late reproductive stage
What’s happening now?
As you approach the later part of your reproductive years, you will release an egg less often (these cycles where you don’t release an egg are called “anovulatory” cycles). This means your chance of falling pregnant is reduced (although still possible) and you will start noticing slight changes in your cycle – maybe lighter or heavier flow, or starting to become a bit less regular – a few days earlier or later.
This is because cycles without ovulation have a less supported luteal phase (the second half of the cycle) where there is less progesterone produced to organise your womb lining and your period. These hormone changes can lead to symptoms despite not being in “perimenopause” by strict definition.
There are some symptoms that can arise from these anovulatory cycles.
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periods becoming slightly irregular and flow changing
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PMS and breast tenderness may become worse
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mental health problems can surface now, particularly where there is a background of severe premenstrual mood changes, postnatal depression or a history of clinical depression.
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migraines and headaches can be triggered or start occurring for the first time due to fluctuating and unbalanced hormones.
Best treatment for this stage
Most women don’t need any specific help for bothersome hormonal symptoms just yet but it’s a perfect time to start getting your lifestyle in order – be active, eat well, get enough sleep , manage your stress.
These healthy habits will not only make you feel more energetic and brighten your mood in the short term but will protect your health and wellbeing in the years to come. They may also reduce the intensity of menopausal symptoms later.
If you are using the combined contraceptive pill for contraception, plan how you will switch it out to avoid falling off the hormone cliff as you approach menopause. Sometimes changing the type of pill to a lower dose or using a progestogen only pill can be considered.
If you are experiencing mental health problems or aggravation of migraines, hormonal treatments can help.
Sometimes these are planned to support your natural cycle or maybe even override your natural cycle (eg the pill). Your choices depend on your symptoms, your past sensitivity to synthetic hormones and your contraceptive needs.
What’s up next?
“Early Perimenopause” is ahead of you.
You may sail through, or you may experience worsening PMS, breast pain, unexplained weight gain, start having hot flushes and sweats, disrupted sleep, aches and pains, notice new mood changes or have aggravation of previous mental health problems. You may think you are going mad (you are not). In early perimenopause, your period will start to become more irregular both in timing and flow.
A note on blood tests
Unfortunately, blood tests are not very helpful as hormones vary from day to day, week to week, cycle to cycle. Your period, age and symptoms are usually enough to estimate your stage.
If there is doubt as to the cause of your period changes or if you are younger than 45 and are not getting a period, your doctor may order a series of blood tests to explore your cycle and exclude other conditions impacting it.
The hormonal blood tests offer clues but are frequently insufficient to make a clear diagnosis until menopause has been established (there has been no period for 12 months).
This information is for general educational purposes only and does not constitute medical advice. Please see your health professional for advice that is personalised to you.
Key take aways
During late reproductive stage your period is still quite regular, your flow may have changed and there may be early symptoms of hormonal change such as mood disorders and headaches.
