1891 Beach Blvd., Suite 200
Jacksonville Beach, FL 32250

Phone: 904.249.3743
Fax: 904.249.2047

Clinic Hours:

Mon – Thurs: 7:30 a.m. – 5:00 p.m.
Frid: 7:30 a.m. – 12:00 p.m.

Women’s Hormone Life Cycles: Perimenopause 

smiling black woman with long curly hair and white shirt

What is Perimenopause? 

The perimenopause or, around menopause life cycle is a transitional phase in a woman’s life that typically occurs in her forties to fifties, usually lasting anywhere from two to eight years. Your ovaries are still producing eggs, although ovulation may be occurring irregularly. Since this is also called your late reproductive stage, conceiving is still possible. Occasionally, you will hear of a couple with grown children in college who suddenly discover they are having an unexpected bundle of joy! 

During perimenopause, the ovaries produce hormones, but progesterone declines even more significantly, causing severe estrogen dominance. Testosterone levels also begin to decline in a woman’s forties. A less-than-optimum ratio of testosterone can result in decreased sex drive, lower energy, less muscle tone, and thinning of the vaginal wall. When the vaginal wall is thin, the vagina is less able to lubricate, and intercourse can become painful. 

stressed looking woman holding her head in her hands

What is Estrogen Dominance? 

Estrogen dominance does not necessarily mean that the body produces too much estrogen. During perimenopause, estrogen tends to fluctuate. Instead, estrogen dominance means your body’s estrogen production is not balanced with your progesterone production. Estrogen dominance occurs when your ovaries continue producing estrogen while producing less progesterone. All women experience this change at varying levels — a natural process of aging ovaries. 

To understand estrogen dominance, you must also understand the role of progesterone. Estrogen and progesterone operate like sides of a seesaw, shifting up and down during a woman’s monthly cycle. When progesterone gets low, that side of the seesaw hits the ground, and this effect causes negative symptoms to arise: poor sleep, fatigue, anxiety, heavy periods, low libido or sex drive weight gain, uterine fibroids, irritability, and even rage. When the progesterone side of the seesaw gets stuck on the ground, the estrogen side is elevated relative to progesterone. It’s not (necessarily) that your estrogen is high — it’s that your progesterone level drops so low that estrogen effectively dominates. 

Other Factors that Contribute to Hormone Imbalance

A shift in hormones produced by the adrenal glands also begins in perimenopause. DHEA levels that peaked in your twenties slowly and steadily decline, dropping approximately 10% every decade. Some medical studies correlate the decline in DHEA production with many degenerative changes in women and men, such as heart disease, cancer, and osteoporosis. 

Birth control pills can also create a relative testosterone deficiency. Taking birth control pills causes your levels of the hormone-carrying protein sex-hormone binding globulin (SHGB) to rise. These higher levels of SHGB, in turn, bind up the levels of free testosterone circulating in your blood, resulting in a condition of relative testosterone deficiency. Although your testosterone levels may (or may not) appear within normal limits on a blood test, the amount available for use by your tissues is far lower than what is needed. The result of hormone imbalance for you: symptoms of low testosterone, which include:

  • Low libido
  • Low energy
  • Poor memory
  • Fatigue
  • Depressio
  • Apathy

How Can I Restore Hormone Balance During Perimenopause? 

Dr. Randolph has created specific guidelines to help you determine your individual supplementation needs depending on your age, menstrual history, symptoms, and hormone test results. Recommended perimenopause supplements are based on specific criteria, including:

  • Age range
  • Life cycle
  • Associated hormone level shifts
  • The resulting type of imbalancemedical condition
  • Common symptoms

All hormonal supplements are bioidentical formulations that duplicate the natural physiology of hormones. Ingredients, as listed, are derived from natural and/or plant-based substances. 

What Can I Expect From Perimenopause Treatment? 

The answer is simple: relief from unwanted symptoms! You should expect improved and renewed:

  • Libido
  • Moods
  • Memory
  • Sleep
  • Strength
  • Energy
  • Weight loss efficiency

When or if symptoms persist, adrenal support (to manage stress), additional bioidentical hormone supplementation, and/or a compounded formulation may also be required.


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