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Hormone Health

Female Fertility Health: Balancing Hormones in Premenopause

Elizabeth Willett - M.A., Certified Herbalist
July 18, 2021
Reviewed by Christine Traxler, MD

Imagine 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
headaches
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:

  • Eat a Fertility Diet – avoid large meals and eat 5 small, well balanced meals daily
  • limit/avoid alcohol
  • limit caffeine to small quantities (and only in the morning)
  • quit smoking if you smoke
  • create a comfortable sleep environment

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.

References

  • Pick, M. (2014). Perimenopause – Starting Your Transformation. Retrieved from: https://www.womentowomen.com/menopause-perimenopause/perimenopause-starting-your-transformation/
  • Portland ME & Jupiter FL. (n.d.). Pre-Menopause or Peri-Menopause?. Retrieved from: http://agemanagementcenter.com/bioidentical-hormone-replacement-therapy-women/pre-menopause-peri-menopause/
  • What is Perimenopause, Menopause, and Postmenopause? (2013, May 13). Retrieved from: http://my.clevelandclinic.org/health/diseases_conditions/hic-what-is-perimenopause-menopause-postmenopause

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About the Author

Elizabeth Willett - M.A., Certified Herbalist

Elizabeth Willett - M.A., Certified Herbalist

Elizabeth Willett is the Senior Herbalist and Lead Educator at NaturalFertilityInfo.com. She holds a BS in Mass Communications (2000) from Minnesota State University, and a Master of Arts degree (MA, 2010) in Holistic Health Studies with a specialization is herbalism from St. Catherine University in St. Paul, MN. Liz has written over 200 articles on women's fertility and brings a vast wealth of knowledge and expertise in holistic health and healing to Natural Fertility Info.com

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