Midlife---Unpredictable and We’re Not Just Talking About Your Mood or Your Period:

What’s Really Happening with Estrogen and Progesterone in Perimenopause

Let’s clear something up: Perimenopause isn’t a steady slide into menopause. It can be a hormonal rollercoaster regardless of whether you feel the rollercoaster or not---often with no warning, no rhythm, and no predictable endpoint.

We talk about mood swings and irregular periods like they’re the headline, but they are just two of many side effects—not the main event.

It’s what’s happening under the hood, especially with estrogen and progesterone.

Forget the idea that estrogen and progesterone just slowly “decline.” Although that’s possible, it is rarely how it actually works. And arguably, if you were monitoring your hormones daily, what we’d see is that it’s very much not as smooth as you may think.

Did you know that estrogen can spike 30% higher than what’s typical in your “reproductive years”—which are typically deemed your late 20s to 30s?

Progesterone? It usually drops earlier and harder, especially in your late 30s to early 40s. That said, depending on your hormonal health in your 20s, it could be sooner than you think.

We’re going to get into some important whys, and if you’ve been waiting for a lightbulb moment—some validation around why you’re noticing changes in your mood or cycle—this is that moment, so buckle up.

Three Ways Progesterone Starts to Tank

You can’t make progesterone without ovulation.Well—I mean, technically we do, but not anywhere near the capacity needed to support our bodies like we do when ovulation actually happens.

Ovulation is where the magic happens.

But during perimenopause, ovulation can go like this:hit, miss, hit, hit, HIT, miss, see ya, bye girl, HITTING YOU HARD, miss, hit, hit, miss.All while still having a menstruation (bleed).

Here’s what we see:

1. Anovulatory Cycles

No dominant follicle matures. No LH surge → no ovulation. No ovulation = no corpus luteum = no progesterone.

2. LUF (Luteinized Unruptured Follicle)

A follicle forms and makes estradiol.LH might surge, but the follicle doesn’t rupture. It still “luteinizes” and produces some progesterone—but not enough. But boy, was that estradiol kicking.

3. Poor Corpus Luteum Function

Ovulation technically happens.But the resulting progesterone output is weak.Often tied to stress, short luteal phases, and/or aging follicles.

Bottom line: Even with menstruation, progesterone might be suboptimal—or missing altogether.

Meanwhile, Estrogen’s Acting Unhinged

Don’t assume estrogen is just dropping. As we saw above, estradiol can be living her best life surging higher than what some are accustomed to... at least sometimes. But this party won’t last.

In perimenopause, estradiol becomes erratic—or maybe we should say, she takes artistic license: One cycle could be flat: no dominant follicle, no ovulation (a pretty classic anovulatory pattern). The next cycle? It spikes way above baseline because the brain is overcompensating. Why?

Because the brain, specifically the hypothalamus and pituitary glands, is/are trying to push unresponsive ovaries to do something. Ladies, does this sound like a moment where you’ve been asking your husband, boyfriend, coworker, or kids to do something for months, and it seems to fall on deaf ears? Or maybe… selective ears? Kinda same-same here.

The result? Inconsistent hormones and mixed messages being sent from the brain (FSH and LH), unpredictable estradiol, and massive hormonal swings (which does not have to equate to mood changes). And when the ovaries do finally respond, I imagine the signal sounds like a scream which might explain why their response is so overzealous at times.

To which the brain goes: “Dang girl, you didn’t need to go that hard,” and pulls back... maybe too much.And so, the miscommunication continues.

Lab Testing Without Context? Be Careful

It’s tempting to run a hormone panel and draw conclusions if you can’t see the bigger picture of possibilities. But unless you know where in the cycle someone is and what else is happening physiologically—you’re reading noise and completely misinterpreting information. I see this often with coaches loosing their "ish" seeing a woman in her 40's estradiol in the 300 +.

Hence why, for whatever reason, every supplement company and coach alike assumes midlife women need more DIM to help clear “high estrogen.” Cue your "hormonal balancer" supplements and messaging. But as you can see from the information above, this could be jumping in too eagerly, with too much force, and with the wrong tool entirely.

Some basics to remember:

• Progesterone only rises after ovulation. Test it too early? It’ll look low—even if it’s not.

• Estrogen can suppress FSH temporarily, making things seem “fine.”

• FSH >20 on cycle days 2–5 may indicate ovarian insufficiency—but high estrogen can mask this.

Cycle tracking and test timing matter. Otherwise, you’re just guessing.

No Hot Flashes? That Doesn’t Mean You’re in the Clear

A lot of women think: No hot flashes = no problem.

Not true. Anyone simplifying you to “hot flash = change” and “no hot flash = no change”? You need to run. Not walk. Run.

Hormonal fluctuation still impacts the body even if you don’t feel it.

For example:

• Bone loss begins around age 40 at 0.3–0.5% per year. You won’t likely “feel” that.

• After menopause, bone loss can jump to 3–5% annually for up to 7 years.

• Mood, sleep, skin, digestion, thyroid, oral health---all affected, and all can shift without hot flashes.

Symptoms don’t always show up where you expect them to. But the changes? They’re happening.

So What Do You Do with This?

• Understand that “normal labs” don’t mean “optimal function”—especially when ovulation is inconsistent.

• Stop assuming estrogen is always low. In perimenopause, it can be high (even really high) for a bit and/or erratic.

• Respect progesterone. It’s most often the first to falter—and often missing long before anyone realizes, even while menstruation still appears regular.

• Track cycles and symptoms together.

• Recognize that hormone shifts affect everything. Even if the symptom doesn’t seem hormonal, the root cause might be.

• Get your lab work done—but interpret it in context. Always.

Final Thought

Perimenopause isn’t just about inconvenient periods or mood swings. It’s a system-wide shift that starts earlier than most people realize and often flies under the radar or gets written off under the umbrella of “you’re just under a lot of stress.” or my other least favourite "this is your new normal, welcome to getting old"...

You don’t have to wait for symptoms to start paying attention. You don’t need to pretend that this change isn’t happening. You don’t need to compare yourself to others to feel justified in saying,“Hey, something’s off.” And you definitely don’t need to minimize what you’re noticing.

If you’re a coach reading this and want individual support navigating cases like this with your clients or if you’re someone looking for a one-time professional consultation to better understand what’s happening in your own body reach out! We are hear to help !

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