Perimenopause and menopause: what happens to your body and hormones (symptoms, vaginal flora + practical help)

Perimenopause vs. menopause: stages of the climacteric

• Perimenopause: begins years before the last bleeding. Cycles are irregular, hot flushes, night sweats, mood swings and sleep disorders are common. It can last 7–10 years.

• Menopause: the last menstruation – confirmed retrospectively after 12 months without bleeding.

• Postmenopause: the period after menopause. Vasomotor symptoms subside, but the risk of osteoporosis, lipid changes and mucosal dryness increases.
  
  

Hormones: what changes and why you feel that way

Key changes occur in oestrogen and progesterone levels. During perimenopause, the supply of follicles decreases → oestrogen fluctuates, progesterone decreases. The brain increases FSH (follicle-stimulating hormone) and LH (luteinising hormone), but the ovaries react less and less.

After menopause, FSH/LH remains permanently high, oestrogen and progesterone low. Consequences?

• Thermoregulation disorders,

• decreased serotonin → mood swings,

• collagen loss,

• risk of osteoporosis,

• changes in the vaginal microbiota and dryness.
  
  

Vaginal flora and GSM: why dryness and burning occur

Oestrogen supports a vaginal environment rich in lactobacilli – thanks to glycogen, which serves as food. Acidic pH (3.8–4.4) protects against infections.

Decrease in oestrogen → less glycogen → less lactobacilli → higher pH, dryness, burning, pain during intercourse. Incontinence and frequent infections are also associated. This condition is referred to as GSM – genitourinary syndrome of menopause.

What helps:

• Local hydration and lubrication,

• Targeted vaginal probiotics,

• Lifestyle adjustments - limit alcohol, smoking, caffeine

• For serious problems – local oestrogen (after consultation with a doctor).
  
  

Symptoms of menopausal transition: common and surprising

Typical:

• Hot flushes and night sweats,

• Mood swings, anxiety, sleep disturbances,

• Dryness of mucous membranes (vagina, eyes, mouth),

• Impaired memory, concentration,

• Cycle changes, joint pain, 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, change in body hair,

• Urine leakage, nocturia (frequent night-time urination).
  
  

Can I get pregnant during perimenopause?

Yes. As long as ovulation occurs, pregnancy is possible. Use reliable contraception.

After menopause (12+ months without bleeding), ovulation has definitively stopped → pregnancy is no longer possible.

Bones, heart and skin: hormonal impact

• Osteoporosis: Oestrogen protects bones – after menopause, density decreases. Smoking, low activity, and genetics also increase the risk.

• Heart and lipids: The cholesterol profile changes – it’s important to monitor LDL/HDL/TGA levels.

• Skin: Loses hydration and elasticity. SPF, collagen, omega-3, and gentle care help.

Practical help: what really works?

1. Basic habits

• 7–9 hours of sleep, a dark and cool room

• A diet rich in fibre, protein, omega-3 and phytoestrogens

• Avoid caffeine, alcohol, spicy foods (they worsen hot flushes)

• Regular exercise: strength training + cardio + yoga. Strength training supports not only muscles but also bone strength – it is important to start before menopause, when bone density naturally decreases.
  

2. Micronutrients and natural support

• Calcium + vitamin D – bones

• Magnesium + Vitamin B6 – sleep, nervous system

• Omega-3 – anti-inflammatory, heart, mood

• Phytoestrogens – soy, flax, clover

3. Therapeutic solutions (always with a doctor)

• HRT – Menopausal Hormone Therapy - replenishes missing oestrogen (with or without progesterone). Effectively relieves hot flushes, sweating, vaginal dryness and protects bones. Not suitable for all women – a doctor decides.

• HAK – in perimenopause with irregular cycles, it relieves heavy bleeding and PMS, while also protecting against unwanted pregnancy.

• Non-pharmacological: CBT (psychotherapy) – help with anxiety, insomnia and moods, breathing, meditation, acupuncture.

Recommended products for perimenopause and menopause

Perimenopause – mood, cycle, sleep, hot flashes

• Clover tincture – phytoestrogens for hot flashes and sweating.

• Ashwagandha Hrotlife 90 cps. – stress, fatigue, vitality support.

• Clary sage tincture – hormonal balance, cycle.

• Reishi Tincture Hrotlife – immunity, stress, hormones.

• Dandelion (root) – supports liver function, hormone metabolism.

Menopause – skin, mucous membranes, comfort

• Sage 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 – soothes emotions, acts as a natural antidepressant.

  

Note: Always consult your choice of supplements when taking medication, during pregnancy, breastfeeding or planned MHT.

FAQ – Frequently Asked Questions

How long does perimenopause last?
On average, 7 years, but individually it may be shorter/longer.

How do I know if I'm in menopause?
Menopause is confirmed after 12 months without menstruation. Hormonal – FSH/LH high, oestrogen low.

Why do I have vaginal dryness and infections?
Low oestrogen → fewer lactobacilli → dysbiosis. Hydration, probiotics, or local oestrogen may help.

Can I still get pregnant?
Yes, in perimenopause – ovulation can occur. Not after menopause.

What helps with hot flushes?
Coolness, layering, avoiding triggers, clover, omega-3, breathing exercises, MHT for severe conditions.

How to protect bones?
Strength 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 body awareness. With an understanding of hormones, the right regimen and natural support, this period can be balanced and vital.