    One of the primary changes indicating the start of menopause is a significant decline in estrogen levels. Given that estrogen plays a vital role in female reproductive health, the effects of this decline can be rather drastic. Estrogen controls the menstrual cycle but plays numerous other noteworthy roles, too. It affects the proper functioning of the reproductive tract, urinary tract, heart, blood vessels, skin, hair, pelvic muscles, bones, and brain![2]

    Low estrogen levels can lead to irregular periods, high cholesterol, bone health issues such as osteoporosis, decreased libido, and even cardiovascular problems. As we’ve mentioned, perimenopausal and menopausal changes aren’t identical for all women, and they can range from mild to life-altering.[3]

    Menopausal Stages

    In a nutshell, the menopausal stages[4] go as follows:

    • Perimenopause, also known as menopause transition, usually starts in your 40s and lasts until menopause, when the ovaries no longer release eggs. This is characterized by compromised estrogen production, which is mainly felt in the few years leading up to the actual menopause. During this stage, women still have their periods, though they might become irregular.
    • Menopause officially starts once you haven’t had your period for 12 consecutive months. Estrogen production is at its lowest, and the egg-releasing process has stopped. While women can still get pregnant during perimenopause (even when their periods are irregular), this isn’t the case once they’ve officially entered menopause. 
    • Postmenopause marks the stage after menopause has been diagnosed, and it can last for years or even decades after you’ve “lost” your period. It often brings about symptoms similar to those experienced during the menopausal transition and, due to low levels of estrogen, carries the risk of developing numerous health conditions. 

    Perimenopause: Everything You Need To Know

    Perimenopause, the initial phase of the menopausal process, is often a preview of what awaits once menopause kicks in. However, for many women, perimenopause is far more than just a glimpse of menopausal symptoms. It can be pretty intense, and to make matters worse, it can start prematurely - as early as the mid-30s! 

    Perimenopause comes from the Greek word peri,meaning “about.” That being said, perimenopause should occur around actual menopause, but for some women, it sneaks up years ahead of its time.[5]

    Why Does Perimenopause Happen?

    Remember how we said that, as we age, estrogen levels drop, causing a series of adverse health effects? It is during perimenopause that this primary female hormone experiences rather drastic fluctuations, resulting in menstrual irregularity and changes in both menstrual cycle longevity and accompanying symptoms.[5] 

    Premenopausal Symptoms

    What’s more, perimenopausal women may experience menstrual cycles with no ovulation - meaning an egg isn’t released. Therefore, perimenopause, or the stage preceding menopause, may be perceived as the body’s method of gradually anticipating and adjusting to the upcoming changes.

    Symptoms of Perimenopause

    One of the first tell-tale signs that you’re experiencing perimenopause are irregular periods. You may notice that your menstrual periods have become longer or shorter. Even if you haven’t experienced changes in flow before, they may occur in this stage. However, these changes aren’t always constant and don’t necessarily manifest every month.[5]

    It is common for perimenopausal women to skip periods, but the severity of changes in your menstrual cycle can indicate if you’re in early or late menopause. For instance, getting your period seven days earlier or later may signify that you’ve just entered perimenopause - especially if you haven’t experienced it before. On the other hand, not getting your period for two consecutive months or more is likely a sign of late perimenopause.[5]

    Mood swings often accompany all three menopausal stages. Increased irritability, depressive moods, and anxiety are often experienced in perimenopause, especially as a result of other unpleasant physical symptoms. Many women experience irritability as a result of poor sleep hygiene. Sleep is typically compromised during perimenopause, as hot flashes and night sweats create a rather uncomfortable atmosphere for achieving optimal rest.[5]

    Mood Swings and Sleep Issues

    Hot flashes are certainly one of the leading associations with menopause and one of the most prominent symptoms of all three menopausal stages. This sudden rush of warmth felt in the upper body, followed by intense sweating, usually lasts a few minutes. Hot flashes are followed by a rapid heartbeat, restlessness, and a sudden drop in bodily temperature once they’re over, which may give you the chills.[6] 

    Hormonal changes also affect tissue tone and plasticity, resulting in vaginal dryness and urinary incontinence. In addition to being more prone to urinary and vaginal infections, women may experience painful intercourse. These physical symptoms, intertwined with irritability, anxiety, and depressive moods, may also affect sexual desire.[5]

    Altered menstrual cycle and ovulation periods go hand in hand with decreased fertility, which is one of the most drastic consequences of perimenopause. It is, however, essential to note that pregnancy is still possible as long as you’re having periods - no matter how irregular they may be.[5] 

    Low estrogen equals an increased risk of fragile bones and conditions such as osteoporosis. The lack of estrogen may also increase LDL cholesterol (the “badcholesterol) in the blood, increasing the chance of cardiovascular issues. In addition to the increase in bad cholesterol, perimenopausal women also face a decrease in HDL cholesterol - the so-called “good” cholesterol, which also jeopardizes heart health.[5]

    Reasons for Premature and Early Menopause

    Why is it that some women start experiencing these symptoms as early as their mid to late thirties? Premature menopause is diagnosed in women under 40, while early menopause begins between the ages of 40 and 45 and affects 12% of women.[7] Here’s why it may happen: 

    • Starting period early: In case you started your period before 11 years of age, chances are you could experience perimenopause and menopause earlier. Family history plays a role in this aspect as well.
    • Poor lifestyle choices: Smoking affects every single aspect of your health, and reproductive health is no exception.
    • Ovarian surgery: Your menopause could kick in earlier than expected as a result of any previous surgeries on your ovaries. In case the ovaries have to be removed, this procedure will trigger what is known as surgical menopause.

    Consequences of Ovarian Surgery

    • Cancer treatments: Radiotherapy and/or chemotherapy could affect the functioning of ovaries, leading to premature or early menopause.
    • Primary ovarian insufficiency: Primary ovarian insufficiency (POI) is a condition that causes a dysfunction or complete depletion of ovarian follicles, resulting in premature menopause.[7]

    Easing Perimenopause Symptoms with Natural Supplements 

    Yes, both perimenopause and menopause are natural, inevitable processes. But does that mean we just have to go with the flow and accept our fate when it comes to their exhausting, life-altering side effects? The truth is that nutritional choices can significantly alleviate these symptoms, and certain dietary supplements may make the transition a lot smoother.

    Vitamin D3+K2

    We’ve already mentioned how low estrogen levels may jeopardize bone density, leading to degenerative conditions during perimenopause and menopause. Vitamin D plays a crucial role in bone metabolism and calcium production. It is also a key factor in cardiovascular health and may help alleviate emotional and psychological symptoms accompanying this phase.[8] The vitamin D3+K2 combo promotes calcium absorption and integration, which is extremely important in perimenopause.

    Omega-3 Fatty Acids

    Omega-3 fatty acids represent a staple in female health in all its stages, including menstrual pain, pregnancy, breastfeeding, as well as perimenopause and menopause. Supplementing with omega-3s can improve mood levels during menopausal transition by reducing both depressive symptoms as well as vasomotor symptoms (VMS) - also known as hot flashes.[9] 


    Probiotics are a must in every supplement stack and are crucial to gut health, immune strength, and mental health. A quality probiotic supplement could improve the cardiometabolic health of perimenopausal women while also helping you balance out your hormones.[10]


    Hydrolyzed Collagen Supplement

    The multifaceted role of collagen in female health, especially during perimenopause and menopause, makes it one of the essential supplements for this important stage of your life. Collagen, the main structural protein in our body, is produced naturally, but this production significantly decreases as we age. 

    Collagen plays a key role in skin health, and it can dramatically improve symptoms of dermatoporosis - a common skin condition in perimenopause and menopause.[11] Collagen also preserves bone density, which we’ve already established is a burning topic in the menopausal transition.[12] 

    In Conclusion

    While certain bodily processes that accompany aging cannot be stopped or avoided, their symptoms and side effects can certainly be managed wisely. We don’t get to decide when perimenopause or menopause will arrive, as they’re completely unique to every individual. We can, however, make certain adjustments and opt for natural supplementation to ease the unpleasant symptoms, in addition to adopting a healthy diet and prioritizing physical activity. Learn more about making healthier dietary choices and optimizing your lifestyle, and discover non-GMO, all-natural supplementation


    1. Mayo Clinic. “Menopause - Symptoms and Causes.” Mayo Clinic, 2017,
    2. “Estrogen’s Effects on the Female Body.”,
    3. “Low Estrogen: Causes, Effects, and Treatment Options.”, 5 Oct. 2022,
    4. Cleveland clinic. “Menopause: Age, Stages, Signs, Symptoms & Treatment.”Cleveland Clinic, 5 Oct. 2021,
    5. Mayo Clinic. “Perimenopause - Symptoms and Causes.” Mayo Clinic, 2019,
    6. “Hot Flashes - Symptoms and Causes.”Mayo Clinic, 2018,
    7. “Premature and Early Menopause.”, Accessed 28 Nov. 2023.
    8. Mei, Z., Hu, H., Zou, Y., & Li, D. (2023). The role of vitamin D in menopausal women's health. Frontiers in physiology, 14, 1211896.
    9. Freeman, M. P., Hibbeln, J. R., Silver, M., Hirschberg, A. M., Wang, B., Yule, A. M., Petrillo, L. F., Pascuillo, E., Economou, N. I., Joffe, H., & Cohen, L. S. (2011). Omega-3 fatty acids for major depressive disorder associated with the menopausal transition: a preliminary open trial. Menopause (New York, N.Y.), 18(3), 279–284.
    10. Szydłowska, I., Marciniak, A., Brodowska, A., Loj, B., Ciećwież, S., Skonieczna-Żydecka, K., Palma, J., Łoniewski, I., & Stachowska, E. (2021). Effects of probiotics supplementation on the hormone and body mass index in perimenopausal and postmenopausal women using the standardized diet. A 5-week double-blind, placebo-controlled, and randomized clinical study. European review for medical and pharmacological sciences, 25(10), 3859–3867.
    11. Szydłowska, I., Marciniak, A., Brodowska, A., Loj, B., Ciećwież, S., Skonieczna-Żydecka, K., Palma, J., Łoniewski, I., & Stachowska, E. (2021). Effects of probiotics supplementation on the hormone and body mass index in perimenopausal and postmenopausal women using the standardized diet. A 5-week double-blind, placebo-controlled, and randomized clinical study. European review for medical and pharmacological sciences, 25(10), 3859–3867.
    12. “Collagen Peptides May Be Beneficial for Menopausal Bone Loss.”,

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