Navigating Peri-menopause with Fertility Awareness

The years leading up to menopause are known as Peri-menopause. During these years, the ovaries start winding down, with menopause being confirm once its been a full year since the last period. Peri-menopause can last anywhere from 4-10 years, and begin earlier for some women, sometimes as early as the mid to late 30’s.

Although Peri-menopause is a universal experience that all affects all women, many find that it creeps up on them, and can only identify the initial subtle shifts in hindsight. These initial changes in hormones can impact certain women more than others, with many reporting that ‘the wheels fell off’ at some point in their early 40’s.

The standard of care from health professionals has had an interesting history, especially when it comes to hormone replacement therapy. This highlights the need for further research, so that future generations can approach this time of life with more awareness, and be better equipped to navigate life during this time.

Lets look at how Fertility Awareness can help you navigate this time of life.

Different Phases of Peri-menopause

Practicing Fertility Awareness will enable you to identify certain changes to your menstrual cycle, of which there are 3 major shifts:

Phase 1

The first identifiable change is that your menstrual cycle will get shorter than what your normal is. For example, if you normally have 30 day cycles, you may start noticing 26 day cycles every now and then, which will start occuring more frequently over time.

Technically, your period is not arriving early… it is arriving on time. What is happening, is that you are now ovulating much earlier every cycle.

Phase 2

The second shift happens as the ovaries are no longer responding to the signals from the brain. Your cycles begin getting longer, and further apart. You may start noticing cycles where you do not ovulate at all.

Phase 3

This is the final phase and consists of the 12 months leading up to the one day that is known as ‘Menopause’. During this year, the ovaries do not ovulate at all, and there is no period.

As mentioned earlier, there does seem to be an earlier phase for some women, which can impact energy, resilience, and emotions – but as yet, there is no clear standard of practice. Many women can identify with this phase in hindsight, or after a few years of noticing these changes. These hormonal changes can show up years before any changes to the menstrual cycle.

Fluctuating Hormones

The fluctuation of hormones during Peri-menopause leads to many changes in your body – which can impact on all areas of your life. The main hormones concerned are estrogen, and progesterone. Estrogen increases leading up to ovulation. Progesterone is produced afer ovulation and drops off at the end of the menstrual cycle.

In phase one, estrogen is fluctuating and surging a little too much (which leads to early ovulation). In phase two, she can fluctuate a lot, but is generally in decline. Progesterone is still doing her thing every time you ovulate – however declining egg quality can impact on progesterone production as Peri-menopause progresses.

After menopause, both estrogen and progesterone are produced in small amounts by the adrenal glands – but not for reproductive purposes.

Because your hormones are fluctuating so much during Peri-menopause, blood tests can be unreliable for diagnosis. However a substantial increase in Follicle Stimulating Hormone (FSH) can be a clear indication that you are entering the final stages of Peri-Menopause. FSH is the hormone produced by your brain that tells the ovaries to ovulate – as the ovaries stop responding, your brain will send out more and more FSH in the hopes that they wake up. This is what can lead to very high estrogen in one cycle, and very low in another.

A note on Hormone Replacement Therapy (HRT)

HRT is entering a new era, with research indicating that it can be beneficial to support women through the changes in Peri-menopause. There are generally 2 protocols for HRT – cyclical and continuous:

Cyclical is where you are on estrogen (patches or gel) for the whole cycle, and then take progesterone capsules for 12 days out of every cycle. If you are still getting your period regularly, this is most likely what you will be on.
Continuous is when you are using both estrogen and progesterone every day. This is more common in the later stages of Peri-menopause, when your cycles are far apart and more upredicatable.

You can use Fertility Awareness while on cyclical HRT, to time it with your natural cycle.

How to track your cycle during Peri-menopause

By learning Fertility Awareness, you can monitor your declining fertility and accurately predict when your period will arrive. Fertility charting will show if you are still releasing eggs (ovulating) and reassure you that you are not pregnant.

It can be a very trying time for some, as these hormonal changes impact on almost every area of your life. Symptoms can vary from woman to woman, and may show up before there are any changes your period. They can include irregular bleeding, hot flushes, night sweats, skin changes and itching, vaginal dryness, urinary symptoms, osteoporosis, loss of libido, breast tenderness, tiredness, weight changes, forgetfulness, brainfog, depression and anxiety.

With more understanding of what is happening, you can meet the challenge of the peri-menopausal phase and reduce stress and uncertainty. NFNZ Educators can provide advice on how to navigate this transition, improving your quality of life during this time.

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