Irregular Periods, PMS, and Perimenopause, Oh My!

Tampons and Pads On Dish On Table

Irregular Periods, PMS, and Perimenopause, Oh My!

Tampons and Pads On Dish On Table

Irregular periods and worsening premenstrual syndrome (PMS) are often the first indicators that the hormonal shift of perimenopause has begun, creating a lot of uncertainty and chaos in its wake. Having a better understanding of what is happening in this normal phase of life as well as implementing strategies to manage these changes can help!

The Perimenopause Rollercoaster

Perimenopause, the transition phase leading up to menopause, typically begins in the late 30s or early 40s…well before you reach menopause. During this time, hormonal fluctuations become more pronounced, leading to erratic menstrual cycles and moods. [1]

Irregular periods during perimenopause can manifest as shorter or longer cycles, heavier or lighter flow, or even skipped periods making it feel like a complete guessing game. These fluctuations are primarily due to declining levels of estrogen and progesterone.[2] The resulting hormonal imbalance can lead to unpredictable menstrual patterns…making your decision to wear white pants a real gamble!

PMS symptoms, such as mood swings, bloating, and breast tenderness, often intensify during perimenopause and are linked to hormonal changes and their impact on neurotransmitters in the brain.[3] So if you’re someone who has experienced PMS, and feels things are getting so much worse despite not doing anything different, you’re not losing your mind.

Managing the Journey

While irregular periods and exacerbated PMS can be challenging, there are strategies to manage and ease these symptoms. Maintaining a healthy lifestyle through regular exercise and a balanced diet as well as managing key stressors can help regulate hormones and alleviate PMS discomfort.

It’s essential to recognize that perimenopause is a natural phase in a woman’s life, and these disruptive symptoms don’t have to be part of the journey. Seeking support and understanding the underlying causes can empower you to navigate this transitional phase with grace and resilience…and not bite everyone’s head off in the process.

If you’re looking for a holistic approach to managing your changing hormones in perimenopause and menopause, I help women navigate both the physical and emotional aspects of perimenopause and menopause so you can go from feeling exhausted, foggy, and irritable to clear, confident, and energized, in a way you can keep up with.

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1. **Santoro N, Epperson CN, Mathews SB.** “Menopausal Symptoms and Their Management.” *Journal of Women’s Health.* 2015;24(5):381-388.
2. **Harlow SD, Lin X, Ho MJ.** “Analysis of menstrual diary data across the reproductive life span applicability of the bipartite model approach and the importance of within-woman variance.” *Obstetrics and Gynecology.* 2000;96(6): 949-955.
3. **Halbreich U, Kahn LS.** “Role of estrogen in the etiology and treatment of mood disorders.” *CNS Drugs.* 2001;15(10):797-817.

Written by Allison Poole, PT, MPT, WHC

Allison takes a modern approach to women's hormone and pelvic health by taking the hard work and confusion out of caring for your body. She combines her 20 years of clinical expertise, compassion and personal experience to help women navigate perimenopause and menopause with ease.

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