Perimenopause and menopause: what happens to the body and hormones (symptoms, vaginal flora + practical help)
Perimenopause vs. menopause: climacteric phases
- Perimenopause: begins years before the last bleeding. Cycles are irregular, hot flushes, night sweats, mood swings and sleep disorders are frequent. It can take 7-10 years.
- Menopause: last menstrual period – confirmed only retroactively after 12 months without bleeding.
- Postmenopauza: post-menopausal period. Vasomotor symptoms subside, but the risk of osteoporosis, lipid changes and dryness of the mucous membranes increases.
Hormones: what changes and why you feel this way
Key changes occur in estrogen and progesterone levels. In perimenopause the supply of follicles decreases → estrogen fluctuates, progesterone decreases. Brain increases FSH (follicle-stimulating hormone) a LH (luteinizing hormone), but the ovaries react less and less.
By menopause remains FSH/LH it lasted high, estrogen a progesterone low. Aftermath?
- Thermoregulation disorders,
- reduced serotonin → mood swings,
- collagen loss,
- risk osteoporosis,
- changes in the vaginal microbiota and dryness.
Vaginal flora and GSM: why dryness and burning occur
Estrogen supports a vaginal environment rich in lactobacilli - thanks to the glycogen that serves as food. Acidic pH (3.8–4.4) protects against infections.
Decrease in estrogen → less glycogen → less lactobacilli → higher pH, dryness, burning, pain during intercourse. Incontinence or frequent infections are also associated. This condition is referred to as GSM – genitourinary syndrome of menopause.
What helps:
- Local hydration and lubrication,
- targeted vaginally probiotics,
- lifestyle modification - limit alcohol, smoking, caffeine
- in case of serious problems – local estrogen (after agreement with the doctor).
Menopausal transition symptoms: both common and surprising
Typical:
- Hot flushes and nocturnal sweating,
- mood swings, anxiety, sleep disorders,
- dryness mucous membranes (vagina, eyes, mouth),
- impaired memory, concentration,
- cycle changes, diseases joints, weight gain,
- dry, thinner skin, collagen loss.
Less known, but common:
- Migraines, headaches,
- shortness of breath,
- burning mouth syndrome (burning mouth, taste changes),
- hair loss, hair change,
- leakage of urine, nocturia (frequent urination at night).
Can I get pregnant in perimenopause?
Yes. As long as ovulation occurs, pregnancy is possible. Use reliable contraception.
After menopause (12+ months without bleeding), ovulation is definitively stopped → pregnancy is no longer possible.
Bones, heart and skin: hormonal impact
- Osteoporosis: Estrogen protects bones - after menopause the density decreases. Smoking, low activity, and genetics also increase the risk.
- Heart and lipids: Cholesterol profile changes - important to monitor LDL/HDL/TGA values.
- Skin: Loses hydration and elasticity. SPF, collagen, omega-3 and gentle care help.
Practical help: what really works?
1. Basic habits
- 7–9 h of sleep, dark and cool room
- A diet rich in fiber, protein, omega-3 and phytoestrogens
- Avoid caffeine, alcohol, spicy foods (makes hot flushes worse)
- Regular movement: strength training + cardio + yoga. Strength training supports not only the muscles, but also bone strength – it is important to start it before menopause, when bone density naturally decreases.
2. Micronutrients and natural support
- Calcium + vitamin D – advantages
- Magnesium + vitamin B6 – sleep, nervous system
- Omega-3 – anti-inflammatory, heart, mood
- Phytoestrogens – soy, flax, clover
3. Therapeutic solutions (always with a doctor)
- MHT – menopausal hormone therapy - supplements the missing estrogen (with or without progesterone). Effectively relieves hot flushes, sweating, vaginal dryness and protects bones. It is not suitable for all women - the doctor decides.
- RIGHT – in perimenopause with an irregular cycle, relieves heavy bleeding and PMS, at the same time protects against unwanted pregnancy.
- Non-pharmacologically: CBT (psychotherapy) – help with anxiety, insomnia and moods, breath, meditation, acupuncture.
Recommended products for perimenopause and menopause
Perimenopause - mood, cycle, sleep, hot flushes
- Clover tincture – phytoestrogens for hot flushes and sweating.
- Ashwagandha Hrotlife 90 cps. – stress, fatigue, support of vitality.
- Sage nutmeg tincture – hormonal balance, cycle.
- Reishi tincture Hrotlife – immunity, stress, hormones.
- Dandelion (root) – liver support, hormone metabolism.
Menopause - skin, mucous membranes, comfort
- Sage medicinal tincture – hot flushes, sweating, nervous balance.
- Clover tincture – mood, sleep.
- Collagen peptides + rose oil (Alteya) – hydration, elasticity.
- Rose Beauty Omega (Alteya) – skin elasticity, hair and hormonal balance.
- Geranium essential oil – calms emotions, acts as a natural antidepressant.
Note: When taking medication, pregnancy, breastfeeding or planned MHT, always consult the selection of supplements.
FAQ - frequently asked questions
How long does perimenopause last?
Average 7 years, individually shorter/longer.
How do I know I'm in menopause?
Menopause is confirmed after 12 months without menstruation. Hormonal – FSH/LH high, estrogen low.
Why do I have vaginal dryness and infections?
Low estrogen → less lactobacilli → dysbiosis. Hydration, probiotics, or local estrogen help.
Can I still get pregnant?
In perimenopause, yes – ovulation can occur. Not after menopause.
What helps with hot flashes?
Cold, layering, avoiding triggers, clover, omega-3, breathing exercises, for severe MHT conditions.
How to protect bones?
Weight training, calcium, vitamin D, healthy lifestyle; in risky cases, consult a doctor.
Menopause is not the "end of a woman", but the beginning of a new level of knowledge of the body. With an understanding of hormones, the right regimen and natural support, this period can be balanced and vital.
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