How to prepare for perimenopause in your 30s & 40s
Updated: Sep 28
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Did you know that most of the brutal symptoms we hear about when it comes to menopause are actually not related to menopause at all, but instead perimenopause?
Raging, heavy periods in your 40s or 50s?
Frequent periods multiple times a month in your 40s or 50s?
Irregular periods in your 40s or 50s?
Mood swings, night sweats, and intense pms in your 40s or 50s?
Yeah, that’s perimenopause y’all.
Here’s the deal, menopause is not what we’ve been led to believe it is. Menopause isn’t a time of unpredictable, frequent, heavy, pms-filled periods. Menopause is a time of no periods at all, for the rest of time.
Menopause is the life event that occurs 12 months after your last menstrual bleed.
All the craziness leading up to that moment - that’s perimenopause.
Why is it important that we understand the difference between menopause and perimenopause?
Because the symptoms are menopause like hot flashes, vaginal dryness, sleep disturbances, and dark hair growth are triggered by LOW estrogen. The symptoms of perimenopause - particularly early perimenopause - are caused by HIGH estrogen, or more accurately unopposed estrogen.
This means if you’re treating the symptoms of perimenopause with estrogen therapy, you’ve got it all wrong. What we need more of during perimenopause is progesterone, not estrogen. Here’s why…
During our reproductive years we (generally) ovulate on a regular, monthly basis. With each ovulatory cycle we make way more progesterone than we do estrogen. (Here’s a great chart that shows what our hormones do throughout our menstrual lifecycle.) This progesterone serves the important role of overpowering estrogen in our post-ovulatory luteal phase which lightens and shortens our periods while preventing raging pms. That’s why when a client comes to me with complaints of heavy, long, or pms-filled periods the first thing we look at is how to boost progesterone and flush out excess estrogen in the luteal phase.
However, when we’re going through puberty and perimenopause, aptly referred to as second puberty, we’re transitioning into and out of our ovulatory years respectively. This means that we’re not ovulating regularly or as efficiently as during our reproductive years. The less we are ovulating regularly & efficiently, the less we are at making progesterone. What that means is that we don’t often make enough progesterone during puberty and perimenopause to overpower the rising levels of estrogen that were created prior to ovulation and we find ourselves struggling with heavy, long, moody periods.
So, if you’re in your 40s or 50s and feel like you’re going through puberty all over again… you are, sort of, in the reverse - transitioning out of ovulatory cycles rather than into them.
In order to get relief from perimenopause symptoms and, ideally(!), ease them before they start, we often need to focus on getting more progesterone - not more estrogen.
The best way to make more progesterone during perimenopause? Get really good at ovulating naturally and making lots of progesterone BEFORE perimenopause begins.
That means we have to be off hormonal birth control, cycling naturally, and having easy periods in our 30s so that our cycle is healthy when perimenopause arrives in our 40s and 50s.
If your periods are already heavy, long, and pms-filled in your 30s, that’s likely to only going get worse when the hormonal fluctuations of perimenopause arrive.
And here you thought you only needed to think about ovulation if you wanted to get pregnant. Nope!
So what can we do now in our 30s and early 40s to support an easier perimenopause experience?
1 - Ovulate Monthly
This means if you’re on a method of birth control that suppresses ovulation like the pill, ring, implant, shot, and in some cases the IUD it might be time to consider transitioning off and using barrier methods or natural methods like the fertility awareness methods that I teach here at Sauvage Wellness.
Ovulation is how we make progesterone. If we’re not ovulating, we’re not making much progesterone. And most of those hormonal methods use synthetic progesterone called progestins to prevent pregnancy which means we haven’t had to make much of our own natural progesterone for as long as we’ve been on those methods.
Many people transition off of hormonal birth control in their 40s or 50s when they’re hoping to go through perimenopause and reach menopause. All of a sudden their bodies have to figure out how to make progesterone again after years, likely decades, of not making it… at a time in our lives when it’s more important than ever to make as much progesterone as possible.
2 - Ovulate Better
Just because we’re having monthly periods does not mean we’re ovulating well. What are some signs that we might not be ovulating well? Poor cervical fluid production, long cycles, ovarian cysts, and for some heavy, long, and pms-filled periods.
Support better ovulation by eating blood sugar balancing meals with fat and protein in each meal AND eating within one hour of waking up each day. Ovulation loves when you eat breakfast and stop skipping meals!
Another great way to support ovulation is to eat zinc-rich foods like eggs, grass-fed beef, shellfish, chicken, and seeds like pepitas. Zinc nourishes the ovarian follicles which house our eggs and are released during ovulation. The healthier & heartier those follicles are, the better we ovulate.
3 - Get Better at Flushing Out Excess Estrogen
Leading up to ovulation we make lots of estrogen in order to trigger ovulation itself. However, after we ovulate we want to flush out excess estrogen and make way more progesterone than we did estrogen. If we’re not able to effectively break down and flush out that excess estrogen from earlier in the cycle it can overpower even optimal levels of progesterone and create heavy, long, pms-y periods.
The best way to flush out excess estrogen is to poop everyday! For real. If you’re not pooping daily, excess shit (literally!) is hanging around in your body and hormones like estrogen can get reabsorbed and wreak havoc on our periods. One of my best recommendations for achieving daily poops is to set aside time to let it happen. Grab a magazine or book, grab a seat on your toilet, and hang out for 10 minutes. Relax and let it happen, rather than trying to rush it or ignoring poop cues during the day which can lead to constipation.
Another key to flushing out excess estrogen is supporting the gut and liver health. Estrogen is broken down first in the gut and then in the liver. If we’re struggling with gut health issues - think IBS, bloating, chronic gas, etc - then we might struggle to effectively break down excess estrogen so that it can be flushed out. And if we’re bogging down the liver with daily or excessive alcohol consumption, chemical-laden home & beauty products, and lots of processed food additives we may also find ourselves struggling to effectively break down and flush out estrogen. Make sure to eat fresh, whole foods, avoid foods that create gastrointestinal upset, eat liver supporting foods like dandelion greens, and limit foods & products that bog down the liver.
Okay, it’s official, I could write about this topic all day. For the sake of letting us all get on with our days, I’m going to wrap it up here… but suffice it to say that there is SO much we can and should be doing in our 30s to set ourselves up for better perimenopause experiences in our 40s and 50s.
If you’re in your 30s or 40s and want to work on supporting your cycle NOW for a better perimenopause transition later, you're going to want to check out my Cycle Wisdom Course which comes with a specialized module all about prepping for perimenopause!
BONUS: One of the best resources I’ve come across on perimenopause and menopause is the book Hormone Repair Manual by Lara Briden, ND.
Disclaimer: Brandy Oswald, Sauvage Wellness LLC, and her employees are not doctors, nurses, physicians, psychotherapists, or in anyway licensed medical practitioners and information presented here is to serve as an educational resource and not to be interpreted as: (1) medical advice; (2) a 100% effective birth control or pregnancy achievement options or (3) nutrition or health guidelines. By reading this you acknowledge that you understand that as a specialized form of consulting, fertility awareness education is not the same as professional or licensed therapy or medical advice and intervention; and recognize that it is your responsibility to seek such services from a licensed professional. Brandy Oswald is not a medical provider and cannot give medical advice. All information provided by Sauvage Wellness LLC and Brandy Oswald is of a general nature and is intended only for educational purposes to help with your personal health improvement goals and should not be relied on as medical advice. Always consult a physician with any health concerns and prior to changing your diet, lifestyle, supplements, birth control, fitness, or prescription medicine routine. Should you choose to use the information provided by Brandy Oswald it is of your own volition and you recognize that neither Brandy nor Sauvage Wellness LLC is not held liable for any intended or unintended outcomes.
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