Something just doesn’t seem right with your body. In the last year, your period skipped a month—twice. Your weight has been creeping up, your libido has disappeared, and you keep forgetting things. You’re too young to be menopausal, so what is happening?
This scenario plays out over and over as women in their 30s and 40s struggle with menopause-like symptoms. That’s because for many women, life-altering symptoms begin during perimenopause, the years leading up to menopause.
What exactly is perimenopause?
Perimenopause is a transitional period where a woman’s body is moving out of the reproductive phase. One group of researchers described perimenopause as “a disruptive process that can last for over a decade and causes symptoms in a majority of women.” (1)
“Disruptive” is the perfect word to describe what happens during perimenopause. In the early stage, menstrual periods become irregular. As it progresses, other symptoms may develop, like insomnia, fatigue, body aches, thinning hair, weight gain, hot flashes, and vaginal dryness. (2)
The perimenopausal transition ends when a woman officially reaches menopause, which means she’s gone 12 months without a period. (3)
The underlying driver of perimenopause is changing hormone levels, specifically the decline of estrogen and progesterone. That’s why hormone replacement therapy (HRT) may help alleviate symptoms.
Should I start hormone therapy during perimenopause?
These hormone-related symptoms are affecting lots of women. In a recent survey, 4 out of 10 of women ages 30-39 say they’ve experienced perimenopausal symptoms. The number increased to almost 8 out of 10 women who were 40-49. (4)
If you’re in this group, you probably agree that just living with uncomfortable symptoms for 10-20 years before your period stops doesn’t make sense. But since the average age of menopause is 51, some doctors think women need to reach menopause to be eligible for HRT. (5) But that’s not true.
You may need to remind your doctor that starting HRT during perimenopause can promote overall wellness. Estrogen helps keep many body parts—like the brain, bones, heart, blood vessels, and urinary tract—functioning well. So, as the ovaries produce less and less estrogen over time, symptoms can develop in these areas. HRT could help protect you against the detrimental health effects of decreasing hormones, like brain fog, bone loss, heart health problems, and frequent urinary issues. (6)
Hormones also affect aging and beauty. That’s why proactively balancing your hormones with HRT early on may nurture your outward beauty. Like many women in their 30s and 40s, you probably have an anti-aging beauty regimen, whether it’s expensive serums and creams, quarterly neurotoxin injections, nutritional supplements, or hair color. Using HRT as part of your beauty routine is another strategy to help with skin appearance and hair growth.
How long should I take hormone replacement therapy?
As you would expect, the decision of how long to take HRT is between you and your doctor. Your provider will monitor your symptoms and adjust your dose as needed.
Keep in mind that if you come off HRT, your symptoms may return, and you lose the potential benefits the hormones may provide for your future health.
What’s the difference between HRT and BHRT?
While most HRT uses synthetic hormones, the “B” in BHRT stands for “bioidentical,” as BHRT is bioidentical hormone replacement therapy. The hormones used in BHRT have a molecular structure that is the same as the hormones your body produces naturally. Scientists use plants like yams or soy to create bioidentical hormones. (7)
At Belmar Pharma Solutions, we use bioidentical hormones to create compounded BHRT in doses specified by your doctor. If you feel like you’re in perimenopause and want to address possible hormonal imbalances, talk with your doctor about whether compounded BHRT might be an option for you.
REFERENCES:
(1) Santoro N, Roeca C, Peters BA, Neal-Perry G. The menopause transition: signs, symptoms, and management options. J Clin Endocrinol Metab. 2021;106(1):1015. doi: 10.1210/clinem/dgaa764
Link: Menopause Transition: Signs, Symptoms, and Management Options | The Journal of Clinical Endocrinology & Metabolism | Oxford Academic
(2) Raypole C. Can perimenopause make you feel like you’re dying? What to know. Healthline. Updated November 11,2024. Accessed February 21, 2025.
Link: Perimenopause Shouldn’t Feel Like Dying: Symptoms and Treatments
(3) Santoro N. Perimenopause: from research to practice. J Womens Health. 2016;25(4):332-229. doi: 10.1089/jwh.2015.5556
Link: Perimenopause: From Research to Practice – PMC
(4) NewBeauty® & Belmar Pharma Solutions survey; 2025.
(5) Hormone therapy for menopause: FAQs. The American College of Obstetricians and Gynecologists website. Last reviewed February 2024. Accessed February 18, 2025.
Link: Hormone Therapy for Menopause | ACOG
(6) Menopause and your health. U.S. Department of Health & Human Services. Office on Women’s Health. Updated January 8, 2025. Accessed February 21, 2025.
Link: Menopause and your health | Office on Women’s Health
(7) Bioidentical. Women’s Health Research Institute. Northwestern University. Accessed February 24, 2025.
Link: Bioidentical | Menopause
