Understanding Hormonal Changes in Perimenopause and Menopause: A Guide for Patients
As a physiotherapist, I often see women in perimenopause and menopause experiencing a range of symptoms that can impact their physical and emotional well-being. These changes are largely driven by the fluctuations and decline in three key hormones: estrogen, progesterone, and testosterone. Understanding how these hormones affect your body can help you manage symptoms more effectively and maintain your quality of life.
Estrogen
Estrogen is a vital hormone that affects almost every system in your body. During perimenopause and menopause, your estrogen levels decrease, leading to various symptoms:
Joint Pain and Muscle Aches: As estrogen levels drop, you might experience more joint pain or stiffness, particularly in the morning. Estrogen helps keep inflammation in check and supports joint health, so its decline can lead to these uncomfortable
Urinary incontinence: Leakage with coughing, sneezing, exercising, a sudden urge to urinate, increase in frequency, nocturia (waking at night to urinate) and an increased number of UTI’s (urinary tract infections) are often experienced by women as estrogen levels fluctuate and drop.
Digestive Changes: Bloating, gas, and changes in bowel habits can occur due to the slowing of digestion linked to lower estrogen levels. Estrogen also plays a role in maintaining a healthy gut, so these symptoms can become more pronounced during menopause.
Tinnitus: You might experience ringing in your ears during menopause. This can be linked to the effects of reduced estrogen on your nervous system and blood flow, making these changes more noticeable.
Dizziness: fluctuations in estrogen levels can lead to dizziness, reduced balance and increased risk of trips and falls, especially during periods of hormonal change such as perimenopause and menopause.
Burning Mouth Syndrome: Estrogen helps keep your mucous membranes healthy. As estrogen levels drop, you might notice dryness or a burning sensation in your mouth, which can be uncomfortable and impact your ability to eat and speak comfortably.
Formication: This is a sensation of insects crawling on or under your skin, which can be quite distressing. Estrogen’s role in maintaining healthy nerve endings and skin is key here, and its decline can lead to these unusual sensations.
Electric Shock Sensations: Some women describe feeling sudden, brief “electric shocks” in their head or chest. This may be related to how estrogen influences nerve function, with fluctuations leading to these sensations.
changes.
Memory Lapses and Concentration Difficulties: Many women report “brain fog” or difficulty concentrating. This is because estrogen is essential for cognitive functions like memory and concentration, and its decline can affect these areas.
Mood Swings and Anxiety: Mood swings and increased anxiety are common as estrogen levels drop. Estrogen helps regulate mood by influencing neurotransmitters like serotonin, so fluctuations can lead to emotional instability.
Hair and Skin Changes: You may notice thinning hair or changes in skin texture as estrogen declines. Estrogen helps maintain healthy skin and hair, so its reduction can result in these visible changes.
Progesterone
Progesterone works closely with estrogen to regulate your menstrual cycle and maintain your reproductive health. As progesterone levels start to drop during perimenopause, you may notice changes like:
Mood Swings and Anxiety: Progesterone has a calming effect on the brain. When levels decrease, you might feel more anxious or irritable, contributing to the emotional ups and downs many women experience during this time.
Sleep Disturbances: If you’re having trouble sleeping, it could be related to lower progesterone levels. This hormone helps promote restful sleep, so its decline can lead to insomnia or disrupted sleep patterns leading to a reduction in quality of life in all areas.
Testosterone
Although we often think of testosterone as a male hormone, it plays an important role in women’s health too, particularly in maintaining energy levels, mood, and libido.
Libido and Sexual Health: Testosterone contributes to sexual desire and overall energy. As it declines during menopause, you might notice a decrease in libido or feel less energetic, which can affect your mood and general well-being.
Hair and Skin Changes: Testosterone can also influence hair growth, particularly on your face and body. As estrogen decreases, the relative increase in testosterone might lead to more facial hair and thinning hair on your scalp.
How These Hormones Interact
The symptoms you experience during perimenopause and menopause are often the result of how these three hormones—estrogen, progesterone, and testosterone—interact. When these hormones fluctuate or decline, it can affect everything from your mood and energy levels to your physical comfort and cognitive function.
As a physiotherapist, I want to help you understand these changes so you can take proactive steps to manage your symptoms. Regular exercise, a balanced diet, and stress management techniques can all support your hormonal health during this time. If you’re experiencing significant discomfort, I encourage you to speak with your healthcare provider about treatment options, including hormone therapy or other interventions, to help you navigate this transition as smoothly as possible.
References:
- Burning Mouth Syndrome: Hormonal Causes and Treatments – WebMD
- Formication: Hormonal Connections and Impacts – Healthline
- Tinnitus and Menopause: Understanding the Connection – Harvard Health
- Electric Shock Sensations and Menopause – Menopause Matters
- Joint Pain and Menopause: Estrogen’s Role – Cleveland Clinic
- Digestive Changes During Menopause – Mayo Clinic
- Menopause and Memory Lapses – Johns Hopkins Medicine
- Mood Swings and Menopause: Hormonal Impacts – National Institute on Aging
- Hair and Skin Changes in Menopause – American Academy of Dermatology
- Testosterone’s Role in Women’s Health – Endocrine Society