A Flash of Wisdom: Navigating the Hormone Rollercoaster
The Great Hormone Rollercoaster: From Prime Time to Post-Menopause
If you're currently wondering why you're simultaneously sweating in a snowstorm and forgetting your best friend's name, you're probably already past the first stop on the Great Hormone Rollercoaster.
Let's break down this transition into "seasons," starting right at the beginning:
Season 0: Pre-menopause AKA the Prime Time
This is where you are before the show starts. Premenopause technically covers all the reproductive years leading up to perimenopause. For most women, this is the time of hopefully regular, predictable periods and no classic menopausal symptoms.
The Hormonal Climate Report
Everything is running smoothly! Your ovaries are releasing eggs and producing oestrogen and progesterone with reliable regularity. Your hormones are doing their job, keeping your cycle on track, your bones strong, and your mood relatively stable.
Why This Matters:
Even though you feel normal, there are subtle changes happening behind the scenes, especially as you move into your late 30s and early 40s:
The Egg Reserve Countdown: Your supply of eggs (follicles) is naturally decreasing. While you might not notice it, this decline is the slow, quiet trigger that will eventually lead to the hormonal shifts of the next stage.
The Fertility Dip: Even with regular periods, fertility naturally starts to decline in the mid-30s.
Tip: Foundation Building
Premenopause is your foundation-building phase. What you do now matters for the decades to come:
Bank Your Bone Health: Oestrogen is a bone protector. Since you have plenty now, maximize it! Ensure you have adequate calcium and Vitamin D and engage in weight-bearing exercise.
Establish Good Habits: Solid sleep, stress management, and healthy eating will make the eventual turbulence of perimenopause much easier to handle. Think of it as getting your car service done before you take it on a cross-country trip!
A Flash of Wisdom Alert: When Regular Isn't Regular
If you are in your premenopausal years (20s or 30s) and your periods are not running regularly, this is a signal you should not ignore! Unlike perimenopause, where irregularity is expected, an irregular cycle during your prime years usually points to something else.
Irregular periods in the pre-menopausal stages of life could be caused by several things including:
Stress and Diet Changes: Sudden weight loss or gain, or intense psychological stress can temporarily disrupt your hormonal balance.
Thyroid Issues: Your thyroid gland is the master regulator of metabolism, and its hormones are closely linked to your menstrual cycle. Polycystic Ovary Syndrome (PCOS): A common hormonal disorder that can cause irregular cycles and excess androgens (male hormones).
Fibroids or Endometriosis: Structural issues in the uterus that can cause heavy or irregular bleeding.
The take-home message here? If you are under 40 and your cycle is consistently inconsistent (skipping periods, or very short/long cycles), talk to your healthcare provider. They can carry out tests to rule out treatable conditions and ensure your hormonal system is balanced before the main menopausal event even starts!
Season 1: Perimenopause – The Trailer
Think of perimenopause as the long, often dramatic, trailer leading up to the main event. It usually starts in your 40s (but sometimes earlier!) and lasts until you have had 12 consecutive months without a period. On average, this wild ride lasts about four to five years, but for some, it can stretch to a decade!
The Hormonal Climate Report
Your body's oestrogen and progesterone levels start to fluctuate wildly. Imagine a toddler with the thermostat—up, down, up, down. This hormonal turbulence is why you feel like you are losing your mind one minute and ready to run a marathon the next.
The Two-Part Perimenopause Show:
Early Perimenopause: Your menstrual cycles start changing (a bit shorter or longer). Symptoms are mild, but your periods are mostly still "there".
Late Perimenopause: The hormonal dips are more extreme. Periods start skipping for 60 days or more at a time, and symptoms often peak during this stage. You are likely just one to three years away from the finish line (menopause).
The Quirky Symptoms You Didn't Sign Up For:
The Period Plot Twist: Your cycle acts like a flaky friend—unreliable timing, heavier flow, or spotting.
The Mood Swing Mayhem: The drop in hormones disturbs your brain messenger chemicals like serotonin and dopamine, leading to anxiety, reduced emotional tolerance, or new bouts of sadness.
The Night Sweats Disco: Waking up drenched and throwing off covers, followed by chilling cold, often resulting in insomnia.
Brain Fog: Difficulty concentrating or remembering simple things.
Tip: Taming the Toddler Thermostat
Prioritise Sleep: Treat sleep like a non-negotiable health pillar (cool room, limited screens).
Get Moving: Exercise helps regulate those tricky brain chemicals and boosts mood.
Stop Smoking and Reduce Alcohol Intake: this helps with many aspects of your health; from reducing menopausal symptoms to reducing your risk factors for osteoporosis, cardiovascular disease and several cancers.
Talk to Someone: If mood swings or menopausal symptoms are impacting your life, talk to your healthcare provider about therapeutic options. You do not have to white-knuckle your way through this!
Season 2: Menopause – The Official Grand Opening
This is the moment of truth. You officially enter menopause the day after you hit 24 months period-free before the age of 50, or 12 months period-free if you are over 50 years of age. It is a point in time, not a prolonged state, and it means your ovaries have retired from the ovulation business. Congratulations, no more monthly pads to worry about! Your menopausal symptoms will slowly (but surely) start to settle with time.
Season 3: Post-menopause – The New Normal
Welcome to your new life! Post-menopause is everything after that 12/24-month mark. Your oestrogen and progesterone levels are now consistently low. While the wild ups and downs of perimenopause fade, a new set of long-term health considerations come into play.
The Hormonal Climate Report
The fluctuating storms are over. Oestrogen and progesterone levels are consistently low, which brings stability but also shifts the focus to long-term health maintenance.
The Health Headliners:
Bone Health: With less oestrogen (a bone protector), there is a higher risk of losing bone density (osteoporosis).
Heart Health: Your risk for cardiovascular disease increases. Oestrogen helped keep your arteries flexible, so now it is time to be extra nice to your heart.
The V-Zone Update (Genitourinary Syndrome of Menopause - GSM): Less oestrogen can thin the tissues in the genitourinary area, leading to dryness, discomfort, and increased bladder issues.
Tip: Long-Term Maintenance
Move your body! Weight-bearing exercise (lifting, dancing) is crucial for bone density.
Get Screened: Talk to your doctor about screening for bone density (DEXA scan) and cholesterol alongside your recommended NHS screening tests including bowel cancer screening, mammograms and smear tests.
Address the Dryness: Do not suffer in silence with GSM - there are very effective treatments, including localised hormone therapy.
Final Flash Thoughts
Midlife hormonal changes are a universal, sometimes ridiculous, experience. Remember this: You are not broken, and you are not alone. This is a powerful transition. Arm yourself with information, laughter, and a good sense of humor, because if you can't laugh at the fact that you are wearing slippers, a parka, and fanning yourself furiously, you're missing out on the gems of advice extolled above.
If you require any assistance with your symptoms or just advice then please do not hesitate to consult us at London Harley Street Practice.
By Dr Tailor
11/12/2025