What Actually Happens to Hormones During Peri-, Meno-, and Post-Menopause

(Quick note: This article is for general info only and isn’t a substitute for personal medical advice. Always chat with a qualified clinician about your own situation.)

1. A 30-Second Refresher on the Key Hormones

Hormone	What it normally does
Estrogen (mainly estradiol)	Builds the uterine lining, supports bones, brain, skin, mood
Progesterone	Balances estrogen, calms the brain, preps the body for pregnancy
FSH & LH	Pituitary “traffic cops” that tell the ovaries to produce estrogen & release an egg
Androgens (testosterone, DHEA)	Energy, libido, muscle & bone support

(For deeper dives see: Endocrine Society and NIH.)

2. Perimenopause: The Hormonal Roller Coaster (Average age 40-51)

Perimenopause can last 2–10 years before your final period.

What’s happening under the hood?

Estrogen spikes and crashes
- Ovaries become inconsistent. One month they pour out estrogen, the next they ghost you.
Progesterone fades first
- Fewer regular ovulations = less progesterone → mood swings, sleep issues.
FSH climbs
- The pituitary yells “Work harder!” so FSH levels rise, often >10–12 IU/L.
Symptoms you might notice
- Irregular periods, heavy flooding, night sweats, sore breasts, “PMS-on-steroids,” migraine flares.

Helpful link: Mayo Clinic – Perimenopause

3. Menopause: The One-Year Marker (Average age 51)

Menopause is officially the day you’ve gone 12 months without a period.

Inside the lab:

Estrogen drops ~90 % compared to your 20s.
Progesterone is near zero because there’s no ovulation.
FSH & LH stay high (often >30–40 IU/L) trying to kick-start the ovaries.
Androgens decline slowly but stick around longer than estrogen.

Top symptoms driven by low estrogen:

Hot flashes & night sweats
Vaginal dryness & painful sex
Mood/memory blips (“menopause brain”)
Bone density loss

4. Post-Menopause: The New Baseline (Forever After)

Hormones settle into their “new normal” roughly 2–5 years after the final period.

Key points:

Estrogen & progesterone stay very low; ovarian production is basically retired.
FSH/LH remain high but less erratic.
Adrenal-made androgens (DHEA, testosterone) become relatively more important for energy, libido, and bone.
Symptoms often evolve
- Hot flashes usually ease, but vaginal/urinary changes, joint aches, and metabolic shifts (belly fat, cholesterol) can stick around.

Resource: Cleveland Clinic – Postmenopause

5. Why These Changes Matter

Low estrogen + progesterone can raise the risk of:

Osteoporosis
Heart disease
Type 2 diabetes
Depression & anxiety

Lifestyle tweaks (exercise, Mediterranean-style eating, stress management) and individualized therapies (e.g., Hormone Replacement Therapy – HRT) may offset risks. Read more: NAMS HRT Position Statement

6. Testing & Tracking: Do You Need Labs?

Perimenopause: Hormones swing wildly; a single blood draw can be misleading. Docs often rely more on symptoms + cycle history.
After menopause: An FSH >30 IU/L plus 12 months without a period usually confirms status.
At any stage: If symptoms are severe or you’re under 40 (possible premature ovarian insufficiency), get evaluated.

Detailed overview: ACOG – Diagnostic Testing

7. Quick Takeaways

Perimenopause = hormonal chaos; menopause = low & steady; post-menopause = long-term low.
Estrogen falls the most; progesterone disappears earlier; FSH/LH rise and stay up.
Symptoms and health risks shift over time—what bugs you at 45 may differ at 60.
Personalized care matters. What worked for your friend may not be right for you.

Remember: Every body is unique. If something feels “off,” talk with your healthcare provider.