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Female Fertility Health: Balancing Hormones in Premenopause

Female Fertility Health: Balancing Hormones in Premenopause

 Female Fertility Health: Balancing Hormones in PremenopauseImagine this… You’re sitting in your doctor’s office waiting to hear the results of recent blood work for your hormone levels. You’ve been actively trying to conceive for many months and you’re not getting pregnant. You desperately want to have a child… after all you’re only 41 years old (or not anywhere near “too old” to have a baby!). You’ve got to get to the bottom of this! Then, your doctor looks at you, begins talking… and the rest you’re not recalling other than you know you heard the word menopause. What?

For some of you this scenario, or a similar version of it, may be very real. I want to make it known, it is not a natural part of healthy aging to be completely in menopause when you are in your 30s and early to mid-40s. In fact, many healthy women don’t naturally begin menopause until their early 50s. “Menopause that occurs before the age of 45, regardless of the cause, is called early menopause. Menopause that occurs at 40 or younger is considered premature menopause.” ~Cleveland Clinic

Hormone tests that reveal early menopausal hormone levels when you are in your 30s or 40s indicate hormonal imbalance. This hormonal imbalance may be from:

  • dietary deficiencies
  • being over- or underweight
  • excessive exercise
  • high levels of stress
  • an underlying health issue (with the thyroid, adrenals, pituitary gland, ovarian development, etc.)
  • a fertility health issue
  • premature menopause (more on this below)
  • the natural transition into and through perimenopause

The majority of the above causes do not indicate your days of being able to conceive are over (with premature menopause being the possible exception). They mean that there is “work to be done”! They indicate the need for dietary and lifestyle changes, and this is a time in your life where natural therapies may be very useful for helping the body recover/heal, or travel through natural fertility-health changes with grace.

What Does It Mean to Be Pre-, Peri- or Menopausal?

Premenopause, perimenopause and menopause are the natural, very normal, transitions in fertility health that a woman goes through as she ages, often mid-life. Each is a stage during which hormone levels gradually shift to stop a woman’s ability to reproduce. The rate at which these changes occur differs for each woman depending on her overall health and fertility health combined.

Pre-menopause – is a term loosely used to refer to the time before a woman enters menopause, including perimenopause, that can span months or years. During this time hormonal balance shifts. A woman can still have her period although it may change and become irregular, meaning cycle length may lengthen, and periods, even discharge (cervical mucus) may change.

This time may also be accompanied by not-so-welcomed symptoms, including, but not limited to (and not all women experience these…):

hot flashes
night sweats
Insomnia or fatigue
lack of libido (changes in sex drive)
vaginal dryness
new or worsening PMS
mood swings
anxiety or depression
temporary difficulty concentrating
heart palpitations/racing heartbeat
breast tenderness
water retention
weight gain
joint and muscle aches/pains
hair loss or thinning

Perimenopause – a period of time, that can last for several months up to roughly 8-10 years before a woman enters menopause, when the ovaries slowly begin to produce less estrogen and sex hormones decline.

Perimenopause can begin in a woman’s late 30s, but often begins in her mid- to late 40s into the early 50s. “The average length of perimenopause is four years, but for some women this stage may last only a few months. Perimenopause ends the first year after menopause (when a woman has gone 12 months without having her period).” Cleveland Clinic. It is also possible for women’s hormones to fluctuate in and out of a perimenopausal state repeatedly before finally being diagnosed as in menopause.

Menopause – is the stage of life when a woman’s body stops producing enough estrogen to ovulate and menstruation stops. Menopause typically occurs after perimenopause, in a woman’s late 40s to early 50s. “Natural” menopause can be officially diagnosed for women in their late 40s to early 50s who have not had a menstrual period for 12 consecutive months.

Premature Menopause, What’s that?

Women can experience menopause early. This is called premature menopause and is not all that common. However, premature menopause can happen either as a result of:

  • surgical procedures for fertility health issues – procedures like uterine fibroid embolization and certainly from having a hysterectomy (even if ovaries are left)
  • ovarian damage which can happen from surgery (can cause scar tissue formation), endometriosis, large ovarian cysts – especially those that burst, and chemotherapy

How To Support Fertility Naturally Through These Transitions

What can be done about hormone levels that are menopausal, when a woman isn’t old enough to be in menopause? How can healthy hormonal balance be supported through these natural fertility health transitions?

1. Make sure You are a part of your fertility health program. Love yourself!
No matter your age, through all the natural therapies, supplements, charting ovulation, doctor’s visits, etc., don’t forget to care for yourself. Emotional self-care is necessary!

Be mindful and help yourself have a positive outlook. Take time to process emotions through massage, counseling, EFT, meditation, positive affirmations, Yoga, lunch with a trusted friend who understands what you’re going through and will just listen, or any other way you like to manage stress.

2. Create a team to support you.
The best way to achieve healthy fertility is to have support. Your team might include your primary healthcare provider and reproductive endocrinologist (if you haven’t been referred to one, consider this for more in-depth fertility testing), a massage therapist or Acupuncturist, a midwife, your best friend, your therapist/counselor, your partner of course and even your fertility herbalist.

3. Include symptom relief as part of your program.
While natural therapies can take time to help the body achieve optimal health and correct imbalance, many can also work quickly to reduce troublesome symptoms. Ladies, it may help, if you experience any of the symptoms I shared above and especially if you are actively trying to conceive, to:

4. Consider using natural therapies.
It may be most helpful in determining the best natural therapies for your needs to work one on one with a fertility herbalist and the tips we offer in the guides below can be helpful no matter one’s age:

Preparing for Conception Over 40
Achieving Pregnancy During Perimenopause
How to Improve Your Egg Health in 90 Days Checklist

5. Consider all of your options!
I understand your dream of having your own children. There are both natural and medical ways to help you try to achieve this dream. There are also many unique options available to individuals hoping to become parents as fertility health begins to change or for couples battling infertility. We share these option in our guide Hope for Infertility – Fertility Options on the Path to Parenthood.

To close, I want you to have hope!

Despite this time frame, perimenopause and beyond, being viewed as the normal beginning of the “end in a woman’s reproductive years”, a woman can still become pregnant when in premenopause and perimenopause because regular ovulation may continue. Again, now more than ever is the time to enlist natural therapies to support you – change your diet, boost egg health, enlist the support of both natural and medical healthcare professionals to guide you and don’t forget to also advocate for yourself on your journey to conception.


Dr. Christine Traxler M.D., OB/GYN
Dr. Christine Traxler M.D., OB/GYN

Dr. Traxler is a University-trained obstetrician/gynecologist, working with patients in Minnesota for over 20 years. She is a professional medical writer; having authored multiple books on pregnancy and childbirth; textbooks and coursework for medical students and other healthcare providers; and has written over 1000 articles on medical, health, and wellness topics.  Dr. Traxler attended the University of Minnesota College of Biological Sciences and University of Minnesota Medical School,  earning a degree in biochemistry with summa cum laude honors in 1981,  and receiving her Medical Doctorate degree (MD) in 1986.

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  1. Avatar

    Hi, thank you for this article. I am 31 and I haven’t had my periods in a year now and I have hot flushes on and off. I have changed my diet and started exercising and taking supplements but I am not sure what else I could do to get my period back.
    I am planning to start a family but I can’t because I am not ovulating and have no periods . Can you please suggest what I can do to get my period back. It is so frustrating 🙁

    • Dear Claudia,

      I am sorry this is happening!

      I think the best next step is to work with your doctor to find out what the cause is. Have you done this?

      Dietary and lifestyle changes are wonderful as are supplements, yet they need to time to be effective. When did you begin these changes/taking supplements? What are the supplements? Health results take time to appear (1-3 months+) and may take some patience!

      I hope I hear back from you when it is convenient.

  2. Avatar

    I’m 45 and suffer with endometrioisis. I have undergone 4 rounds of ivf (DE) and all failed.
    My Uterus has always been good. Doctors say they do not understand why It has not worked for me.

    I still have monthly periods and we still hope that but some miracle I may conceive naturally. I try to eat healthy and well and take all the necessary vitamins. I have even tried acupuncture for a while.

    Could you recommend anything?

  3. Avatar

    What do I need to do to have my period back? I am 48 years old and my last period was on June 2nd. Please help. Thank you.

    • Dear Sharon,

      Your period may not come back regularly or monthly as you once had it. It could be that this is your natural transition into the time before menopause. All women reach this stage at some point. I know it can be hard! So, consider revisiting this guide for natural therapies to learn more about and consider.

  4. Avatar

    Dear Elizabeth,

    I am 49 years old. My period has been skipped. I had a period in January and it skips about 5 months. I had my period again in June 2nd, 2018 and was very happy, but now July I don’t have it. What do I need to do to maintain a regular period again? Please help. I have ordered Maca and vitex supplements on this website and hope this help.

    • Dear Sharon,

      Thank you for reaching out to us! I venture a guess you understand and know that cycles are supposed to shift and become fewer the nearer a woman gets to age 50 and menopause. This is what we all go through! They may not come every month anymore. So, the tips in this very guide are worth considering so that you pinpoint ovulation exactly when you have a cycle to optimize chances of natural conception. While hard sometimes, it may also be time to learn Fertility Options on the Path to Parenthood.

      I want you to hold onto hope and get to know your body initmately during this time of transition, but also need to be honest so that you can move forward with ease. My best!

  5. Avatar

    I want to know what o do. My period suddenly stopped about 1.5 years ago. Im 43, ive read about soybean, but there are too many arguments for and against its use. What do you advise me to do. Im scared of taking hormonal pills, what natural ways can i follow. Ive heard about black cohosh and vivex but thay are not natural to my part of the world.

    • Dear Bukola,

      It seems you’ve talked to your doctor about why this could be happening for you given you are on hormonal pills. If you have not, do talk to your doctor. I see you are on our premenopause guide, have you learned you have entered into premenopause?

      We can not suggest Vitex and Black Cohosh with the hormonal pills, but if you chose to stop the pills, they would be worth learning more about. If you can not find them where you live, investigate ordering them via the web.