Perimenopause is defined as the 10 years prior to menopause, so most women in their 40’s are in perimenopause. The 40’s are characterized by a decrease in fertility, which is due to the decrease in hormone production.

This decline in fertility is the same reason for the increase in complaints of women in their 40’s. We commonly hear about irritability, nervousness, depression, anxiety, sleep disturbance, belly fat, water retention and weight gain from female patients in their late 30’s and 40’s. These symptoms are usually from the declining production of estrogen, progesterone, and testosterone.

Most women, after thorough testing, usually get a huge relief of symptoms by adding progesterone to balance the estrogen already produced by the ovary. A consultation to thoroughly test hormones, vitamins, and other metabolic indicators, and replacement of hormones, stress management, and good exercise and nutrition, can make the perimenopause for women more manageable.